Ruptured Patellar Tendon Surgery

[Bmcnamara417]

Ok here goes.....lol

Saw Doctor for 1st time today since surgery on Feb 18th.  He said.....I don't care what you do with your brace when you are sitting.   Wanna unlock it to 180 degrees for whatever reason...go for it!  BUT....don't you dare walk with it unless it is locked out at zero.  My quad can't handle the forward stress of my 6ft 250 pound (I'm not sure in the metric conversion)  fat ass!  He honestly believes I will be on golf course by May and back to full duty as a firefighter by early june!  That's  little over 3 months from time of surgery folks.  I have also found that if I leave my brace on and unlock to say.....180 or less and then sit on a bench or table or high bed and let my lower leg dangle...I can get my ROM a lot further than by just doing heal slides.  Oh and I got 81 degrees at Physical therapy today.   Basically. ...you should never be unlocked and moving around...until your knee and quad can handle it.  So.....diane...if your brace is unlocked while you are moving around on crutches. ...and somehow you stumble and end up trying  to take a step on your bad knee....then you are ready gonna mess it up!  Lock in  at zero....and just try to stand on both feet without moving.   If your brace is locked out there is no way you can do any damage...unless the brace just falls off for some reason and you end up on the floor.  Let me remind everyone...this is the second patellar tendon I have ruptured (did my left in 2012).  Anyone got questions?  Im a pro at this stuff (haha).  Fire away!!


Good night from Buckeye land (that's Ohio in the US),

Brett

[madvillain]

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?

Wheel:  sounds like overall you are doing good.  I am at 15 months and my left knee seems similar to yours.  It clicks on occasion, especially after a hard leg workout and I also have minor ache in the knee from time to time.  None of these issues are on my right knee, which thank goodness, feels amazing. 

The left knee has been very, very slowly improving with the tracking and pain (occasionally feels as good as my right knee) but over the last 3 months it hasn't really changed much.

Things that seem to help: manipulating the knee cap before I work out and then foam rolling, gua sha scraping (once a week) and then ice wrap post workout.

I've been doing a lot of high rep lowish weight reps on the squat and deadlift and straightleg deadlift and I'm really starting to feel the power come finally at 15 months.   I still have some issues with knee bend but usually once I warmup I can get to parallel on my squat reps.

Don't think I'll ever be an "ass to grass" squatter but in general I think my approach of lighter weight higher reps is working well.  I really don't want to ever seriously injury myself again trying to look macho on the squat rack before I'm ready.  I think when I can do 225 for 10 solid reps (and I'm probably a couple months away from that at best) then maybe I'll try some heavier weights for lower reps.

[diane72]

Good to hear all the progress of people both further on in their journey and recent. Will it ever end? Sounds like no.

Just back from the hospital and I am now officially to target 90 degrees ROM. Physio appointment tomorrow!

D

 

[John42]

Hi Diane72

Good news update - however listen to your knee - don`t push it and you should be up to 90ROM within 4/6 months and the next target is 110 ROM, anything over 120ROM is acceptable.

On your next visit to the hospital/phisio - have your good knee measured which should be 135/145ROM

Best/John   

[Bmcnamara417]

John,

Did you say 90 degrees at 4 to 6 months?   Heck I am at 85 in 3 weeks....could have hit 90 if i pushed it a little more.  Its obvious there are two trains of thought on recovering from this injury.  One being aggressive the other not.  Having done the other knee in 2012 and going aggressive with that one and aggressive again on this one.  I have to say that there is no other way.  I have a friend that tore his patellar in 2011.  His doctor took the non aggressive approach.   His is a former top notch athlete and is still in great shape.  He complains all the time that his knee still isnt right.  Remember, the repair is 50 percent stronger that you tendon was to begin with....it can take it!  There is no reason someone cant recover from this to 90+ percent in 3 to 4 months max.

[John42]

Hi Bmcnamara417   

Impressed to read that you reached  85ROM in three weeks post op, but the tendon cannot be fully healed in that time - I would suggest that caution is required to avoid a re rupture.

Take care

JohnK/ Manchester UK

[diane72]

Hello All!

So another good physio session today (I love my physio!).

She got me to 70 degrees bend so my target by next Thursday is to get to 75 degrees on my own with the heel slides. I also did my first straight leg lifts (with lots of encouragment from her and grunting from me!!! How can something so simple take such effort?!!). I forgot to ask her about measuring my good leg-will try remember next week. I actually am intrigued about my good leg I have always thought I was over average bendiness (freaky thumbs that bend right back etc.) let's see what it shows!

I've got a really nice excercise schedule to do at home now so feeling happy I can make progress!

Diane 

[Johanna]

Hi everyone,

I recently obtained a second opinion about treatment options for my completely ruptured patellar tendon.  This doctor practices at USC Keck Center out here in Southern California.  He is highly respected and replaced both of my brother's hip joints (and my brother now walks as if he were only 30 years old).  He supported the cadaver graft proposed by my surgeon.  He agreed with me, that further delay might just increase the quad atrophy.  He did say that surgery itself is not terribly complicated, however the condition that arises from it is delicate and that it is critical that blood flow is established to preserve the graft tissue.  He also stated that there might be limited ROM from such a procedure, however it was the only option that he could foresee that would restore me to being able to walk stairs and get up from a seated position more normally in addition to eliminating my continued need for a walker and a brace. 

I will see my surgeon again this Tuesday afternoon.  I hope to set the revision surgery date at this time.

