Ruptured Patellar Tendon Surgery

[carkeltom]

fishy, you are my hero.  Seriously, a ladder?  I can not even imagine getting on a ladder at this point.

But, this is my first day back at work.  Got up early to take a shower, so will not be doing that every day.  What a chore.  A little tired he at the end of the day, but at least I feel productive.

Tom

[SkyeGospel]

Sorry I haven't posted here for a long time but I do catch up with all you guys write when I get a chance and I really appreciate hearing all your stories and advice.

It is now 13 weeks since my injury and nearly 7 weeks since my surgery. My adjustable angle brace is set at 45 degrees until the end of this week but I managed to bend knee to 70 degrees today at the physio (today was my second appointment with physio). Ice has really been helping with pain at nights but still very painful and waking all the time.

I do have a couple of questions if any one can help:

1. The wire loop that some people have put in throughout the knee cap and shin to hold things together until the tendon is healed: I have noticed people on here talking about being given a date to have it removed. My surgeon just said that at some stage in the future it would eventually snap ("like a paper clip that keeps getting bent") Is this normal? And does anyone know if it causes a lot of pain when it does eventually snap?

2. I am probably just being paranoid here but I keep wondering if maybe the tendon has pulled apart again. It is so sore all the time and when I try doing any kind of straightening of the leg when lying back there doesn't seem to be even a twitch of movement - just like things were before the op. my physio also seems surprised that there is absolutely nothing doing there yet. I have a follow up appointment with my surgeon on Friday which will hopefully put my mind at ease but I was wondering if there is anything I could do that might put my mind at ease that there really is a tendon there?? Is it common for things to come apart after an op or is that very unlikely? I was told after the op that it reattaching the tendon had been like "sewing jelly" because the surger had been so long after the injury which is part of the reason I am worried.

I hope you are all doing well.

Stuart

[carkeltom]

Skye, glad to see your post.  Since we are basically at the same recovery period post op, I am in the same boat.  I started last week at 30 deg with the brace after my first true outpatient PT appt and switched it to 45 today, so I am ready for my PT appt on 9/10.  I still use the ice too.

The repair wire, I have seen two theories on this board.  One is that the surgeon has gone back in a just basically snipped the wire, so that it does not further hinder gains in ROM.  Not sure of the exact timeline, but I have seen three months on this board.  The other method, and I think it has been for people whom the wire has hindered, I know of one girl from about 2006, on the board who had this problem and they went back in and removed the entire wire, but this seemed to involve a more invasive procedure.  And maybe it snapped on this girl in a way that inhibited her recovery and thus, the other procedure.  But, if your OS gives you more information, let us know.

Skye, I would hate to hear that you re-ruptured the tendon.  I know that you had a 6 week lag with surgery, and I did read that the longer the time between injury and surgery, there is an increased time in recovery, but I dont think that the one study I read or any other items saw a decrease in positive results.  And again, from having read most of the posts on this board, you are not alone in having to wait for surgery.  Misdiagnosis is not good with this injury, since the tendons dont just heal like muscles and bones and ligaments. 

Skye, keep the faith and we hope to hear good things.  Dont forget to keep us posted.

[SellaVee]

I do have a couple of questions if any one can help:

1. The wire loop that some people have put in throughout the knee cap and shin to hold things together until the tendon is healed: I have noticed people on here talking about being given a date to have it removed. My surgeon just said that at some stage in the future it would eventually snap ("like a paper clip that keeps getting bent") Is this normal? And does anyone know if it causes a lot of pain when it does eventually snap?

2. I am probably just being paranoid here but I keep wondering if maybe the tendon has pulled apart again. It is so sore all the time and when I try doing any kind of straightening of the leg when lying back there doesn't seem to be even a twitch of movement - just like things were before the op. my physio also seems surprised that there is absolutely nothing doing there yet. I have a follow up appointment with my surgeon on Friday which will hopefully put my mind at ease but I was wondering if there is anything I could do that might put my mind at ease that there really is a tendon there?? Is it common for things to come apart after an op or is that very unlikely? I was told after the op that it reattaching the tendon had been like "sewing jelly" because the surger had been so long after the injury which is part of the reason I am worried.

I hope you are all doing well.

Stuart

Stuart, it's good to hear from you and that your bending your leg.  Sorry to hear you're still not sleeping well.

[SellaVee]

Oops, pressed the wrong button and posted too soon! 

Regarding the wire:   Lots of people have wire, some have the wire removed, others don't.  A few people have had their wire break during exercises or PT and felt the ends of the wire digging in to tendon or muscle and therefore had it removed as it was too painful to carry on.  Sometimes it has broken and not been noticed.  People who have had their wire removed have often felt a big improvement in terms of ROM and pain.

My own registrar said last week that they plan to remove the wire when my leg is strong enough to do a straight leg raise.  Until then, I need the support from the wire.

Regarding the tendon:  I've had exactly the same thoughts and feelings as you, but based on my experience I'm not the least bit surprised that you can't lift your leg.  We both suffered a delay in having surgery, 3¹/₂ weeks in my case.  This meant my thigh was like a jelly and so I'm having to work much harder and longer at strengthening it.  The good news is, for the past three days I've been able to lift my leg.  You're younger than me so you'll probably get there faster.  As far as the tendon being like jelly goes, surgeons like to say that kind of thing.  One poster was told it was like joining the ends of two paintbrushes.  And lets face it, jelly doesn't really break . 

