Ruptured Patellar Tendon Surgery

[SellaVee]

My bend is nearly at 90 degrees.  Unfortunately, I feel the wire poke into me (at tibia end of PT) at 90 degrees and also when I bend the knee while walking. It's pretty uncomfortable so I'm not sure I'll be able to bend past 90 until the wire comes out at 6 months.

Today I did my first straight leg raise (with 5 degree lag).  Once again it was not strong at all but it was a good feeling to hit another milestone.

Still nowhere near being able to extend the leg from a 90 degree bend.

My wire only started hurting after I saw my surgeon and I don't see him for another 6 weeks.  Have any of you had trouble with the wire? When did you have the wire out? When you had the wire out, was your recovery affected at all? 

Kath

Hi Kath

I started having trouble with the wire over a year after my op.  I'd regained full ROM and apart from going down slopes and stairs I was doing very well and spending time on my exercise bike improving both my leg and general fitness, using a resistance band and fitting in Pilates regularly.  Unfortunately I think all this exercise broke the wire.  Things move rather slowly in the UK but the good news is I'm having the wire out next week.  I can't wait.  It's really bothering me now and on my last X-ray last month I could see that part of it looked like a coat hook.  It started as a figure of 8 but it's in pieces now.

I'll report back next week and let you all know how it's gone.

Sella

PS  Those knees look fabulous Jerry!

PPS  Thomas99 hold on to that positive mental attitude.

[Kaddydee]

SellaVee, all the best with the wire removal. 
Please do let us know how it goes! 

Kath

[fishy]

Fishy here, and its 21 months post double RPT.  I am a 68yo male, and marathon was my "game". I am doing great, both legs are functioning great and I continue to improve.  Knees look ok, muscles still have a cottage cheese appearance but are getting more toned.  Stairs are ok up but handrail down.  Trying to get back in shape for long walks.  For all my brothers and sisters with RPT just keep the faith....patience and keep asking questions until you get the answers that are right for you.   Bob

[madvillain]

7 weeks and 4 days from injury and 7 weeks 3 days from surgery.  Posting today to mark a milestone: I squatted down to the toilet without grabbing anything nearby!  Didn't even realize it until I sat down and though "I didn't grab anything!".

You gotta take the small victories after a double RPT!   I have progressed in my rehab to weighted (very light weight) step ups, body weight squats, shallow lunges, seated leg extensions, wall squats and exercise bike.  I'm adding some VMO specific stuff this week that I found online.

Bike is really great for pushing the ROM as I can position my feet on the peddles slightly "closer" in order to push the ROM gently.  I'm at about 115 degrees with my left knee and about 110 on the right.

Kinda interesting as the right leg is stronger, but the left knee has better ROM.  Accordingly I try and push the ROM a bit harder on the right and the strength a bit harder on the left.

Got the New Orleans trip in now only 10 days.  Can't wait to get some sub-tropical sun on those scars!

[Thomas99]

Just wondering if anyone else has had two hamstring tendons removed and grafted in as a replacement patellar tendon ??

Surgeon removed two of my right hamstring tendons and grafted them into my left patellar tendon. Old patellar tendon was mostly removed as it was pretty nasty and had lots of scar tissue.

[SellaVee]

I am now wireless!  Went into hospital at 0745 on Wednesday and was first on the list for surgery. Was back home in my own bed by mid afternoon.

Post op the ward staff provided tea and toast but I was so tired I couldn't eat it all.  After a nice long nap the physiotherapist came and told me they'd removed all 3 pieces of wire from my knee and he watched me walking to make sure I was OK to be discharged.  I rang my husband to come and collect me and he took me home for a late lunch.  I almost fell asleep eating it so gave up and went to bed.  I think they must have been generous with the general anaesthetic, and I hadn't slept much the night before.  I've been asleep much of the time since.

I can remove the big bandages myself tomorrow so I'll report back on how it looks.  Incision stings like a giant paper cut and throat is sore from tubing but I'm feeling very positive.

Sella

[nmacseven50]

Hello I wanted to post on here because I'm going through this. I partially ruptured my patellar tendon in November and had surgery Dec. 4. It was from playing basketball on chronic patella tendonitis. I'm 8 weeks post op now and things are alright. I am just getting out of the brace now. I am working on physical therapy and currently at the stage of doing squats, single leg step ups and a lot of band work. I feel like I am hitting the point in my rehab where I am really starting to get stronger. With that said, it also comes with a lot more pain. I am usually very sore after Physical therapy and it lasts usually until the next day sometime. I also get very sore when I walk a lot. If I go to town and go to a mall or grocery shopping, etc I am in some pain afterwards. I have also felt a couple times where I feel like my knee wants to almost give out or it feel like it wants to go into hyperextension.