One of my brothers asked me a question that I didn't think of during the second opinion consultation.  Thus, I am posing it here.  Does anyone know what the statistical success rate is for this kind of repair?  When I search the internet for further information regarding this specialized surgery, invariably the articles that surface are about using a portion of the patella tendon as a graft for an ACL rupture instead.

Reading here, it seems that most posters are much younger than me, and quite fit from athletic pursuits.  I am 69 years old and have lived the entirety of my life sidelined by the severity of my knee(s) defect which prohibited me from most anything short of walking and sitting. (I was subjected to frequent dislocations at every turn from the age of 13 on.)

I would appreciate links to more information regarding this type of surgery.  This will be the 4th knee surgery I've undergone with my left knee and I admit I am daunted by the prospect this time around.  Contrary to the type of repair required for a partial rupture, I am inclined to believe that I will need to move with caution from here on out to avoid a repeat of this injury.  (I've got a neighbor, 73 years old, who had his tendon graft re-rupture just a month after it was implanted.  He's experienced an additional complication as well with a Mersa infection.  Six surgeries later, he's going in for another knee implant this week, which will hopefully be the end of his ordeal.)

Thanks in advance...and it is good to read of your progress...brings me hope...

~ Johanna ~

[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?

Wheel:  sounds like overall you are doing good.  I am at 15 months and my left knee seems similar to yours.  It clicks on occasion, especially after a hard leg workout and I also have minor ache in the knee from time to time.  None of these issues are on my right knee, which thank goodness, feels amazing. 

The left knee has been very, very slowly improving with the tracking and pain (occasionally feels as good as my right knee) but over the last 3 months it hasn't really changed much.

Things that seem to help: manipulating the knee cap before I work out and then foam rolling, gua sha scraping (once a week) and then ice wrap post workout.

I've been doing a lot of high rep lowish weight reps on the squat and deadlift and straightleg deadlift and I'm really starting to feel the power come finally at 15 months.   I still have some issues with knee bend but usually once I warmup I can get to parallel on my squat reps.

Don't think I'll ever be an "ass to grass" squatter but in general I think my approach of lighter weight higher reps is working well.  I really don't want to ever seriously injury myself again trying to look macho on the squat rack before I'm ready.  I think when I can do 225 for 10 solid reps (and I'm probably a couple months away from that at best) then maybe I'll try some heavier weights for lower reps.

Do you do the gua sha yourself? How did you learn to do it. I've been doing rolf sessions 1x per week, but it's damn expensive and not covered by insurance.

[Cdn_Forces_Blown_Quadtend]

Hello all,  so I'm brand  new to the site.  I'm now 6 days post Op for a Quad tendon rupture. I lucked out with how fast from injury to table I was. Injury happened at 915am and was going to sleep in the OR around 2145 that evening.  Was also released by midnight to go home. It's been informative reading the posts so far. If someone would have asked me about what this type of injury would in tail I'd think of the physical side not the mental/emotional . Talk about dealing with an emotional roller coaster. Amazing how many things in life you take for granted  (putting clothes on, sitting, or getting into bed even. Crazy how fast life can completely change in the split seconds of a slip and fall. I was a month to the day of Deploying Overseas(I'm an aircraft mech ). Cleared my medical for the Deployment  literally the afternoon before. So here I am 6 days in wearing everyone's fav the immobilizer brace. I'll be dropping on every so often to let everyone know how it's going. 

Rodd

[John42]

Hi Rodd

Welcome to the RQT web page, not the best club in the world for membership, however by reading some of the previous posts, you will obtain a lot of info about your injury.

Suggest that you have a look at the following thread -

Ruptured Patella Tendon, Quadriceps/surgery as the rehab is very similar - likewise click onto the undermentioned thread as it contains various documents which I have put together with KneeGuru.

https://www.facebook.com/QuadricepsPatellarTendonRupture

Keep posting -remember "PATIENCE" a long haul to recovery.

Whereabouts do you live?   How did you sustain your injury?

Take care

JohnK/ Manchester UK

[Stuart Rulka]

Rodd, welcome to our rather exclusive club. Gather you are in Eastern Canada. This thread is RPT but the RQT thread has been quiet for a while so you may get more response here.  Not sure if this means our injury is rarer or indeed why sometimes it's the patellar tendon and sometimes the Quad that lets go.
By tapping on a name you can see an individual's story. I am the only RQT on this thread regularly but the info is relevant to both.

[Cdn_Forces_Blown_Quadtend]

Thank you John K for the welcome, I'm on Vancouver Island British Columbia Canada.  Its pretty sad to be honest i'm an avid skiier and have had 15 days this season.  I was actually at the bases shooting range to do my pistol qualification (last tick in the box for deployment) it had rained about 70mm over night and was currently raining we had to walk down a small grassy embankment(4ish feet high to grab my gear) and my feet slipped out from under me.   Wish it was a better story....   

Rodd

[John42]

Hi Rodd

Delighted to hear from you so soon - you may have noted buddies on KneeGuru will follow your posting, and as stated we will try and give you help as and when .

Vancouver - been there - loved the Buchard gardens and bussed for more than 1000 miles watching out for black bears.

Best

JohnK/ Manchester

[Stuart Rulka]

Rodd, my apologies, Ishould have guessed Comox. Where did you have your surgery? Had mine in Duncan following a fall geocaching in the Gulf Islands. Didn't realise how lucky I was, having surgery 16 hours later till my PT told me somebody in Burnaby waited four days!
Assume the forces will line up your physio. Mine was head of Physio for our Olympics, and was very aggressive. Had me back on the Grouse Grind six weeks to the day following surgery. If you haven't yet done so , check out the RQT thread.
Good luck!