I was 9 weeks post op on Friday.  I did worry about whether the repair had held when I couldn't lift my leg, but I worked out that the problem was down to my quads not being strong enough.

The physiotherapist had told me to practise pressing the back of my knee hard down on the bed then release.  I hold it for about 5 seconds.  I repeat the press, hold and release 30 times to work the quads, then I press really hard down on the bed, tighten my quads as much as I can, press hard again, pull in my stomach and lift.  If the knee bends I stop and practice more quad sets.  I only lift my leg 2" as instructed but I could now go higher.  You will get there Stuart.

Hold on to James 1:4,

Sella

[SkyeGospel]

Thanks Carkeltom and Sella. That is all really reassuring. Sella it is actually so encouraging to me to know it took a long time for you to do the straight leg lifts too (though obviously wouldn't have been too encouraging for you at the time. And thank you for James 1:4.

Feeling much brighter today. Ditched the crutches for some walking (with brace on obviously!). And go in with my wife for her ultrasound tomorrow to see how 4th child is doing

Thanks again,

Stuart.

[SellaVee]

Stuart, you're welcome.  There are so many different rates of recovery from this injury that it can be demoralising if everyone seems to be ahead of you, so I thought you'd be encouraged by my experience.

How exciting about the new baby.  How many weeks?  My first grandchild is due in December.

I'm really fed up with the crutches but I'm like a drunken sailor without them.  I list to starboard.

Sella

[bballkingofnba]

Hey SellaVee, is your injured kneecap higher than the non-injured one? I am just asking everyone the same question because I am yet to meet someone who has recovered with equal patellar height. I feel like all that bending elongates the tendon since the tension is changed due to the repair.

[SellaVee]

Hi bbalkingofnba, I'm not aware of any difference yet but my knee is so swollen it's very hard to tell.  It's something I've been looking out for but my knees look so different it's hard to say.

Once my brace is off for walking I'll get a better idea of how the knee is behaving.  It looks very weird compared to my other knee.

[bballkingofnba]

A good way to figure out is when you stand just slide down your thighs with each of your thumbs until you feel the top of the kneecap and then just compare the height of your thumbs to one another.

[fishy]

I had a grueling PT at the VA hospital... capped off with a deep massage to each leg that left me cringing with pain... Thank you US Army, on this day of remembrance on 9/11 it is awesome to have these dedicated professionals work on an old wreck like me.  I spent the next six hours walking and standing and going up and down a ladder...and I stumbled off the ladder, took several steps and crashed into a wall (I never fell) and guess what happened....absolutely nothing!  My legs worked just fine and I continued to finish the day....sore, but no damage.  All the work outs, PT, but mostly patience has paid off.  Just thought my brothers and sisters posting on this site might take some encouragement from my story.  I keep you all in my prayers...

[copper44]

Hello Everyone.  I had my second followup appointment withthe Doctor/Nurse earlier this week and my knee is progressing well.  The incision looks good despite it not being as healed as similar cases.  I think this is because 3 weeks post surgery my steri-strips were still hanging on.  Thankfully she pulled them off (something I should have done a week earlier) and a few days later my incision looks even better.  She also told me to start massaging vitamin E or Mederma into the incision area to break down the scar tissue.  I know Mederma is much more expensive, but does it work any better?

I'm still not allowed to weight bear .  She said my target date has always been 6 weeks, but I don't remember having that discussion!  I remember talking about not driving for 6 weeks, but nothing about not being able to touch my leg to the ground for 6 weeks.  I can still set my brace and bend the knee to 40 degrees until my next appointment, but by then my quad will be complete jelly! 

My only complaint is still the rash and blisters I developed from the steri-strip adhesive.  All of the strips have been removed and I can definitely tell the difference.  The rash is starting to heal (I've read that it can take up to 3 weeks to clear completely) and the intense itching has subsided.  The knee is pretty ugly right now though, but I'll take ugly and functioning over pretty and broke any day!

Glad to hear that everyone is doing well and progressing along.  Hope to start posting similar stories soon.

[John42]

Hi Copper 44

Glad you are making progress - on the point of driving, I would suggest that you should not attempt to drive until such time that the brake pedal can be depressed with force in an emergency stop - in fact, one requires clearance from your OS, otherwise, you could invalidate the car insurance policy.  Even then, the drivers seat should be placed as far as it can go.

Keep posting

Take care
JohnK/ Manchester UK

[JC55]

Complete patella tendon tear Sunday Sept 8, 2013 with surgery on Monday the 9th.  I'm posting to get words of advice/wisdom/support, etc as I begin this journey.  Unfortunately (or maybe fortunately, depending on how you look at it), I am no stranger to orthopedic surgery or rehab.  However, this is first injury of a leg and I'm concerned about recovery.  Ice packs have been my best friend and elevation has helped.  Last night was first decent night of sleep and was even able to wash up today with the help of my wife.  I'm seeing my surgeon tomorrow for post-op visit and was wondering if anyone had suggestions for questions based on your experience that you asked or wished you had asked.  Thanks and I hope you all are progressing well!

[copper44]

John, you are absolutely right.  If I can't weight bear until 6 weeks then I don't see myself driving until quite a few weeks after that.  I was expecting to already be putting limited pressure on the leg at 6 weeks so I just have a new and extended timeline.  Right now I am focused on 12 weeks which I've been told is when the tendon is 90-100% healed.  In the meantime I am going to follow instructions, stay off of that leg and do my ROM exercises :-)