Ruptured Patellar Tendon Surgery

[SellaVee]

BustedWheel, I think your summary is spot on but I will say that I continued to improve well past the 12 month mark.  Maybe not big changes, but everything got better until I broke the bloomin' wire.

Kath, I was seriously worried about the wire removal - both the op itself and the general anaesthetic, but I felt I had no option.  The fact that I had such a very short hospital visit cheered me up no end.  My stay was so short that I didn't get to see the surgeon before I was discharged.  I did see the physiotherapist who checked that I could walk OK.  He told me there was no problem with my leg other than me naturally wanting to protect the incision.  He also said they had removed 3 pieces of wire.  They only put 1 piece in so I'm guessing the GP was right when she told me I'd broken it in 2 places.

The op has been done arthroscopically (keyhole surgery).  I've been told to leave the dressing in place until my next clinic visit so I can't see my scar but by counting the steri strips underneath it looks like there have been 3 or 4 small incisions in the original scar line.  It is a piece of cake compared to the original repair.  I was expecting to have the whole knee opened up again.  The incisions lie over about half the length of the original scar.

I think the reason I feel so bruised and battered is because, according to my physiotherapist friend air is pumped into the knee to make room for the camera and instruments.  I imagine my knee blowing up like a balloon. And according to daughter-in-law they also wash the site out so I've had liquid in there too.  Perhaps that explains why my shin and around the outside of my leg is such a fetching shade of yellow and blue.

Pre op I saw the registrar and he told me that the small incisions would only take 2-3 weeks to heal.  I hope he's right because we also have an overseas trip planned in March/April and it will be my first long haul flight since the accident.

At the moment I'm walking OK and climbing stairs normally but coming down 1 step at a time because my knee feels a bit tight due to the bruising (and probably the dressing).

Good luck with the surgeon tomorrow and I'll let you know how I get on at clinic next week.

[BustedWheel]

I was lucky.  No pins,plates, wire or screws.  The sutures they used internally can stay in absent some reaction down the road. 

[Kaddydee]

Hi all,
I saw the surgeon on Thursday (12 weeks).  Thankfully my wire is still intact - one big loop from bottom of patella, down to top of the tibia and back up again.  He said that the pain I feel is from the wire stretching but it isn't doing me any damage so we'll keep it in until the 6 month mark. 

I was very excited at the visit because I did my first leg raise from a 90 degree bend (bent to straight).  I haven't been able to do this for over two years so this was the first sign that the operation has had some success.  Hopefully there are a lot more goals that I reach over the coming months.

I also did my first full rotation on the bike on Friday.  I was on tiptoes to get enough bend (I'm at 95 degrees)  but gee it was a good feeling! 

Now that I've stopped using crutches, I have just started attempting walking up the stairs correctly.  I am still fully reliant on hand rails as my quad strength is pathetic but hopefully this will improve quickly.

As for physio, a lot of stabilizing activities, including throwing and catching a ball while I stand on one leg and for a harder option, standing on a pillow.  It's amazing how I have struggled with this but I'm seeing a big improvement with my walking as I learn to control my balance while catching the ball.  And my three young kids love doing this with me! 

Just started lunges, wall squats while squeezing a ball between my knees and continue to do calf raises,  quad exercises, hamstring exercises, lots of knee bending and lots of stretches.

I still massage my knee morning and night as my knee is still swollen (and bruised). Plenty to keep me busy!

The best therapy for me at the moment is that I've started running my little kids music classes again.  So, I've been bending, jumping, dancing, getting up and down off the floor etc while I sing and move with little kids.  I have so much fun that I forget the limitations of my knee!

That's it from me.

Take Care,
Kath

[John42]

Hi Kaddydee

Suggest you look on Amazon and purchase a floor cycle - about $50 or £30 - then sit in your chair and peddle away each and every day as and when you like. 