I have a few questions:
How should I address the pain I have after PT and walking? I know I am going to be sore and that's fine. How do I make sure it's just soreness and that I'm not actually hurting something in my knee?

What is the actual recovery time back to sports for this issue? I mean how long will it be until I can actually play basketball without pain and the thought and fear of re injury? I know a lot of it is mental.

Once I am back to sports, what can I expect after playing? For example, will my knee swell up and become painful after a practice or game? How long will that last? And is this something that will bother me during sports way after I am recovered? I know a friend of my parent's who played basketball and football when he was younger. He had a knee injury about 15 years ago and he still complains about pain and stiffness when he exercises or runs.

I appreciate any answers I can get! Feel free to comment or share your experiences. Any posts are great. The more info the better. Feel free to ask me any questions as well.






 

[John42]

Hi Nmacseven50

Glad that you have now posted on the correct thread.

I don`t think that you should not consider active sports for at least six months and even then, start up slowly - Always in fear of a rerupture. 

I am hoping that you receive other posts to give you further guidence, but listen to your knee.

Trust you printed out my list of documents - read these in conjuction with previous posts on this thread.

Best 
JohnK/ Manchester UK

[madvillain]

John's advice is good advice.  6 months is usually considered the minimum recovery time before a return to sports.  There really isn't much, if anything, you can do to accelerate this time table.  Patience is key, as of course is working hard in the mean time and trying to "enjoy the process" of your recovery.

I am at 8 weeks and trust me I'm raring to go but I've come to trust the process and use patience.    I have recently realized that despite the myriad things I do every single day to help my recovery I have a long, long, long way to go.  I won't go into too much detail, but right now I am heavily pushing the VMO strength.  I realized walking around Carkeek park in Seattle this weekend that my gait is still quite stiff (downhill especially), and I have a lot of VMO strength to gain back.

Just trust the process and take it one day at a time.  Safety first as well. You'll get better.  I had a double RPT and I will be playing tennis this summer, no doubt, but we can't rush the recovery more than is safe!

[fishy]

Fishy here.  I was doing my usual updating by reading these posts.... came across mmacseven50....I read then re-read your posting and I want to assure you that 1) you are very welcome here because of the injury you have sustained and 2) you need to rethink your recovery.  If you come to the same conclusion after reading the articles & blogs, etc., then STOP.  The injury you have requires time to heal....enough time to heal the torn and repaired items and then rebuild the muscles associated with the repairs.  Some have suggested 8 months, I have read a year...it takes time and organized PT.... and I wish you a speedy recovery.  Keep posting, we need your input!  Bob

[nmacseven50]

Thank you for the responses! I've decided to alter my mindset a bit. When I went to my physical therapy appointment today my therapist said that more than likely the pain I am feeling is from over using my knee the last few days with walking and stairs. I am going to cut down on the amount I walk and only go somewhere if it is necessary. With that said, the current pain I have is bothersome so I do have an appointment to meet with my OS and get his opinion. My basketball coach is really trying to instill patience in me and I am really going to work on that. I don't want to jeopardize my basketball future just because I want to walk or go somewhere. It's definitely tough trying to be patient, but in the long run I know it will be worth it. 

[nmacseven50]

I wanted to ask a question. So being that I am in some pain and have some uncertainty at this point of my rehab, I need to know how to be able to find the perfect balance of doing enough to get ahead with my recovery, but not to overdo it and fall back.

I am a bit confused. I have heard some people claim that it is important to do the workouts everyday and to almost 'rush' the rehab. It seems as though they are making a claim as if the longer you wait, the chances of full recovery go down. Being that I am in the pain I am in I have been considering laying off the exercises for a few days. Reason being, I have read some of the posts on this thread telling others to really stay patient and that it's ok to take time and you can't ever take too long. Is it ok to stop your PT exercises for a couple days? To let the pain pass? Or is it better to fight through the pain and continue the exercises?

[SellaVee]

Hi Nick and welcome to the forum.  I can understand your frustration.  When I ruptured my patellar tendon in a fall I was devastated and wondered how I was going to get through the summer and I am about as far away from being a college sportsman as it's possible to be.  I have often thought that for a young sports person this injury must be so much harder to bear mentally, and I think we all almost have to mourn the loss of that working tendon we used to take for granted.

On the other hand being young and fit you will heal faster - provided you don't try and overdo things.  I think this is your biggest danger at the moment.  It's very important to build up strength in you injured leg but you've also got to protect the repair and not do any further damage.  Even in training surely it's important to build in rest days?

While I think you need to do something every day (to pass the time if nothing else) that doesn't have to mean stressing your knee.  In my opinion your physiotherapist is the most important person in you rehab and patience is your best friend.  If you want to work out every day spend one day on your upper body and another on core strength to give your knee a rest.  I think it's way too early for you to be pushing through the pain barrier so much.  Concentrate on walking properly.  Walking is still working your leg.  If the weather is bad where you live do what the oldies do and go mall walking!  You'll get the exercise without risking a slip on icy surfaces.  But don't overdo do it, keep it short and avoid stairs for now.  Listen to you knee.

