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  • Patellar Tendon Rupture.....

    Okay here goes...

    On May 9th I was playing basketball with some friends, lost my footing on some wet ashphalt and felt a "snap" in my knee. It hurt immensely. I looked down to see the kneecap about 3-4 inches higher than what it should be. I went to the hospital, xrays were done, and the ER doc said that I had ruptured the patellar tendon. They put it in a Zimmer Splint. (foam and velcro wrap with metal re-inforcing on the back and sides)

    I saw an Orthopaedic Specialist 2 days later (this was the soonest I could get an appointment). He took a look at the knee and the xrays and said that I had likely ripped the tendon off of the bottom of the kneecap as opposed to tearing it mid tendon. He said that it was a good thing as it is a stronger fix when it tears off of the kneecap.

    Surgery was scheduled for the 18th of May. (9 days after the injury) The surgery was delayed due to swelling and the fact that I had some exams to write for my schooling. It was the first time ever for surgery. Everything went well. The Orth Surgeon came into the recovery room after I came out of anesthetic and explained what he had done. The tendon was sutured and passed through 3 bone tunnels in the kneecap and anchored above the kneecap into some muscle tissue. He said the procedure went well....no complications.

    The knee was locked in extension for 2 weeks using the Zimmer. During this time I was not to do anything. At 2 weeks the staples were removed and I was switched over to a hinged knee brace (still locked in extension).

    I started PT 6 weeks post-op. Our goals were 30 degrees flex and full passive extension for the first 2 weeks, and 45 degrees flex and full passive extension for the next 2 weeks. Weightbearing was allowed as tolerated. PT consisted of passive range of motion exercises, ultrasound, high voltage stimulis, and ice. Our goals were met with quite a bit of screaming on my part to get the 45 degrees.

    On June 30th I had a check up with my Orth Surgeon. He said that thing seem to look OK, and that we can proceed with full active flex and active ext to 120 degrees. He did express some concern about the amount of scar tissue. I told him about the pain experienced during PT and he stated that it will be rather painful trying to get the range of motion back because we literally have to tear through the scar tissue that has formed. I asked if it was wise to take my painkillers left over from after the surgery before PT. He said to go ahead.....at this point he is confident that the repair will hold, and any pain experienced will be from scar tissue only, not to worry about re-damaging the tendon.

    Over the past 2 weeks we have gained about 15 degrees more...so up to about 60 degrees. It has been extremely painful trying to get more range. I am "walking" with almost no weight on the single crutch. I am able to do straight leg raises with no extension lag with some pain. I am also able to do leg extensions while hanging the leg off of a chair...also some pain. I can bear full weight while balancing without the knee brace. PT now consist of the same as before, but with added quad strengthening excercises. We are hoping to have enough stabilization next week to discontinue the use of the knee brace.

    I was wondering if there was anyone else out there that has had this injury and what their experience was like. Does anyone have any secrets to being able to bear the pain of ripping through the scar tissue?

    Thanks....

    Peter

  • #2
    Well on July 5 I was playing basketball and went up to dunk the ball. I heard a pop in my right knee and then a pop in my left knee. I looked down and noticed that my knee cap rode up by my quaracipes. I automatically thought I had torn an ACL or something. I was rushed to the emergency room and was diagnosed with a bi-lateral ifra-patellar tendon rupture. I was operated that night and came out with good news of the operation. I am now on my third week and can bear weight on my feet. I wear knee emobilizers and just stay home all day. I have to wait for the third month to start my PT. I did get my staples removed and the doctor did try to bend my knee a little bit and boy was it painful. Atleast you have one knee to worry about but as for me I have both so I guess there was a two for one special that day. But I'll have to get by. What doesn't kill me won't hurt me, well maybe a little bit.

    Comment


    • #3
      Patella tendon rupture

      I ruptured mine (right knee) about 3 years ago and had a similar experience, altought rehap started about week 5. I was particularly frustrated by the lack of 'aggressive' treatment in re-hab; I didn't care about the pain because I knew that each round of streching and pain just meant more movement in the future.

      I recently had the same injury occur in my other knee, so I'm back at it again. I'm starting week 4. There was more post-op pain with this one - I think because the rupture occured at the tibia (point of tendon insertion), rather than along the tendon itself.

      Comment


      • #4
        Pretty unlucky for you to rupture at the tibial end. Normally the patellar tendon is very strong there.

        Comment


        • #5
          Ruptured Patella Tendon

          Hi Peter

          Just read your posting of a year ago and wondering how you got on, have you fully receovered or still having problems

          JohnK/ Manchester UK 1/5/2006
          Jkramrisch@aol.com


          n May 9th I was playing basketball with some friends, lost my footing on some wet ashphalt and felt a "snap" in my knee. It hurt immensely. I looked down to see the kneecap about 3-4 inches higher than what it should be. I went to the hospital, xrays were done, and the ER doc said that I had ruptured the patellar tendon. They put it in a Zimmer Splint. (foam and velcro wrap with metal re-inforcing on the back and sides)

          I saw an Orthopaedic Specialist 2 days later (this was the soonest I could get an appointment). He took a look at the knee and the xrays and said that I had likely ripped the tendon off of the bottom of the kneecap as opposed to tearing it mid tendon. He said that it was a good thing as it is a stronger fix when it tears off of the kneecap.

