Ruptured Patellar Tendon Surgery

[JC55]

Hello all.  Tom here.  Well, I just happened to look at the calendar and it caught me off guard.  Monday 7/18 will be three years since my double rupture.  I thank this board and it's posters for keeping me afloat.  Not a lot of information out there on a double rupture.  Crappiest injury I have ever had the pleasure of having (and I have had a s**t load of them).  Seems like just yesterday I was out in my garden crying my ass off and wondering why I could not stand up.  Took like three tries before I realized I was screwed.  Think I did it all.  Surgery, PT, exercise and a build back up.  Not where I was before, but I can live with it.  I am back to coaching softball and soccer.  Giving pitching lessons to the girls and even though I only jog around the bases, that is good enough for me.  Still have some residual pain at times, with swelling after doing too much.  When I feel stiff, I stretch.  When I feel pain, I ice and elevate.  When I want to relax, I do.  Hope everyone is doing well with their recoveries.  Hope to meet someone sometime who has had this happen, but in three years, everyone still thinks I had knee replacement.  But, this is worse.

WOW, Tom...glad to hear you're doing well.  I haven't been on site for months and was just thinking about everyone and thought I'd check in.  Next month will be 3 years since surgery. I have no limitations on activity except I do get stiffness if I'm in a squat for too long. However, that goes for my good knee too so maybe it's just age😄. Good luck to everyone and to the newbies, keep your head up...it does get better. Do your PT, listen to your knee and push yourself each day...it'll pay off.  PS: European trip was awesome, London, Amsterdam, Heidelberg, Lucerne, Paris, Barcelona. Loved the high-speed train from Paris to Barcelona...great way to travel. It's good to be back in the U.S. but already planning next trip to Ireland and Scotland. 

[JaredM]

Hey everyone,

Just started reading this thread, and it looks like some great information and experiences to read through, so I'll start on that. Just wanted to post my story since I just was operated on yesterday for a rupture of my left patellar tendon. I'm at home now, but the pain has been nearly unbearable. I've been keeping the ice running on it the whole time and trying to elevate it as much as I can tolerate, pain-wise. I have my first PT appointment coming up Monday, so I'm kind of curious to find out what kind of progress might be expected. I know it's a long road to get back to normal.

Anyway, thanks everyone for the great resource!

Jared

[Norene]

Hi JaredM

Where are you located?  Different areas seem to treat this injury in different ways.   I was in a cast & brace for 3 months after surgery with no PT at all.  Started PT at 14 weeks post surgery.   My surgery was a little over 6 monts ago and I am at 135 ROM with my knee ( also my left patellar tendon ) and can do most except stairs.  I am doing fairly well going up - not so good going down although I think some of it is a "mind over matter" problem.

I had a nerve block for the surgery and the pain the day after was worse than anything I have ever experienced - that includes giving birth to two kids completely natural with no pain meds.

I can only echo what many will say - PATIENCE - it is the only thing required to work through the rehab ahead.

Two weeks ago I thought I was doing great then woke up one morning with my entire thigh inflamed and could not walk at all.   My OS took x-rays - all okay - so he gave me an anti-inflammatory prescription and a week later I was doing great again.  No rhyme or reason for the set back.

Take care and I wish you well.

[John42]

Hi JaredM

Welcome to the RPT thread on KneeGuru

How did you sustain your injury?   Where do you live.

Read up previous posts and click on the undermentioned thread .  Remember - it a very rare and serious injury - patience required - ask questions

https://www.facebook.com/QuadricepsPatellarTendonRupture

JohnK/ Manchester UK

[Bascat]

HI JaredM.  Don't expect much at this stage and will depend on where you live as to what they do. Plenty of posts on here that will inform you plus there are some guides on the Internet if you Google rehab patellar tendon which should give you some indication. Every case is unique. Good luck with progress and slow and steady wins the race.

Johanna sounds like a nightmare what you continue to endure in terms of fighting for your caremail your tennacity iso amazing.  Makes me appreciate the NHS we have in the UK despite its short comings. 

Update at around 16 weeks (I've stopped counting)  post surgurey on both knees. I feel like I'm treading water the last week or so as waiting to see PT which will happen on tuesday. I cold have seen one sooner but have decided to wait as the one I'm holding out for is a knee specialist and deals with sport injuries. The other PTS are more community based and have little to none experience of this type of injury. I'm out of braces still using crutches just in case more than anything.  Walking speed and mobility has increased considerably.

ROM I've not measured but at least 100. My quads are still not firing and can't do leg raises and big steps and stairs are a problem. I hope this is just a case of waking them quads up. I've read some other posts about how the brain shuts the musscle down after trauma  and how the neurotransmitters need reactivating (in my head that's how I understand it). Hoping it's nothing more sinister and that the PT can sort this out with some electrical stimulation.

 I can't help feeling recovery could have been a little quicker if the right people joined up at the right time had treated me. Part of me thinks I should take more self initiative and crash on withow going to gym etc but rather not risk things. I get to work and about and have a level of operation that's tolerable and no harm done at the momment.

