Ruptured Patellar Tendon Surgery

[Bmcnamara417]

Steps?  I was climbing steps both before the surgery and after with no crutches and brace locked out.  I have a good 12 steps to the second story of my house where the bedrooms are.  In fact, before surgery, I went to a college basketball game in a 13000 seat arena and climbed almost to the top row.  I'm not trying to brag....ok...maybe I am.  I have found the best way to go down stairs is backwards or sideways.  I prefer backwards.  I have another therapy session Tuesday morning....we shall see what that gors....I just have to beat 60 degrees ROM.  That's where I was on Friday.  I have to admit I have been a little lazy with my exercises over the weekend....maybe all of the walking and climbing the stairs at home will make up for it.  Let's hope your doc allows some weight bearing!  My post surgery orders actually said weight bearing as tolerated....I guess I have a pretty high tolerance. 

Cheerio,

Brett

[bustedwheel10]

Hi - been awhile since I logged on here. I'm now 13 months post-op - wanted to give an update and get advice.

My ROM is very near 100% - can get into a full deep squat - calf and hamstring not quite touching but very close
Right Quad still atrophied - probably about 2" smaller (25" vs. 27" on uninjured leg)
Strength Levels have recovered to about 80-85%+ - 170lb snatch, 250lb clean, 425lb dead lift
Have begun doing some gentle uphill running
Rowing back at under 1'30" for 500m - so within 10 seconds of pre-injury

The issue is swelling - still puffy around entire front of knee, particularly on outside of patellar tendon and behind knee on inside edge of knee. The patella also clicks a little bit when knee is partially bent, and I press on inside of knee cap and then gently extend my knee against moderate tension.

Training is somewhat limited and swelling more pronounced after a training day - my goal is pain free movement and while strength levels have gradually been coming back (or at least not getting worse) - swelling and pain seem to have stopped improving at about month 6.

Thoughts?

[diane72]

Hi All,

Brett, your post made me smile. What a man brag, no never-ha ha ha, only joking. My doc said to stay with 'toe weight bearing' until he sees me again, which isn't until 30th March  Oh well, plenty to get on with in the meantime to strengthen the leg. Sounds like your progress is going excellently? How is the pain/swelling?

Bustedwheel, sorry as I'm about 5 weeks post-recovery I don't have much advice to offer but Brett on here has had the injury before so he may be able to give advice and John 42, Stuart and a few others are still around.

As for me, I had another physio appointment yesterday. Although I could only get to 40 degrees ROM on my own she could get me to about 58 degrees so she was confident if I kept working at it I could hit the 60 degree target for next Thursday at the hospital in order to be unlocked to 90. Let's see, I will do my best!! I also got a new exercise-inner quad ranges (trying to lift my heel up while sitting flat) with a towel under my knee. Wow, it hurts but bizarrely the pain is further down my leg just at the top of my shin-anyone else had that?

I'm as far as 2006 and  page 85 on this message-board, don't know how I will pass the time once I've read them all!

Sending good wishes to all,

Diane 

[Stuart Rulka]

Diane, once finished you can start on the RQT thread, lol. Similar but some differences. Having some trouble understanding why your Doc says toe weight bearing only. Seems to me that having the knee flexed would put more stress on the repair than having it locked. Ask your PT what she thinks.
In addition I must have misunderstood the point of the brace; to my mind it was to ensure that you stayed within an acceptable range of motion, in case of a fall foe example in case of a fall. Don't understand 90deg if you have demonstrated only 60! Maybe John can enlighten me.
Keep up the hard work and good luck

[diane72]

Hey  Stuart,

I'm only up to 2006 on reading this board, so another 10 years of messages to go but then I will definitely start on the RQT thread!!

 I'm of the same mindset as you on the degree flex vs. weight bearing and I do wonder how much experience Watford General have of this injury. I've been playing it safe anyway, based on Brett's advice I've been locking my brace at a more restrictive degree flex than what I am trying to do with the ROM exercises. I started locking it at zero, when it was at 0-30 flex and now I am at 60 I'm locking it to 0-30 when going about on crutches. My gut is my ROM is ahead of my muscle strength and it was a real breakthrough realisation that got me out of the wheelchair onto the crutches.

Thanks for the luck, I need it!!!

Diane 

[diane72]

Hello All,

Well today marks my'6 weeks from surgery' day. I thought I would celebrate with an update.