          Surgery was scheduled for the 18th of May. (9 days after the injury) The surgery was delayed due to swelling and the fact that I had some exams to write for my schooling. It was the first time ever for surgery. Everything went well. The Orth Surgeon came into the recovery room after I came out of anesthetic and explained what he had done. The tendon was sutured and passed through 3 bone tunnels in the kneecap and anchored above the kneecap into some muscle tissue. He said the procedure went well....no complications.

          The knee was locked in extension for 2 weeks using the Zimmer. During this time I was not to do anything. At 2 weeks the staples were removed and I was switched over to a hinged knee brace (still locked in extension).

          I started PT 6 weeks post-op. Our goals were 30 degrees flex and full passive extension for the first 2 weeks, and 45 degrees flex and full passive extension for the next 2 weeks. Weightbearing was allowed as tolerated. PT consisted of passive range of motion exercises, ultrasound, high voltage stimulis, and ice. Our goals were met with quite a bit of screaming on my part to get the 45 degrees.

          On June 30th I had a check up with my Orth Surgeon. He said that thing seem to look OK, and that we can proceed with full active flex and active ext to 120 degrees. He did express some concern about the amount of scar tissue. I told him about the pain experienced during PT and he stated that it will be rather painful trying to get the range of motion back because we literally have to tear through the scar tissue that has formed. I asked if it was wise to take my painkillers left over from after the surgery before PT. He said to go ahead.....at this point he is confident that the repair will hold, and any pain experienced will be from scar tissue only, not to worry about re-damaging the tendon.

          Over the past 2 weeks we have gained about 15 degrees more...so up to about 60 degrees. It has been extremely painful trying to get more range. I am "walking" with almost no weight on the single crutch. I am able to do straight leg raises with no extension lag with some pain. I am also able to do leg extensions while hanging the leg off of a chair...also some pain. I can bear full weight while balancing without the knee brace. PT now consist of the same as before, but with added quad strengthening excercises. We are hoping to have enough stabilization next week to discontinue the use of the knee brace.

          I was wondering if there was anyone else out there that has had this injury and what their experience was like. Does anyone have any secrets to being able to bear the pain of ripping through the scar tissue?

          Thanks....

          Peter[/QUOTE]

          Comment


          • #6
            Hi Peter

            Having just read your posting, noted that you had a RPT some 9 months ago. What is todays situation?? did you recover 100% or are you still having problems.

            Best wishes
            John Kramrisch Manchester UK
            Jkramrisch@aol.com

            Comment


            • #7
              Dee - Pensacola

              I to join the band with this injury. I am due to have surgery May 8th (unsure) I cannot bend my knee @ all much discomfort. Drs visit I could not extend my any means. With searching online I found this site and I see I am not the only one. Wish me luck all that read this.

              Comment


              • #8
                Had surgery in March of 2005...

                Had a complete rupture falling down a flight of stairs and had surgery 4 days later.
                I started PT 4 weeks after surgery and was released from therapy 4 months later.

                By August of 2005 I was jogging, playing softball, and weight lifting. I am 40 years old.

                This morning I ran 5 miles on the treadmill and played softball in the evening after a full day of work.

                The knee still doesn't feel "right"...not painful, but not "right". It probably never will
                with all the scar tissue involved with the healing. But I'm as active now as I've ever
                been. I guess I could describe the feeling as if you had a wad of Play-Doh stuck in
                your knee. I know it sounds weird...but that what it feels like to me.

                Good luck in your surgery and don't get too depressed. Just find a good theropist
                that you have a good relationship with. This is crucial to your rehab. And do the
                exercises they tell you to do at home.

                Larry in Maryland

                Comment


                • #9
                  Originally posted by Unregistered
                  I to join the band with this injury. I am due to have surgery May 8th (unsure) I cannot bend my knee @ all much discomfort. Drs visit I could not extend my any means. With searching online I found this site and I see I am not the only one. Wish me luck all that read this.
                  Dee:
                  It is a very serious injury that takes considerable time and patience to deal with. I ruptured my left patellar tendon in mid Jan 06 and actually could walk around slowly with the very swollen knee - but it was putting increasing stress on the other ligaments and the MRI confirmed the complete tear. I had surgery in late February (5.5 wks post injury)including a hamstring graft to reinforce the tendon. First 10 days I stayed off the leg entirely. Next three weeks very passive physio you do on your own moving leg to 45 degree ROM and feather weight on left leg. The following four weeks involved more passive physio with leg bend to 90 degree ROM and 25% weight bearing on. I was fortunate that I did not have any significant pain outside of the first 3-4 days after surgery. Next 6 weeks (weight bearing as tolerated) I went from 2 crutches to 1 crutch over the first couple of weeks, then 1 week with a cane before I started walking. I have gone from 90 degrees to 140 by just doing gradual 30 sec holds 3x10, 3 times per day. Started riding the stationary bike with no resistance halfway through this period to improve ROM (2X25mins per day). I'm around day 100 now and hopefully the doc will okay squat exercises (biking with resistance, etc) to rebuild my quad shortly. Once you get walking the swelling comes out of your ankle and life gets a whole lot better. I never figured out how to carry a plate while using both crutches - just didn't work. I'm still pretty fragile but seem to be moving in the right direction fairly quickly now. It will be time consuming to rebuild the quad.
                  All the best on your surgery and rehab.
                  Rob

                  Comment


                  • #10
                    Now I am in the same boat!

