Ruptured Patellar Tendon Surgery

[Chiropractor2001]

I am happy that you are getting better.
I started weight bearing about 2 weeks ago. It feels okay. No crutches.  Also I am on a vibe plate two times a week ( for 5 -10 min ) just to wake up the muscles. Russian stim or conventional stim are great for muscle activation.  It works for me. I also add a bit of laser to reduce the inflammation.  I increased my ROM to about 100 today. I know maybe I am pushing it too much however it is almost  8 weeks post op so it should be okay. The clicking sound in your knee is nothing.  Your patella is readjusting.  Some of it will go away after one year and some will stick around. It will not great any damages. I was talking to a freind of mine who is the sport doc for few teams and he said that he has never seen  a re rupture in Patella tendon  . However he has seen a lot of patella rupture in the other leg..( genetics and same sport )..
My muscles are getting stronger and hoping to return to practice in feb  ( if nothing else happens)

[Chiropractor2001]

Hi all...
The OS  is taking the reinforced wire out this week? Anybody has gone through it... what to expect? Should I ask him to do a MUA while I am under..
ROM does not pass 100.
Started doing a bit of muscle stimulation..walking without the crutches  ( doing okay) ... pain on driving after 10 min on the inner side.. ( 8 weeks  and 3 days post op)..
Thanks

[John42]

Hi Chiropractor2001

Were you give the OK to drive by your OS - from my own experience, this is risky at eight weeks post OP - have you tried to do an emergency stop?

JohnK/ Manchester UK

[Chiropractor2001]

Hi.. thank you for your concern ...  yes  I was given the okay at 6 weeks since It is my left leg and the car is automatic transmission  and I can best my knee over 90..
However even though I was given the okay, I only drive the short distances.
Any feed back on the reinforced wire taken out and mua and progression  after that ??

[Johanna]

Hi Chiropractor2001...just a quick post for now to share with you my experience with wire removal...here's what I wrote for Bascat a while back:

I had a wire around the perimeter of my knee cap and down below the attachment of the achilles tendon graft.  My surgeon removed it about 3 months post surgery.  There wasn't much pain with that procedure, it was done in a day surgical site, although I was out during the removal and sent home within a few hours, after post op recovery.  At this point, I am not sure that it was helpful to have it removed, but on the other hand, I am a bit relieved that I do not have the worry about it breaking either.

I had quite an improvement in ROM afterwards. [I just came back to add that I read back my posts and at 10 weeks my ROM was 95, so you can note how much better it is.] It was measured about 6 weeks out (after the procedure) and at that time it was 131.  I think it is even better now.  You might want to read back on this site about MUA.  I recall some members here (or perhaps I read it during my google searches) shared the pros and cons.  There are some real risks involved if memory serves me correctly.

Will update you all in a few...

~ Johanna ~

[Chiropractor2001]

Thank you Johanna
Greatly appreciated.  I spoke to the OS assistance and he is saying that they probably won't do the mua for you
They say because the wire is being removed at 8 weeks and you are already at 90 degrees so you need to work hard to get the ROM back and break all the scar tissue formation.  Safer but more painful and longer.
I will see how it goes on wendesday.
Johanna ... did you get a MUA done when they removed the wire.. and were you weight bearing fully ( with brace on) no crutches before the wire removal???
Thanks

[Norene]

Hi Chiropractor2001   -   I never had a wire after my surgery since the bottom part of my knee cap broke into smaller pieces so I cannot speak to that.    The top part of my knee cap ended up in my thigh (I still have a dent in the muscle from where it was)   My OS had to reattach the patellar tendon to the remaining knee cap but no wires were used.

At 9 months out from surgery and things are okay.  My ROM is at 135 -140 depending on the day.   I continue to go to PT once a week.   I am working on my balance now which has been really off since the accident.  I still have some scar tissue that causes pain at times.   My physical therapist uses ultra sound to try to break it up.   I also have a TENS machine I use at home to stimulate the muscles.   

My biggest issue right now is the inconsistency of how my knee acts.   Sometimes stairs are no problem, two hours later going up the stairs can be very painful.   Some days there is no pain, other days my knee aches all day long.    As we head toward cold, damp weather I expect it will bother me more.   I panic some days thinking about icy sidewalks (a slip on ice is what caused my accident) but I know that will get better.   I used to panic walking in crowds thinking someone might bump me and cause my knee give out but now it doesn't bother me.

My advice is have patience.  Your ROM will increase as you use your knee more.   Remember that tendons and ligaments take longer to heal than bones.   Also keep in mind that we all heal differently.  What someone here posts about their experience may not match what your experience is.   