- I can now reach the 60 degrees ROM on my brace that it has been set at (although bizarrely on one side, the inner side, it is now 60 degrees and the on the outer side it shows 10-20 degrees less but won't move further because the inner side has locked at reaching its maximum of 60-anyone else had either side of their brace showing different degrees?)
- My breakthrough of the week is I can now do an inner quad range heel lift with a bath towl rolled up under my knee
- These lifts I think have really helped strengthen my leg alot and now I feel comfortable tensing my muscle and holding my leg in place while hopping with the crutches with it in the 0-60 degree flex (I have been slowly working up to it from the lock at zero)
- I have been restricted to toe weight bearing, bit frustrating as it seems others on here build up weight bearing while building up the ROM in parallel.
-Doing my physio exercises loyally every day at minimum 4 x per day
- Still on sick leave but I will be re-assessed by the GP on 18th March and I was going to suggest I go back to work 'online' but no travelling yet (It is over an hour's drive each way to my work, so couldn't expect my husband to do that aswell as all the school drop offs and pick ups!).
- my leg brace will be unlocked to 90 next Thursday, another physio session on Friday

Here's hoping the next 6 weeks will bring step-change and get me walking again!!!!

Diane 

[quickrecovery]

Hi everyone!  We have a brand new poster here!  How's everyone doing?  Where's everyone from?  Hope everyone is recovering nicely and using the wealth of information in this thread.  I've read this thread for hours so far.  Really good stuff.  People seem nice.

I fell down some stairs and found out I had a ruptured patellar tendon.  I'm currently on day 9 post operatively.  Adjusting post operatively has been difficult.  I was originally taking a lot of percocet but after a week I decided to change just to Tylenol.  I'm hoping that I can be off Tylenol soon too.

Sleeping has been a challenge.  I usually sleep face down and sometimes to the side, but due to the discomfort in my knee while in the zimmer splint, I usually just wait till I am so tired that it doesnt matter what position I'm in.  I saw someone post that you should put a pillow between your legs such that the pillow supports your knee and ankle.  That helped a bit.

I'm scheduled to see my OS on March 14th for a post operative followup.  This followup scheduled 2 weeks after surgery is something I am looking forward to.  I'm hoping to get my staples out and have a detailed plan on what my recovery might look like.  I'd also like to know what the PT schedule may look like. 

I've been told that I should be able to see an improvement within 6 weeks post surgery.  I don't know what that means. 

Right now I cant bear too much weight on my operated leg.

[Bmcnamara417]

Hi everyone!  We have a brand new poster here!  How's everyone doing?  Where's everyone from?  Hope everyone is recovering nicely and using the wealth of information in this thread.  I've read this thread for hours so far.  Really good stuff.  People seem nice.

I fell down some stairs and found out I had a ruptured patellar tendon.  I'm currently on day 9 post operatively.  Adjusting post operatively has been difficult.  I was originally taking a lot of percocet but after a week I decided to change just to Tylenol.  I'm hoping that I can be off Tylenol soon too.

Sleeping has been a challenge.  I usually sleep face down and sometimes to the side, but due to the discomfort in my knee while in the zimmer splint, I usually just wait till I am so tired that it doesnt matter what position I'm in.  I saw someone post that you should put a pillow between your legs such that the pillow supports your knee and ankle.  That helped a bit.

I'm scheduled to see my OS on March 14th for a post operative followup.  This followup scheduled 2 weeks after surgery is something I am looking forward to.  I'm hoping to get my staples out and have a detailed plan on what my recovery might look like.  I'd also like to know what the PT schedule may look like. 

I've been told that I should be able to see an improvement within 6 weeks post surgery.  I don't know what that means. 

Right now I cant bear too much weight on my operated leg.

Read all my posts from the last few weeks,,,,Yo really should be doing PT right now.  There are 2 approaches to this injury.  One with PT right out of the gate the the waiting 4 weeks.  Waiting is bad...I have now ruptured Patellars in both knees the other in 2012.  My recovery back to work as a firefighter in 2012 was 3 months.....a record according to my doctor.  I feel the early Pr. Was the reason....and working by butt off at the same time.  I have been full weight baring since surgery with brace locked at 0 (3 weeks post surg this coming thursday.  I could go in forever....got questions?  Start firing!

[John42]

Hi Quickrecovery

You have found the best thread covering a RPT injury - do well to read as many previous posts and at the same time, have a look at the undermentioned thread which I put together with KneeGuru.   This containes numerous documents which explains your rare injury and the rehab process.

