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Author Topic: Ruptured Patellar Tendon Surgery  (Read 1249567 times)

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Offline SellaVee

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Re: Ruptured Patellar Tendon Surgery
« Reply #4890 on: August 30, 2013, 12:00:13 AM »
Hi Tom

Thanks for the suggestions.  I have printed out a few of the protocols but haven't actually had the nerve to show them to my physiotherapist  :-\.

I appreciated the information on wound care - your advice is never unwarranted.  How handy is that having your own nurse?!

I know a guy whose sister is a physiotherapist and he got her to ring me.  She also mentioned massage, and said it can help with reducing swelling, so I'm massaging all around the dressing and down the sides of my knee like you said.  Every medic who has seen the wound has said it's looking good.  I haven't had a drain in and apart from occasionally feeling like a giant paper cut it's given me no problems.

I couldn't figure out at first why I didn't have any staples or stitches taken out - turns out they used dissolvable ones, so I didn't have steri strips just a big Mepore (brand name) dressing.  If it wasn't for the brace I'd be leaving the scar open to the air.  Do you have yours covered when wearing the brace?  if so, what do you use?

I asked about getting the wire out but didn't get an answer.  It was discussed, just no decision.  Because I broke a bit off my kneecap when the tendon went I've been told the wire is helping that repair, so I'll ask again next week.

John42, you'll be pleased to hear I've ordered a pedal exerciser.  I found getting on and off my exercise bike was too tricky and I can use the pedal exerciser in the sitting room when I'm watching TV.
Ruptured patellar tendon (avulsion fracture) 11 June 2013
Surgical repair with wire 5 July 2013
Wire removed 28 January 2015

Offline carkeltom

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Re: Ruptured Patellar Tendon Surgery
« Reply #4891 on: August 30, 2013, 12:26:26 AM »
Thanks fishy.  I appreciate hearing that you are doing well at PT and getting around.  I know that I am several weeks behind you and am looking forward to just getting my braces unhinged, to restart those muscles while I walk.  I am sure that the OS will give me some new ideas when he gets me going on PT.  I will tell you honestly that I have not taken a step without my brace.  My braces have only been off while I work my leg or do the muscle stimulation or take a bed bath in my chair.  I have some real fears of my knees buckling after such a long (6weeks) of inactivity.  But, I am looking forward to the challenge.  And I have the accessible parking sticker for the car, but havent had much of a chance to use it.

SellaVee, my brace is somewhat weird as I have not heard of anyone else having it.  It is a DePuy.  I have two pieces of foam that wrap around my calf and my thigh.  The braces have a hinge in the middle with metal on the top and bottom.  There are adjustable for height plastic pieces with foam on them that are great.  I am an expert on putting my brace on and am very particular about it now.  There are 5 velcro straps on each leg, but those drive me crazy as they are beginning to fray after 6 weeks of use.  So, my incision is open to the air, when I do not have an ace bandange on for compression or to keep it clean when I have gone outside.  I understand the wire being in for now them with the broken patella.  My doctor said I was lucky that I didnt have that happen also as it is frequent with the injury.  And you know what Sella, I have that papercut pain all the time, especially when I am passively bending the knee and stretching the tendon.  Right on the top of the kneecap and incision.  For the longest time, I thought I was ripping my incision open.  Probably just some local pain. 

Sella, where are you at in terms of knee flexion to be able to pedal?

Good day on the board.  But I need to not stay up so late.

Tom
Bilateral patellar tendon rupture 7/19/13

Offline SellaVee

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Re: Ruptured Patellar Tendon Surgery
« Reply #4892 on: August 30, 2013, 10:41:45 AM »
Tom, I know what you mean about staying up too late.  That's always been a bad habit of mine, but I am able to sleep late in the morning these days!  I'm making sure I get plenty of rest.

The paper cut feeling will get better but it's very much an "ouch!" when it happens.

