Ruptured Patellar Tendon Surgery

[John42]

Hi Mike

Welcome to the RPT thread on KneeGuru - not the best club to join - first of all to respond to your question regarding a plane journey - order a wheel chair and reserve a seat with extra leg room - this is essential as you will not be able to stretch your leg for some time.  How did you sustain your injury?  Where do you live.

Read some of the previous posts on this thread - continue travelling by car, but lying prone on the back seat - or in the front passenger seat with the car seat placed as far back as possible.  DON`T attempt to drive until cleared by your OS, but this is going to be in several months time.

Suggest you click on the undermentioned thread and read a collection of documents which I have put together with KneeGuru.

PATIENCE is the keyword - listen to your knee

Take care

JohnK/ Manchester UK


https://www.facebook.com/QuadricepsPatellarTendonRupt

[CapHill]

Thanks JohnK.  I am in the Washington, DC metro area and slipped on some wet stairs and landed on my fully bent right knee.

Thanks for the feedback on travel.  Will definitely keep that in mind.  I do already have seats with extra leg room, so should be fine there.

Didn't realize it would be that long before I could start driving.  Will certainly follow the advice of the OS on that.

Mike

[Ben5000]

Thanks for the kind words bballking.  My knee feels ok today, no better or worse after the marathon yesterday. Also looks the same (but still more swollen than the non-injured knee). I've included a pic.

My goal is to run an ultra-marathon next June. 100 miles. I had to cancel one that I was registered for when the RPT happened.

Take care
Ben

[JC55]

CapHill, welcome to the club...sorry you had your injury but in the right place.  We are very similar, I'm 6'4" and I'm 5 weeks post-op today.  I know what you mean about lying in backseat...what a pain.  I was placed in immobilizer for first three weeks and then released by OS to 30 degrees in new ROM brace.  I have just been released to 60 degrees this week with next appointment at 7 week mark.  My PT told me all OS have different protocols...some are very aggressive and others more conservative based on integrity of repair, age, fitness level, etc.  The one word you need to repeat to yourself is patience.  You will get better, but it takes time...it is a very serious injury with damage to soft tissue, medial and lateral retinaculum, etc.  I'm impressed that you are full weight-bearing this early...I'm locked at 0 degrees when walking with only weight-bearing as tolerated.  Although the knee feels better I don't trust my quad muscles yet.  Several suggestions I've learned from this site...buy a leg lifter, get a sturdy shower chair (my wife bought me the bariatric model after the first one felt too flimsy and I'm only 200 lbs), get informed and ask questions, and listen to your own body.
Good luck to you and I look forward to keeping up to date on your progress.  Also, John is the man when it comes to this injury...he has lots of information, documents, etc that have been very helpful.

[bballkingofnba]

Hi BEN,

Wow yours look great for 8 months! You must be a great healer and i noticed from your older posts that you staretd your own rehab even before PT so I m guessing that helped! Mine looks very similar to yours and one thing i noticed with yours as well is that the VMO on the injured knee starts a bit higher up than the VMO on the non injured knee. I have that as well. I am not sure if that is due to missing muscle mass or maybe because the kneecap sits a little higher since the vmo connects to the edge of the kneecap.

Is you tendon thicker? When I  flex my legs to 90 degrees and take a picture my injured tendon looks so much thicker! I will try to get a pic up.

[fishy]

I just found this forum and spent quite a bit of time reading through some of the posts.  It is quite informative and I figured I would post.

I am 4 weeks (tomorrow) post op from full RPT surgery on my right knee.  I didn't need screws and wires, as the rupture was in the middle of the tendon.  The first 4-5 days were quite painful, but I have seemingly got to a pretty good place after 4 weeks.  I have my next OS appointment the first week of November and was told to also schedule my first PT visit at that time. 

I am currently still using crutches (though can bear weight and get around the house without them), and also have my leg in immobilizer until my OS visit.  I am hoping that I will be cleared to a ROM brace when I go in at that point.    Sutures came out after 10 days and still have steristrips on.

I am hesitant to go into the shower without my brace, so I need to bag up in large trash bag to keep it dry.  Looking forward to being able to take a shower without it.

Taking my first trip across country on a plane next week, which I'm sure will be an adventure.  Anyone have any advice to plane travel at the 5 week post-op point? 

Looking forward to continuing to read this great site for inspiration.  Its amazing how an injury like this can make even the easiest things seem complicated. (I am 6'3" and cant get my leg into car so need to sit across back seat)

Mike

Hey Mike;
  I have flown twice since my double RPT, around week 8 and 12.  My suggestion is to contact your air
carrier and tell them you need their assistance.  The air carrier can get you wider seats (like the bulkhead seating I got) and will provide a wheelchair and attendant schooled in getting you safely on to your flight (the TSA can be daunting BUT they have handicapped rules that will make your journey easier)...also,file for and get a handicapped parking sticker, and ride the handicapped carts whenever possible.  Using all the support that's out there will make your journey to recovery all that more possible.