I think this injury has developed my character in terms of thinking what others endure. We crash on through life without really thinking about and understanding the needs of others and this this injury has made me think differently about things and appreciate compassion that others have so this will hopefully make/made me a more rounded person.

Appologives again for fat finger typos and wish everyone a good recovery...don't you just envy those flying gymnasts at the Olympics!

[Johanna]

Howdy RPTers...

Here I am a few days after my recent OS appointment.  Before I update you on that, welcome Jared and it's always uplifting to hear from those of you who have gone on to improved mobility, JC55...nothing like it to bring a hopeful energy to those here still in active treatment mode.

Jared, I've undergone numerous knee surgeries in my life...congenitally messed up knee joints...what distinguishes this recovery is how lengthy/tedious it seems to be.  Feelings of frustration/despair are not uncommon from what I've learned reading at this site and from my own experience.  Yet, for every bad day there are the good days and little by little progress is made, in spite of wondering if the basics...getting up from sitting/or lying down and walking...do return.  So, I'm giving you a hang in there message.  And, if you can spare a few bucks, do look into the Breg Ice Cube device...it circulates ice cold water through a pad you place on your knee.  It can make a huge difference in your comfort level.

Norene, glad you found your prescription alleviated your thigh pain.  I wish I could take anti inflammatory meds...I have to be on a blood thinner, so that is a no go for me.  At least I felt a bit less angst over blood clot possibilities.

Bascat, indeed, my tenacious nature has kicked in overdrive during this ordeal, and once I'm further along in my recovery, I plan to write a comprehensive letter to all the parties involved.  I talked to one supervisor at the VNA (home health services) and said I wanted to meet with their management to discuss my experience and how I think things could be streamlined. I used to be a methods/operations analyst - like an industrial engineer (Cheaper By the Dozen, anyone?) I told her I don't plan on going on a personal attack, rather I want to help identify where things bottleneck and how that could be avoided.  I hope to do the same thing with my insurer.  I've a vested interest in changing their protocols...I have to have the other knee replaced, and I surely would like a smoother time of it afterwards.

Okay...on with my update now.  I met with my OS Thursday am.  We didn't have as much time to converse as usual, he had to catch a flight...meeting up with his crew buddies from college for a reunion and to crew in a race shortly.  He was a bit rueful about it all since he hadn't crewed since then and he thought it'd be brutal.  For me, I'm praying he doesn't injure himself...good God...I need him to function at his best for the next year or two...:-).  Anyway, he had me remove the brace and do straight leg raises for him...still just fine.  He also had me in a seated position, lift my leg out...90 degrees to 180 degrees.  Both worked just fine.  He told me I could shower (his marking on my leg hadn't washed out from sponge bathing...blush).  And, I can go into the pool...I'm going to wait until the incision is fully healed before I attempt that, however.  He said that he wanted to see me again in six weeks before I begin out-patient therapy.  He specifically said he didn't want me lifting weights just yet.  I was told to start going without the brace.  So, since I had to go get an x-ray...I thought I should try it out right there, and walked without the brace on to the x-ray room about 30 feet round trip.  It sure felt naked not wearing a brace of some sort; it's been almost a year having to wear some device.  I was told not to walk at all without a walker right now.  He checked my x-rays, and was glad to see that the bone is growing in around the graft.  He reiterated that he hopes never to do this kind of surgery again.  Can't say I blame him!

Because he's out of town until Tuesday, I'm walking with my brace completely open.  I am approaching this gradually.  And, I want him around should I need him! lol   I am carefully getting up from a seated position using both legs and I can feel my quad muscle engaging more in my treated leg.  I actually find that reassuring, since the quad wasn't firing since I had the knee replacement, and now it's getting strength back.  I will begin to walk entirely brace free little by little around the house first. 

My OS told me he wants me to continue to do quad sets, straight leg raises and heel slides until I return to see him.  And, I am trying in earnest to continue reducing calories/lose weight.  I even asked him what he does to manage it.  He looks like an active basketball player...tall and thin.  He said it's all about the calorie intake.  I intend to learn more next time, when we have more time to converse.  I look for tips from anyone who has found a way to maintain a healthy lifestyle.

I am really looking forward to realizing some leg strength to get up from normal seating so I feel liberated to go out in public, and not worry about getting stuck either from a chair or a toilet, for heaven's sake!

I am able to sit in our little movie theater now (I do bring an extra cushion)...I can get up OK from the seats that have arm rests in there. At least it's something I can do to get out of the house! This afternoon, I saw that oldie but goodie, On Golden Pond.  I love the photography in that movie...and I felt nostalgic...it was my father's favorite movie near the end days of his life (my parents moved to Bellingham WA from SoCal because my dad was passionate about being able to sail in the Puget Sound and take walks in the beautiful woods).  I wasn't laughing quite as much this time...I must have been in my early 40s when I saw it last.  Now that I'm a retiree myself, the aging jokes aren't quite so hilarious.  And so it goes...

Sending you all best wishes for mobility liberation!