A number of people on these boards have commented on the Velcro fraying but mine's holding up very well.  Sometimes I have to wrestle the straps apart.

As to flexion, I can only go by the brace.  The physiotherapists round here don't seem to believe in measuring flexion.  I was interested to read on the quadriceps board that amberisma could quote weekly changes in flexion to the nearest degree.  I've twice asked for my good leg to be measured as John42 suggested and been told "I can see it's more than 90o." by one and "It's over 100o." by the other.  Lying on my back I can bring the heel of my good leg up to my butt.  Sitting on a chair with the brace set at 60o I can dangle my other leg until the brace stops it.  At 70o it doesn't reach the stop.

At the moment I sit with my injured leg on a skateboard and I now move the skateboard back and forth using that same leg then push it a bit further with the good leg.  When the pedal exerciser arrives I'll start by going back and forth rather than over the top unless I've increased my flexion by then.  The surgeon has said 90o is my maximum for now.  I see him again next week.

I'm 8 weeks post op today.
Ruptured patellar tendon (avulsion fracture) 11 June 2013
Surgical repair with wire 5 July 2013
Wire removed 28 January 2015

Offline carkeltom

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Re: Ruptured Patellar Tendon Surgery
« Reply #4893 on: August 30, 2013, 05:32:07 PM »
Sella, I know.  my PT at home barely brought her angle protractor.  I have read that 3 degree per day with exercise and passive ROM is good.  Nervous about the OS appointment next week.  I am pretty sure he is going to leave the brace on, just unhinge it.  I have a recliner and spend most of my time in the chair.  I tried my floor exerciser last night and I had to have it way out in front of me to be able to go around.  very loose legs.  They felt like noodles.  I figured my right knee would be worse sinnce I had some other slight damage to the knee, but holy hell the left was just weak, weak weak.

I like your skateboard idea.  I have a strap I hook around my feet and then pull my toes and ankle straight or up and then I grab behind my knee and pull and stretch my knee.  That was the system my PT and I came up.  Necessity is the mother of invention.  I also have wood floors, so I also extend my knees and then do the same thing with my heels sliding on the floor. 

Last night in my extended non-sleep state, I actually found a PT protocol from a PT student who worked with a bilateral patellar tendon rupture.  Very aggressive PT protocol, so I plan to share it with my PT when I go for the consult.  The PT student addressed my concerns about not having a good leg to stand on or use as a benchmark.  About the only bad part about the PT protocol and paper was that the person they were working with reported a pain level of about 8 out of 10 after and during therapy.  Have never been one to suffer masochists, so that is not a good thing.

I also saw that the soft tissue, scar and muscle massages also do very good with increasing blood flow and nerve regeneration.  Well, keep up the good work.  Maybe some newbies will join our conversations.  This seems to be the only active forum for patellar tendon ruptures.

Six weeks post injury today.  Seems just like yesterday if you ask me.
Bilateral patellar tendon rupture 7/19/13

Offline fishy

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Re: Ruptured Patellar Tendon Surgery
« Reply #4894 on: August 30, 2013, 06:33:30 PM »
Its the small victories that add up to recovery.  Since my accident May 26, 2013 and subsequent repair surgery I have been unable to use the toilet without planning in advance how to sit and stand because my legs could not hoist me vertical.  NOT ANY MORE!!  The quad strengthening I have been doing as part of my PT has finally yielded my first successful sit and stand!! Woo Hoo.... oh yes, that would be the loo for all my british friends ::)

Offline carkeltom

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Re: Ruptured Patellar Tendon Surgery
« Reply #4895 on: August 31, 2013, 06:51:09 AM »
Yeah fishy i know what you mean.  going to the toilet with two bad knees is horrible.  I always use the handicapped stalls if I am out since I know I can really torque those bars when standing.  If I did not have my arm strength, I would be screwed.  I feel like I am launching myself off the toilet when I am done.