You should be throwing the brace away at six weeks, and expect to have about 30ROM, and your next target is to reach 60ROM up to ten weeks post op.

I am still using a pillow between my knees after 12 years, to get a good nights sleep.

Where do you live?  Keep posting - lots of buddies on this thread to answer your questions.

Take care
JohnK/ Manchester UK 



https://www.facebook.com/QuadricepsPatellarTendonRupture

[diane72]

Hi quickrecovery.

Love the optimistic name!!!

Welcome to the 'club' of recovering patellar tendon rupture sufferers. First 2 weeks after surgery I literally was unable to do anything and had to use a wheelchair. I think that is quite normal but then weeks 2-4 you should be making progresa. For me the pain decreased then but I was struggling to make progress. However a visit to the physio at about 4 weeks discovered that because I had been sent home from hospital with cructhes but no leg support in excruciating agony for 12 days prior to surgery my mind had 'switched off' my quad patellar signal pathway but some focused conscious over-ride with the physio (and some tips from these guys) got the quads twitching again and I'm now moving around on crutches (but still toe weight bearing only). So my tip is if at any stage in the next few weeks you are not progressing the way you expect to then do seek additional advice from wherever you can get it. You'll see my post just below yours on where I am at 6 weeks but bear in mind most of this came in the last 2 weeks due to some of the issues I had early on. I do think speed of recovery is also linked to how quickly you have surgery (logically the longer you keave it the more the muscles will atrophy but you may catch up in later weeks)-what was the time frame for yours?

Good  luck and looking forward to sharing the journey.

Diane 

[Stuart Rulka]

John, with all due respect, I would suggest putting the braces aside, but still within reach, at six weeks. Depending on activity, and conditions outdoors, I still used mine as a safety mechanism at eight months, even though I resumed hiking at six weeks!

[Bmcnamara417]

At 2.5 weeks post surgery I am at 60 degrees ROM...maybe 70 if I push it.
Walking without crutches with brace locked at zero and have been since 3 days post surgury.
I am allowed to unlock brace to 60 when sitting, sleeping and driving (yes...driving).

Once again doctors have two different approaches to rehab with this injury.  I did the same to my left knee in 2012...and was 95 percent recovered in 3 months. I can thank the rehab protocol and an awesome PT (twice a week) for that. 

[diane72]

Brett,

This is great news and great to see the progress you are making!!! You must be feeling so positive!

I have been reading alot of the historic posts and it is bizarre just how different the approaches are by some clinicians (I read some people were even kept in a full leg cast for 6 weeks!). Certainly what you are doing seems to be working well.

I have to say it seems strange to me that they would have me go all the way to 90 degrees open brace while still toe weight bearing only. It does make sense to build up the muscle/weight bearing in parallel. I can only think it is because they want to ensure the tendon has totally healed and is stretching well before they start adding weight. One of the downsides of the NHS is you don't have much choice when it comes to who you see.

John, I'm interested to know about 'throwing away your brace' at 6 weeks. Did you mean people start walking with no brace and no crutches as 'a norm' at that stage? Also as someone that has been on these boards for years, what is the norm do people throw away the brace or the crutches first? I appreciate everyone is different but would be good to know.

Diane

[Stuart Rulka]

Diane, I realise your query was directed to John but I too would like clarification. In my view the crutches and the brace serve two entirely different purposes. The crutches serve to keep weight off the injured leg and provide stability once weight bearing. The brace ensures you do not bend the injured knee past the point you have achieved during PT.
we still don't know why you have been told toe weight bearing only. As stated before I don't understand the rationale for this. Logic says full foot weight bearing will put less (no) stress on the repair. I have arthritic wrists and tossed the crutches about 5 days post-op with no ill effects. My PT had me remove the brace as soon as I entered his office for exercises, but I retained it for safety outside for about 6 weeks and for several months thereafter while hiking through the winter.
I keep hoping someone will provide some definitive answers. That is why we question, question!

[diane72]

Hi Stuart,

All input welcomed! What you are saying makes logical sense to me! Hmmmmmm, don't see the consultant until 30th March which is a pity as I'd really like to ask him these questions. I did send him an e-mail re-querying the toe-weight bearing and his assistant contacted me to say 'yes' stay at that. I see the nurse this Thursday I can ask her but I doubt she'll know she doesn't seem very experienced.

D