[vonlehmd]

sella, cooper, john and redcoat, good to hear from you.  cooper, initial passive ROM is good since you can not build strength in the quad until you have ROM to do the exercises to get the strength.  sort of a catch 22.  And working the patella on top of the joint to break down the scar tissue is very important.  I spent a lot of time massaging the knee.  I think Sella had the same experience.  Plus, it feels good.

I have learned that keeping the hamstrings loose and stretched is a key also.  I have been having some back problems, mostly from catching myself when I stumble.  I have been ditching the braces in my office and at home, although I dont go outside.  PT yesterday was done all without the braces.  Seated squats with about 30 lbs, with both legs and single.  My legs still look thin and unattractive.  Walked a mile and rode two on the treadmill and stationary bike.

But I seriously hate the fact that I hurt both tendons.  I so wish I could go back to that day and not climb in my garden.

I am with you.  I am another rare case of a bilateral patella tendon rupture.  It was a gym accident.  Was performing calf raises on an upright leg press machine with a lot weight when a few things went wrong.  Basically hyperextended both lower legs 90 degrees.  Not a pretty sight.  Happened in Lakeland, FL on 9/11/2013 while traveling on business.  I live in Stuart, FL.  Had surgery on 9/13 to reattach both same day.  At 5 weeks out, I am full weight bearing while sporting DonJoy leg braces locked at full extension.  Can get about 65 degrees flexion while sitting, and wound 45 degrees while doing heal slides.  I started massaging the heck out of my knees which seems to help a lot.  I use Bio Oil which is great for this.  You can pick it up at BJs or Costco.  Any insights/ideas always appreciated.

[carkeltom]

Hey Caphill, Vonlehmd and Racerchick.

Von, the fact that we had both knees injured at the same time complicates knee cap height.  My OS said he measured after doing the first one and mine seem to be similar.  With the swelling finally subsiding, aside from the morning after PT, I have noticed a slight bend in my scars, which is disappointing since I was hoping for better looking scars.  The the quads going and the massage.  PT is getting easier, even though I still have that uneasy feeling when bending both knees at the same time as they feel like they will collapse, but the muscles kick in and catch me.  Looking forward to a long full recovery.

Racerchick, an ultramarathon sounds grueling and not my cup of tea,  but you sound like you enjoy it.  I am looking forward to the resumption of coaching girls softball and being able to run the bases.

Hoping everyone else out there is doing well.  The board seems to go in spurts, but I read every day that I get the chance. 

Tom

[vonlehmd]

Hey Caphill, Vonlehmd and Racerchick.

Von, the fact that we had both knees injured at the same time complicates knee cap height.  My OS said he measured after doing the first one and mine seem to be similar.  With the swelling finally subsiding, aside from the morning after PT, I have noticed a slight bend in my scars, which is disappointing since I was hoping for better looking scars.  The the quads going and the massage.  PT is getting easier, even though I still have that uneasy feeling when bending both knees at the same time as they feel like they will collapse, but the muscles kick in and catch me.  Looking forward to a long full recovery.

Racerchick, an ultramarathon sounds grueling and not my cup of tea,  but you sound like you enjoy it.  I am looking forward to the resumption of coaching girls softball and being able to run the bases.

Hoping everyone else out there is doing well.  The board seems to go in spurts, but I read every day that I get the chance. 

Tom

My scars look horrible.  Surgeon used cat gut thread/ sutures, not staples.  Almost an S shape and extreme welts.  Looks horrible.  Nurses and others were almost horrified to see it when bandages first removed.  I can live with it if function is good or better.

[copper44]

It's been a little bit since my last update, but work has been super busy.  I like busy though because it makes the time go by faster. 

Anyhoo, I am 9 weeks post surgery and making steady progress.  I've had 4 full PT sessions and have gone from 54 degrees ROM to 90 degrees ROM doing heel slides, quad setting and knee massaging.  I think this is good.  I've also been doing a lot of gait-improving exercises to strengthen my hips and glutes because my walk is quite ugly.  I don't mind though because ugly or not, I'm still walking!  I hope to start bike riding next week. 

I walk without crutches as much as I can, although I do use one when I am out and need to get going quickly :-).  I try to ditch the crutch and brace around the house although I still limp and the knee feels really weird when I do. Probably to be expected, but it still feels odd and I really hope it goes away. 

I have an appointment with my surgeon on Monday where I hope he will say I can drive, the next big step in my tendon rupture journey.

Hope everyone is healing well.  Until next time...