Works wonders

JohnK/ Manchester UK

[nmacseven50]

Hello all-

I had a few questions about rehab and I wanted to see if I could get some answers. I don't mean to interrupt Kaddydee's post so please make sure her post doesn't get lost!

I am at 9.5 weeks post op. (10 weeks on Thursday).

My first question: Is it normal to have a good amount of atrophy at 10 weeks post op? I have a good amount still but It is definitely improving!

Second: Is it common/safe to start using the elliptical machine at this stage? I am walking without a brace without pain. I am 'sore' but not in pain. I am at 110 degrees and I am able to ride the bike without pain on a bit of resistance.

Thanks for any answers, and btw I had a partial tear and surgery, not a complete rupture.

[John42]

HI  nmacseven50

In my view even at ten weeks, you are pushing it, because the repaired tendon has not healed 100%

Listen to your knee, don`t overwork it - you have still some months to go.

JohnK/ Manchester UK

[Dan]

Hello all
My name is Dan, and a little over a month ago I joined the patellar tendon club.

Here's the short story:
January 8, slipped on a wet tile floor walking in to an office building.
January 12, surgery, with a protective/stabilizing wire

Today is 4 weeks post-op, right leg has been immobilized the entire time.
Spending most of my time on the couch, using a walker to shuffle around the house when necessary.

Friday will be my second follow up visit with the surgeon, I think he will put me in the hinged brace.
The wire is scheduled to be removed at 8 weeks, after that is when the serious PT starts.

[John42]

Hi Dan

Welcome to the exclusive RPT club, we don`t charge for giving up free time to try and help fellow RPT patients.

By now you will have realized, that you have sustained a very serious injury, with a long rehab process.

You would do well to read some of the previous threads and at the same time click on the undermentioned thread which contains a number of documents which I have put together with KneeGuru.

ASK questions - sleep with a pillow/cushion between your knee - DON`t push it - listen to your knee, and Don`t drive until your OS gives you the ok, which will be in about three months.

Where do you live.

Keep posting

Take care
JohnK/ Manchester UK

https://www.facebook.com/QuadricepsPatellarTendonRupture

[Dan]

John
Thanks for the welcome.
I live in Wisconsin, the Milwaukee area to be a little more specific.

I'm 50 years old, in average shape. There are no athletic activities that I need to return to,
my goal is simply to resume my normal lifestyle.

In working my way through the material you linked to, and elsewhere on the net, I've seen marked
differences in the aggressiveness of various rehab protocols.
My surgeon seems on the conservative side, since I've been immobilized without any mention of attempting
to flex the knee. I am a little apprehensive that he will try it on Friday and what it is going to feel like.

[dtr42]

Hi Dan ,welcome I am 50 as well  and done my knee a year ago.Don't worry about surgeon bending your knee I will be surprised if he will force anything .He will get you to try a straight leg lift [dont be worried if you cant do it as it takes a surprising amount of muscle to lift it the 20mm of the floor ] also he may ask you to try and bend it but it may be relatively small amount between 30-60 degrees.I was in a leg brace with no movement for over 7 weeks and was amazed at the muscle mass loss on the quad but again time is a great healer and my bad leg is now stronger than the uninjured one .Try and get physio and hydro therapy as they are a great help and try not to get too down [it happens to us all ]when things seem to go very slow , as it takes time and Patience on this wee adventure .good luck and remember at its very worst it's a bad knee and it will get better with time

[Bevboogie]

Hello all. I'm a newcomer on here. I'm 36 and was extremely active pre injury. I played college sports & was weight training & doing cardio 5-6 days a week. I sustained my injury walking down stairs & slipped. When I hit the floor & saw my patella in my lower thigh I knew what had happened. I injured myself on January 19th & had surgery on January 26th. I had my staples removed on February 5th. Had my first PT on Feb 10th & could only reach 28 ROM. Had my 2nd PT session 2day & the physio was really pushing hard on my active ROM. Had me trying to do standing straight leg raises. does this seem right for my time frame? I see my OS again on Tuesday so I will also be asking him. Any info from "veterans" on here feel free to shoot it my way. John K if u could send me those valuable documents that would be great.