Have noticed the past two days that my left quad is definitely not as strong as my right.  Somewhat weird as I am also having more pain in my left knee also.  Seems to be located at the quad and patella and below the patella at the tibia and on the inside of the left knee.  I actually had to take a narco painkiller tonite after my evening exercises and muscle stimulation.  That is the first pain pill in over a week. 

Hope all my US RPTers have a good labor day holiday.  I usually attend the church I got married at fall picnic, but not this year due to the horrible terrain and not wanting to chase down three kids on crutches.  I am planning on next year though.  Have a good weekend and I will be around all weekend reading more on my knees.
Bilateral patellar tendon rupture 7/19/13

Offline fishy

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Re: Ruptured Patellar Tendon Surgery
« Reply #4896 on: September 01, 2013, 07:11:15 PM »
Yeah fishy i know what you mean.  going to the toilet with two bad knees is horrible.  I always use the handicapped stalls if I am out since I know I can really torque those bars when standing.  If I did not have my arm strength, I would be screwed.  I feel like I am launching myself off the toilet when I am done.

Have noticed the past two days that my left quad is definitely not as strong as my right.  Somewhat weird as I am also having more pain in my left knee also.  Seems to be located at the quad and patella and below the patella at the tibia and on the inside of the left knee.  I actually had to take a narco painkiller tonite after my evening exercises and muscle stimulation.  That is the first pain pill in over a week. 
Hope all my US RPTers have a good labor day holiday.  I usually attend the church I got married at fall picnic, but not this year due to the horrible terrain and not wanting to chase down three kids on crutches.  I am planning on next year though.  Have a good weekend and I will be around all weekend reading more on my knees.

Hey Carkeltom;
  Been there, done that.  My right quad is weaker than my left.  My left quad, though stronger, is strongest on the inside so when I use the elliptical my knee rotates inwardly...I told this to my PT instructor and doc and they suggest tightening my butt cheeks...LOL.  So my progress is not linear but I am progressing.  I tend to go to the movies more these days....indoors is definitely flatter than outside.  Regardless, I will keep moving and grumbling under my breathe....but I know I am getting better and that is my goal.  Enjoy the rest of the weekend and give your kids a big hug.

Offline hages1

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Re: Ruptured Patellar Tendon Surgery
« Reply #4897 on: September 01, 2013, 09:47:21 PM »
Hi all!
4 weeks post surgery(7weeks post injury) was able to do a SLR today for the first time! I went to pt last week and the PT told me there is not much to do since os does not allow to bend knee at all. Pt gave me a few exercises mainly passive quad strengthening.i have been doing these on my own and whatever i could to keep muscles active.
can't wait to get out of this brace and to start the real rehab...

Offline carkeltom

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Re: Ruptured Patellar Tendon Surgery
« Reply #4898 on: September 02, 2013, 03:03:21 AM »
Hages1, I think that is quite normal not bending.  I think that is why the in-home PT cut me loose.  I was doing more than she asked in terms of repetitions.  I dont think I could do a straight leg raise if I tried, without the braces on.  Sounds like your quads are getting stronger, which I know is a plus.  Has the surgeon unhinged your brace at 7 weeks?  I am so hoping that this following Tuesday, he unhinges it at least to 30 degrees.  I think I am getting close to the passive 90 right now, but today was a bad day.  I sort of slipped off the toilet when lifting my self up and felt like I was going break thru my braces.  Thanks goodness they were locked I guess.  A little ice this evening and compression and they feel ok.  I am just so ready to get out of the house and drive.  Glad to see that you are doing well Hages1 and continued good rehab.  I did find an amateur protocol from a PT student who had a double RPT client.  Answered some questions I had about how to handle the PT without a "good leg."

And will do with the kids Fishy.  They try to keep me company, but get caught up with their own lives it seems and have tired of their dad being glued to the recliner.