Now for my own progress report.  The big bandages are off but I still have a dressing in place.  Mechanically my knee feels fine but the incision site is tender and my knee and shin are bruised.  Some days I feel like I've been hit by a baseball bat.  Too much walking and standing makes my knee swell and feel as if it's on fire.  I've been using ice packs again and working on finding the balance between rest/elevation to prevent swelling, and motion to prevent stiffness.  As my daughter-in-law, the medic, pointed out, it's been less than a week since my surgery!  Still feeling optimistic.

[Kaddydee]

SellaVee,

Thanks for the progress report.  The surgeons make the wire removal seem like such a simple thing (and it is compared to what we've been through) but from what I've heard it can set you back a couple of weeks.
As you said, it's all about trying to find the balance between getting on with what you've been able to do and allowing the knee to recover after surgery.

I will see my surgeon tomorrow to talk about wire removal.  A part of me wants it removed straight away as it pokes me every step I make and really hurts when I try to use the bike as therapy.  The other part of me wants to delay the removal until after an overseas trip my family has coming up in April.  I'm hoping that  I'm able to walk normally on the trip but I'm really scared that my knee will react badly to having the wire out (it always reacts worse than everyone else!) and it will mean I'm not as ready for the trip as I'd like to be.

I'll see what the surgeon thinks tomorrow.

SellaVee, do you know how long your incision site was this time?  What did the surgeon tell you to do/not to do after the removal?

Take Care,

Kath

[BustedWheel]

I won't claim to be typical, but for the benefit of some prior posters I will post my timeline.

46 going on 47.  RPT right knee, tendon ripped off kneecap.  12 weeks since injury, 11 weeks since surgery.  No fractures or other damage.  Not a crazy athlete prior to injury, but go to gym or run 2-4 times per week, lift weights, etc.  Played a lot of sports, including team sports, but those days are behind me by at least 20 years.  Operated on on a Friday, out of hospital the next day, Saturday. 

Day 1.  Walked out of hospital on crutches and braced.  First two nights had excruciating pain.  No more morphine.  Nerve block wore off. 

Weeks 1-2.  Out of work, pretty much flat on back, not walking too much.  However, I could walk with crutches.  Left leg wrapped and didn't shower, etc. for 4 days.  Changed dressing, wound didn't look bad.  Showering and other personal hygiene (like crapping) was fairly difficult.  No prescribed exercises for leg or PT.  Take Percoset and Advil for pain (Advil also for swelling).

Week 3.  Went back to work.  Leg in immobilizer.  Was able to get in and out of cab.  Started going to gym.  I would ace wrap the repaired knee, put a cloth and Velcro knee brace over it, and them strap on the immobilizer.  The leg wouldn't bend even if I wanted it to.  Worked out machines, dumbbells, exercise ball.  Upper body.  Nothing for lower body.  Doctor didn't even want me to do heel slides, quad sets, etc.  Said that getting back to my normal routine day to day activities was enough. Granted, I'm a lawyer, so it's not like I am operating heavy construction equipment or doing physical labor or anything like that.

Week 4-7.  Leg in immobilizer.  Shifted from crutch to cane.  Able to walk better.  Again, no PT for knee.  Doctor didn't want me doing anything for leg.  Doctor said is was ok (good in fact) if I could work out upper body so long as pressure or movement of knee was kept minimal, because getting circulation going and blood pressure up was good for healing.  At end of period, was able to walk without cane.

Week 7-8.  Doctor opened knee brace to 90 degrees.  Began PT.  PT said knee looked good.  I was able to do leg lifts, other things he had me do. 

Week 8 to Present (11 going on 12).  Do various ROM and other calisthenic type exercises (no added weight) form ROM and strength training.  Ride exercise bike no problem.  Can do elliptical no problem.  Walk on treadmill for gait training no problem.  Do some light weight resistance training for legs, nothing major.  My leg strength is nowhere near where it was.  Used to be able to fire up 150 lbs on the leg extension no problem, hack squat more than my body weight.  But there is some progress.  No brace needed for walking, have good gait and control. 

My understanding is, typically, 12-16 weeks (3-4 months) is a healing milestone, in that you can increase exercise/PT within reason.  6 months is a healing milestone, as you can try reasonable return to athletic activities like light running/jogging.   At 12 months, it's about as healed as it is going to get.

The lesson is don't overdue it, be reasonable, baby it a little, even, as time passes you can do more and more.  Once you get past the 6-7 week mark, and into PT, you will start making bigger and bigger strides.