[Super_arran]

Long time since my last login.

It's been about a month since I had my cast taken off (second time round) and put in to my brace again (locked out at 20degrees) a lot has happened in that month.

First off I went away to Zante for a week; on a lads holiday.
Honestly, it was the best thing for my knee IMO.
The airport check-in is the quickest thing in the world (I flew from Manchester) if you look like a bit of a cripple with a pair of crutches. We booked extra leg room before we flew so I could stretch out a little too.
In Zante I expected to be pushed and shoved a lot on the strip. I couldn't have been more wrong. Drunk people seem to respect injured people a lot more than sober ones! I felt like Moses walking about.
Anyway, the reason I think it did my knee good is because I was walking on crutches none stop for a good week and it really helped get some strength back in to my leg; which lost a lot of muscle due to rupturing my patella twice in as many months.

In the weeks that followed I worked on bending my knee a little more each week. By the third week I was getting around 30 to 45 degrees of motion.
I saw my surgeon who suggested I moved on to the smaller knee brace rather than the full leg one I was currently using. This helped a lot because it felt like I had a lot more freedom regarding my knee movements. (Although at first it felt like my knee would give way).

The following week I decided that I'd see how it felt to sit in my car seat as I'd asked the doctor if I'd be okay to drive again, to which he suggested if I felt like I could then yeah, it'd be alright. 
It felt a little strange but after moving the seat back a little I was able to drive again. I think driving has helped the rehab on my knee (clutch leg).

So now it's around 6 weeks since I've been out of my cast, I'm back at work and walking (still slightly limping) without crutches. I've got around 70-80 degrees ROM now, which I'm told is quite good.
The pain in my knee is sometimes really bad, although; I say knee, it's more my shin where the wire has been past through.
Walking up stairs is getting easier, I'm no longer taking them one at a time. But walking down stairs is the same old story of one at a time.

One last thing. My surgeon said he is now thinking about keeping the wire in for good instead of removing it after six months which he originally planned. Has anyone had their wire left alone? And if so did it hinder you in any way?

Arran.

Ps. I'm sorry if some of the above doesn't make much sense....It's pretty late

[fishy]

Week 20 ended without incident, unless you consider recouping from double RPT anything but normal (and I do).  There is still pain along the repair line where the ligament attaches to the knee, and if I sit in a chair for a few minutes there is a spike in pain until I can move my leg (or even better, stand and move).  My normal background pain is usually close to zero, but at times the repair line pain can spike to four or five.  An Advil takes the edge off and the pain, but one night my sleep was disrupted for several hours until I relented and took an Advil.  My quads are getting stronger...I can stand most times without using assistance (my arms), I am walking faster, and I can walk up and down stairs normally (but I am very slow both ways and my brain is screaming "watch out"...lol).  My emphasis this week is to continue doing what I have been doing for recovery....lots of walking, hydrotherapy (when Possible I attend an aerobics class...in water), and I'm looking for a gym closer to my home for weight training. I hope everyone that is taking this journey with me is having a good day.  Patience is our mantra, and for those struggling right now... be realistic about your progress, fearless in asking for help, and mindful that you are healing.  And a good sense of humor is a bonus!!

[JC55]

6 weeks post-op today.  I see OS Friday followed by PT.  Currently at 60 degrees with heel slides and doing walking sessions with brace released to 30 degrees.  Also doing the regular stuff: quad sets, electro stim, calf and hamstring  stretches, patella mobilizations and lots of massaging.  Knee feels good when working it but stiffens in between sessions.  Looking forward to getting released to 90+ degrees on Friday and maybe adding in some active flexion/exercises.  Mental attitude greatly improved but still have to tell myself to be patient.  Will add in extra PT sessions in a couple weeks since once a week is too long inbetween sessions.
Glad to hear from Cooper44, Fishy and Tom and the others and happy everyone is doing well.  Welcome to the new posters an well...I wish all peace and happiness this week and keep celebrating the small steps!

[bballkingofnba]

JC you seem to be going on the perfect track. I had the similar PT protocol as you where I started PT 18 days post op as well. However, my PT was arrogant and made me bend as far as I could and as a result I bent too much too soon. The PT would not even look at the doctor's prescription!! I wish I had known then to switch PTS.. I didnt get a re rupture but I think i def strecthed the repair resulting in a higher kneecap. So be super patient with the bending. You can get flexion back upto 3-4 months easily. Do not rush it at all!

[bballkingofnba]

Also my PT had me do short arc quads right away too. Which is active extension! I was barely able to get my leg up the first few weeks but by week 5 i was able to do short arc quads pretty normally.....I am surprised my tendon stayed intact after all that. The repair must have been strong but my PT pretty much did all he could to mess it up.