Tom
Bilateral patellar tendon rupture 7/19/13

Offline fishy

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Re: Ruptured Patellar Tendon Surgery
« Reply #4899 on: September 03, 2013, 05:08:31 PM »
Week 14+1day.  What is this quad pain all about?  I do my at home PT, stretch regularly, and still there is the random pain.  Usually when I sit for any extended period of time....example: at a restaurant last night, cramped seating and pow.... could not stand up to stretch it out and the pain was beginning to build until I excused myself and got a chance to stand and walk it off.  Just amazing how I have to relearn to walk...my quads are just now capable of lifting me on and off the toilet.  And walking changes from the morning when I am my strongest to wobbly and slow in the evening.  Its all good though, I remember the braces, the walker/cane, etc.  Enough complaining, gotta get back to my floor minibike.  Take care my brothers in recovery....you are all in my nightly prayers.

Offline hages1

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Re: Ruptured Patellar Tendon Surgery
« Reply #4900 on: September 03, 2013, 07:45:51 PM »
Tom,
I am only 4 weeks after surgery, i am due to see surgeon in 2 weeks time.
doing a lot of quad strengthening on my own, so when i do start bending hopefully it will go a bit easier.
My goal is to get back to playing basketball in 12 months!
keep the spirits up!

Offline carkeltom

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Re: Ruptured Patellar Tendon Surgery
« Reply #4901 on: September 04, 2013, 04:26:18 AM »
Fishy, not sure what the quad pain is.  I wouldnt think it was a cramp as you were sitting and the quad was stretched out. 

hages1, I sit and do quad sets all the time in hopes of being able to walk normally.  I have softball starting next March, and my goal is to be able pitch to my girls and be on the field for practices, since I will be coaching at least two teams next summer.  If you find a muscle stimulator, I suggest one of those also.  I try to do it at least 4 times per day.  I spent $70 with shipping and it will help when I get to helping fire the muscles with lifting.

So, on another note, I had my 6 week post op visit.  Xrays looked good.  I told him that I felt the right knee was swollen today after slipping off the toilet on Sunday.  I was lifting/launching my self off the toilet and my heel slipped on the floor and then caught.  It felt like I jammed my lower quad, just above the kneecap.  So, he checked me out and decided to drain my knee.  He got about 60cc of bloody fluid and then they gave me a new brace.  An OSSUR Inovator DLX.  It is still locked until PT evaluates me for walking.  I have to return in 4 weeks and he said he wants me weaned from the crutches by that time.  He sort of left the PT and how to deal with the bilateral issue up to me and the PT.  Funny thing was, I was very nervous.  He at first said that he was going to unhinge the brace to 90 flexion and I think he saw that I was nervous and decided to hold off till PT saw me.  The nurse who put the brace on thought the new one, with the top thigh strap was to far into my groin and left it off.  My wife said she could tell I was more nervous and cautious stepping, but I could tell that my knee would bend more than it should without the top strap.  Needless to say, I returned home and figured out this new brace.

Two really good things though came from this day:

First, the doc said that if my work was OK with me not being able to do CPR, I could return to work, and of course they said.......hell yeah.  So hi ho hi ho it's off to work I go. 

Second, since I got the new braces, i can use the old ones to shower in.  It maybe awkward and I may not get my legs completely clean, but I know that it will feel good to just have running water on my body.  I figure, with the spare set of braces, I am set to go.  That is the better of two things.

Well, I will catch up with everyone after my first PT visit.

Tom
Bilateral patellar tendon rupture 7/19/13

Offline SellaVee

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Re: Ruptured Patellar Tendon Surgery
« Reply #4902 on: September 04, 2013, 12:28:51 PM »
Tom, I'm interested to note that we have some similarities in treatment.  I had a follow up at 5 weeks and the surgeon said I could have my brace unlocked to 900 and sent me off to the clinic physiotherapist.  I was very nervous about this and when the physio heard 900 he raised his eyebrows so we agreed to start at 300.  That same day I had two separate visitors.  One friend is a physio and the other is a doctor.  They both questioned the 900, but here is your OS saying the same thing.