~ Johanna ~

[ladeyemi]

Hi guys,

I'm five and half months or so following my rupture (London based), I'm on my third physiotherapist. I've gone with the NHS for now. I'm seriously thinking about seeking private physiotherapy. Does anyone have any recommendations on clinics, physiotherapists?

Any help would be much appreciated.

[John42]

Hi Ladeyemi

As I have always posted on this thread - " ask your PT - have you seen this type of injury before? ", in the majority of replys, the answer is no, because this injury is so rare.

Which part of London do you live in?

Take care and keep posting

JohnK/ Manchester UK 

[ladeyemi]

Hi JohnK,

Cheers for the reply, yeah my 1st and 2nd both had experience with RPT's, I didn't get a chance to ask the new one. It's all been a little bit frustrating and disorganised. Essentially I've restarted with a new physio twice (going through the same initial assessment). Annoyingly I've been doing really well on the rehab/recovery front and feel like if I had a more consistent physiotherapy approach I'd be even further along. There's no rush on my part but it feels like I could be further along. I live in East London, work near Tower Hill.

[Vickster]

The physios at Wimbledon clinic at Parkside have a very good rep, working with top knee surgeons. Claire Robertson, consultant Physio has been recommended to me in the past (patella/knee specialist)
Not a local option to you though and also quite expensive

[JaredM]

Thanks everyone for the replies. Sorry, I haven't gotten back sooner. I just haven't been on my computer, but should be more now. Reading the history in this thread has been great for me, honestly. I know it's not an easy recovery, but knowing what to expect based on such a range of experiences is so much better than me kind of guessing based on what I read on the internet.

Anyway, to answer some of the questions (I'm sure I forgot some)

I live in the USA, in Northern Illinois. I am 36 years old.

My injury was sustained over two wonderful incidents. The first happened around the second week of July. I was in Las Vegas for work. After a show, a group of us were walking down sidewalk to get to our bus. I was pretty distracted, talking to people and tripped over a concrete step that went out into the sidewalk. I flew through the air, hands in front of me, superman style and landed on the ground. Extremely embarrassing since there were so many people around! When I got up, my left knee had some sharp pain in it. I figured I sprained it and basically took it easy on my leg until I got better. I cancelled plans for bicycle trips and everything.

Fast forward a month to last Saturday. My knee wasn't hurting anymore, but felt a bit weak, especially going downstairs. I went to a party for a friend. I was sitting back, having a few beers, and someone decided I "needed" to come over to see something. They pulled me up to my feet. I was a bit unbalanced and my knee basically gave out, I stumbled, and then fell backwards to the ground. When I was on the ground, I noticed my kneecap was up in my lower thigh area. Major problem! It was strange though since it really didn't hurt at all unless I tried to straighten it out or push down on it to stand up.

So, an ambulance was called, they got my leg straightened out (ouch!) and into a brace, and then 5 days later, I had the surgery. Woke up from that and have been in more pain than I ever could have expected, but it is getting better now. I have one of the bandages that let ice water flow through it, and that thing is a life saver.

One question I had for you guys was what kind of care did you guys have to do for the wound? I guess I'm supposed to leave my bandage on until my first appointment with the doctor, when he will remove the staples, two weeks after the surgery. I'd imagine it's gotta get pretty gross under there!

Sorry for rambling so much. It's just great to interact with people that have "been there"!

Jared

[Norene]

Hi JaredM - I was told to change the dressing on my surgical site 48 hours after getting home.   I have posted a picture of my knee 48 hours after surgery and what it looks like now.    My staples were in for 10 days then I was put in a cylindrical cast for 4 weeks. 

You might want to check with the doctor's office about changing your dressing.   You will have to have someone help you with it (my husband took care of mine) but it really was not bad.

[ladeyemi]

Hi Vickster,

Thanks for the suggestion will check them out see if they can point me in the direction of someone nearer me.

[Vickster]

The Fortius clinic has a v good reputation. Maybe they have a Physio department?
Or where does your surgeon have his private practice? That could be another avenue for physios working with him.
If you are trying to get back to a specific sport, look for a Physio with a specialism (I've seen a Physio focused on cycling in the past for example)

[Johanna]

Welcome ladeyemi.  Sending you much encouragement while on the road to recovery.  This site will be enormously helpful to you...for empathy and useful tips as you make your way. Jared, I went from the hospital to a stint in a rehab facility for two weeks before I came back home.  In the interim, prior to staple removal, the nurses removed my dressing and swabbed the incision with this brown/iodine liquid and then applied a fresh dressing each day.  This was done until I saw my OS for my first post op visit.  I hope your doctor's office will offer you wound care instructions.  BTW...it was different when I had my wire removed.  My OS opened up just a couple of inches of the incision and instead of staples, there were strips holding it closed.  I left the out patient center with gauze covered by an ace bandage under neath my brace.  Since they didn't mention wound care to me, I called my doctor's office and his nurse told me in this instance to leave the bandage on until I returned to see my OS, which was just a week later.  Perhaps the procedure is dependent on the length of the incision and the manner in which it is closed (?)

~ Johanna ~