[Chiropractor2001]

Hi noreen
Thank you for your feedback
Greatly appreciated.  I hope you will get 100 % soon.
Everything I read and how we treat in clinic is a bit more aggressive than what the OS are asking me to do... it makes me wonder why? All new research says to become more aggressive and start rehab soon. And after 6 weeks you should do some strengthening exercises.... my OS is saying not to weight bear...
Anyway... I think he is more afraid to re rupture... Anyway I will see on wend what he says after the wire removal..
And you are right... we all recover at different pace...
Good luck to all of us..

[Johanna]

Hi Chiropractor2001,  I didn't have the MUA done during my wire removal.  From what I read in about the first 50 pages of this thread, I would be quite hesitant to have it done.  I recall some real downsides to the procedure...additional complications.  I was weight bearing from the beginning.  However, I had a cadaver tendon graft rather than a patellar tendon repair.  So, that may make quite a difference in the treatment protocol.  I wore a hinged brace locked for the first three weeks or so (see my posting history for the weekly progression of it, if you like...) and then it was unlocked to 30 degrees and 10 degrees each week thereafter.  I am considerably overweight and much older than most posters here.  That was one reason that my OS installed the wire for additional support.  I was told to do isometric quad sets about 10 an hour immediately after surgery from then on. 

I am making my way quite cautiously on this.  My OS explained the healing process of the tendon.  It takes a whole year for it to be fully completed, and for bone to grow at the attachment site(s).  I am not willing to jeopardize it in any fashion.  (I have a friend that had his tendon repair re-rupture twice...and he had to endure almost 2 years of multiple surgeries (it got infected too).

For me, I believe consistent strengthening of the surrounding muscular tissue each day will ensure an acceptable result. Of course, I recognize that my mobility goals are much more basic as a consequence of my age and lifestyle.  For the athletes that post here, the strategies to regain more function vary considerably. 

I have surmised that irrespective of age and experience the recovery is a slow, daily grind not well suited to shortcuts...too much at stake.  Having faced, in my case, the very real possibility of being walker/brace bound for the rest of my life (and even confined to a wheelchair), I am grateful for the miracle of the surgical intervention made available to me.  In his 32 years of practice, I'm the first he performed...and he is a brilliant doctor practicing in SoCal, a highly populated area, if that gives you a reference point to just how rare this injury actually is. 

Sending you, all who post here, my best wishes for patience and optimism that things will improve! ...a message I say to myself as well! :-)

~ Johanna ~

[Chiropractor2001]

Thank you for the information
I totally agree. I don't want to do anything to re rupture this tendon.  At this point, I am doing isometric contractions on vibe machines and home exercises. I am weight bearing in brace ( no crutches). I am at 8 weeks and I know alot of people have started their strengthening exercises ... I am waiting until at least 12 weeks. However , I will try to get as much rom as I can from now until 15-16 weeks.
Again thanks for the info and wishing you all the best..
They mention that aftwr wire removal , rom will increase very quickly... let's hope so.
At my age 45 .. I need to think about my 4 kids more that how fast I can run.

[Chiropractor2001]

Hi all
I figure since there was not much information on this to put it out there with the reinforced wire.
The surgery was done yesterday.  30-45 min.
Easy . I was told that I can weight bear right after surgery. And continue with ROM.
The good thing is ..no pain with the surgery.. and no med... the only thing is that the knee clicks alot and I believe that is normal since all the pressure in on the tendon now.
The ROM increases as soon as the wire is out.
I am happy that the wire was there to protect the tendon and now we can move alot quicker to improve... hopefully.

[John42]

Just remember - listen to your knee - don`t push it - the tendon has still not healed.

JohnK/ Manchester UK

[Chiropractor2001]

Quick question? I am 11 weeks post op patellar tendon repair... I am still at about 120 passive and 112 active flexion... ( my other leg active flexion is 137)
I am not.sure if I. Need a second  opinion regarding the range of motion.
Should I consider mua to get the ROM back??
Has anyone got their ROM fully back at my pace ??
Any suggestions?

[Norene]

Chiropractor2001  -   I did not start PT until 13 weeks after my surgery.    At my first session evaluation I was at about 124 degrees ROM.    It took about 4 weeks for me to reach 135 degrees - PT twice a week, daily exercises at home.   I was released from PT last week.   My ROM is about 137 - 140 degrees for both knees. 

That all said - I still encounter problems with stairs.   After being on my feet for extended times - like today working on the holiday meals - my knee gets very hot and is very sore.    My OS and my PT doctor both told me that at 2 years I will be much better but it will take 3 years to forget I had this accident.   January 28th will be a year since I ruptured my patellar tendon.

[Chiropractor2001]

Thank you for your feedback...
So I guess I need to wait few weeks and see how it goes..
Thanks for sharing your feedback..