My next follow up with my surgeon is tomorrow and I'm pleased to say I'm now wearing my brace unlocked to 900.  I unlocked an extra 100 every few days over the past 4 weeks and I'm now confident walking about with it unlocked and my knee has gradually increased its bend without me worrying about going too far.  Maybe I just needed to be brave but confidence is a huge issue for me.

The other similarity is the height of the brace.  I thought it was just me.  My brace goes up really high!  It was quite embarrassing having it fitted  :-[ .  I've got used to it now.

I'm not back at work yet but when I did go back in January, 6 weeks after foot surgery, it was great to be out of the house.  Just make sure you rest and elevate your legs whenever you can.  I used to swing my foot up onto a spare chair whenever I could.

Last night I had a meeting where I sat for two hours with my leg under a table.  It was resting on my trusty skate board and I was moving it back and forward but it was very swollen by the end.  My foot still swells 9 months after surgery, so I'm expecting my knee to keep swelling for a while.

Great news about the shower.  You'll love it.

My pedal exerciser has arrived so I'll be going for a "bike ride" this afternoon.  I see the physiotherapist again on Friday.  Will let y'all know how I get on.

Hages1, I've been doing quad sets too and my thigh isn't quite so floppy.  Keep up the good work.
Ruptured patellar tendon (avulsion fracture) 11 June 2013
Surgical repair with wire 5 July 2013
Wire removed 28 January 2015

Offline copper44

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  • Right Patellar Rupture on July 31, 2013
Re: Ruptured Patellar Tendon Surgery
« Reply #4903 on: September 04, 2013, 09:39:18 PM »
Hello again.  It's been almost 3 weeks since my surgery, but it seems like 3 months! LOL!  Talk about going stir crazy.  I'm still doing well with few complaints beyond the boredom.  I set my brace to 20 degrees on Monday and started on my path to improved ROM.  Knee is very tight as expected and it definitely feels weird, but I don't have any pain.  I will see my Doctor again on Monday and really hoping I can start partial weight bearing.  That will be the last step towards a normal shower! I also go back to work on Monday.  I have a desk job so I'll be working from home on a laptop.

I can increase my ROM to 40 degrees next Monday.  I'm excited about that because even though there are loads of rehabilitation protocols on this board and on the web, they all seem to agree that early ROM is critical for a successful recovery.

I only have 2 annoyances:  1) My surge-strips still haven't come off yet.  They are tattered, loose and beat up, but still hanging on.  I hate it because I have little bumps and my knee itches on the places where the strips have detached.  2) The area right above my knee keeps jumping.  I wonder if it's my leg muscle's way of telling me it is going away. Bye-bye muscle.  See you in a few months.

Glad to hear everyone's progress, especially those double RPTs.  You guys are my heroes!
7/31 Right Patellar Tendon Rupture
8/16 Patellar Tendon Surgery

Offline fishy

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Re: Ruptured Patellar Tendon Surgery
« Reply #4904 on: September 05, 2013, 01:55:54 AM »
Hey Copper44;  Welcome to the club.... The tendon takes about 12 weeks to heal (My OS says the most dangerous time is around 8 weeks, you feel better, your tendon gets more tension as you try to exercise muscle)...and unfortunately your quad takes a hit (atrophy).  I am at that stage (14 weeks) where I can exercise without much concern about reinjury (I am a double RPT).  Not only did I have atrophy, I literally have to reteach myself to walk!  Its all part of the process...I remember the scars healing under the straps of my braces constantly being irritate.  I put a bandage over the healing scars to keep them from becoming inflamed. Ugh.... It all is good eventually.  Patience.  Walking was my favorite form of exercise (My lady friend would holler "Run Forrest Run" (remember Forrest Gump?).  Patience, humor, and more patience...you will recover.
Stay strong my friends, and you all are in my nightly prayers....















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