[John42]

Hi Bevboogie

Welcome to the RPT thread on KneeGuru - a RPT injury is most commonly known as a sports injury, but I am sure that you are now aware that you have sustained a very serious injury with a long rehab process - six months or more.

Suggest you read the undermentioned thread which contains a number of documents which I have put together with KneeGuru - these documents outline the nature of your injury and the rehab process. 

ASK questions?  PATIENCE - don`t push it - dont attempt to drive until your OS confirms that it is safe for you to drive.

Have noted that you live in the big apple  New York.
Take care
JohnK/ Manchester UK




https://www.facebook.com/QuadricepsPatellarTendonRupture

[Stuart Rulka]

Bevboogie. There are two schools of thought on rehab, as you may have gathered. Your OS will probably conform to the slow and sure school which will safeguard his surgery.
I consider myself fortunate to have had a very competent and aggressive PT who put me on a bike at my first visit, 2 weeks post-op, and told me to see what I could do. By the next week I completed a full revolution and never looked back. Was doing my normal uphill hiking at 6weeks. I was an RQT and we do seem to have an easier time of it, but research your PT and have faith in him/her.
Good luck

[madvillain]

Well I passed another test in my recovery, taking a 5 day trip to New Orleans at week 9 (exactly 9 weeks from the date of injury and surgery) and walking 5-7 miles a day with no braces and navigating all sorts of steps, including some fairly boozily.

Really did a number on my legs but I was able to work through the soreness and come out better for it as all that walking really worked the VMO and the gait.

As I approach 10 weeks I continue to ramp up activity and I am pushing through what I would call "general stiffness and soreness" in the knees.  No sharp pains but the increased activity has returned to pre-injury levels and the stiffness after a long day on my feet is evident.

I'm taking a day or two off from the gym just to give them a little break but will continue back up early next week. 

Stay strong everyone and safe.

[madvillain]

Hello all. I'm a newcomer on here. I'm 36 and was extremely active pre injury. I played college sports & was weight training & doing cardio 5-6 days a week. I sustained my injury walking down stairs & slipped. When I hit the floor & saw my patella in my lower thigh I knew what had happened. I injured myself on January 19th & had surgery on January 26th. I had my staples removed on February 5th. Had my first PT on Feb 10th & could only reach 28 ROM. Had my 2nd PT session 2day & the physio was really pushing hard on my active ROM. Had me trying to do standing straight leg raises. does this seem right for my time frame? I see my OS again on Tuesday so I will also be asking him. Any info from "veterans" on here feel free to shoot it my way. John K if u could send me those valuable documents that would be great.

Seems fine to me but you need to be doing a lot more ROM of stuff on your own.  Google "heel slides" and also if you have access to a rowing machine that will help.  But honestly just do 50 heel slides 3 times a day and you'll be up to 45 degrees before you know it and up to 60 and then up to 90 and eventually, like me, with a lot of hard work and trusting the process, you'll be at 120 degrees before you hit week 10 and the surgeon will give you a sideways look (or pat himself on the back!).

I did prone straight leg raises at day 10 after surgery and my tendons didn't snap in half

John is right there are certainly two schools of thought on PT and level of aggression.  Thing is, if you are an athletic middle aged male that had a less invasive repair (no wires) you almost certainly want to aggressively rehab.  That doesn't mean doing dumb things, but it does mean bending that knee over and over and over again as far as it will go in order to break up that scar tissue and prevent as much muscle loss as you can.

Look into Gua Sha scraping tools as well.  You don't need a fancy one, just a 10 dollar one on Amazon to help break up the scar tissue.

I posted what I consider a very good PT guide on the Diaries page.  Check it out out when you get a minute.  It's helped me stay 3-4 weeks ahead of schedule in my rehab.