                    On Friday I went to a wedding pre picnic and have never injured anything in the past. I snowboard ski mtnbike and bball. I made a hard cut to the bucket and collided with they other person, LORD I have never felt pain like that. One ambulance later and I was at the hospital on morephene, within less than 24 hours I was in surgury. So now I am sitting on the couch trying to heal and I can say the surgery went apparently good it was a BAD tear from the bottom of the bone. I can say that Vicodin SUCKS it make you feel like crap and all stuffed up. I am hopefil to go to the doc on friday so he can check the bandage. I am having all kinds of issues because I am normally active so mentally it is hard to deal with. I still have my trainer come over every other day to train my upper body. Looks like I will be on this board alot more in the comming months.
                    Thanks,
                    Brian

                    I know what you are going through let me knwo if you need any support!

                    Comment


                    • #11
                      Brian:
                      You are fortunate to have surgery so quickly following the injury - which generally improves the odds of a good outcome and reduces the atrophy time for your quad. It took me a couple of weeks to mentally understand the scope and severity of the injury. I suggest that you concentrate on passive range of motion exercises- these are crucial (as per your physio), RICE (rest, ice, compression, elevation), and not doing anything to tear the fine work of your surgeon. You will be in a very fragile state for at least the first 10 to 12 weeks and need to lie low on resistance training until your surgeon says that the tendon has fully healed (probably start low resistance cycling around week 11 - buy a stationary bike).

                      Life improves substantially after that point when you can crank the resistance on the bike, (should be walking without a device), head to the gym & physio and start seated squat/hamstring, straight leg pully, and other resistance exercises (as well as full body weight exercises). I have had my first week of resistance training and have already improved to about 3X the initial first day weight (e.g. 90lbs one leg seated squat). I will probably start road riding in another week.

                      In your current circumstance I suggest the following: keep a positive attitude - take a shower every day (change dressings daily- no infection) after the surgeon okays it - make sure you have help to get in and out of the shower, for meals, etc - keep the crutches near your bed in case you head to the washroom overnight (night light helps) - have access to the maximum TV-movie-sodoku/Xword/book selection. You will likely be off work for 3-to 4 months. Use the time to mentally recharge as recommended by Ernie Els (Golfer) who tore his ACL boating last August and was back golfing in Dec. Lay off the beer and colas (and overeating vs activity ratio) to minimize the coach potato weight gain (e.g.Diet Pepsi, water) and overnight trips to the washroom. Also use extreme care on stairways. I used the crutches to climb them with someone right behind me going up, and felt the safest sliding down on my back side step to step going down until I could weight bear 100% and go down standing up. Crutches going down narrow stairs seem really risk to me. Be careful with your uninjured leg. You will be putting a lot of pressure on it until your weight bearing improves.
                      Rob

                      Comment


                      • #12
                        patellar tendon.....snap

                        hey guys, reading your posts has given me some outlook on how things will go. i am a medical student at msu and ruptured my patellar tendon this last week while playing kickball. i know....kickball. it was a med school student event so i was surrounded by my classmates, which was nice and not so nice. i didnt think the intial pain was that bad. i mean it hurt, but maybe i blocked it out in hopes of not looking like a punk. we have been studying the nuero-muscular-skeletal system this summer so we all had an idea of what happened. i was hoping it was just dislocated, but then one of our drs was playing with us and he ran up and was like get him to er. he explained to me what had happened and all i remember was dreading the rehab. er confirmed what i was already told. my family came and picked me up and now im near home. we have a family friend orthopod who got me in today for an office visit. the injury was friday. the surgery is scheduled for tomorrow at 3. im hoping things go well and scarring is minimal. i will keep you guys posted. please continue writing as well, its encouraging to see others going thru your hell. it helps make you realize, it will be ok. good luck to all of you and lets hope for a speedy recovery for all!!!!

                        Comment


                        • #13
                          ASAD:
                          I hope your surgery went well. You guys in the states seem to get the fast surgery (things are not as quick here in Canada). Try to make the most of the rehab time in terms of spending time with family and friends, mentally recharging, etc. After four months of rehab time, I've had my second day on the road bike and enjoyed it immensely (a lot better than the stationary bike). I passed a deer on the side of the road yesterday that came to watch the spectacle of the rehab rider whizzing by.

                          I averaged 27 kph for a 30km ride today on moderate rolling terrain (between 32-34 kph preinjury -I'm definitely to stay away from the hills for now, but completely flat terrain is hard to find - pat tendon is holding up well so far). Since I am embedded on my seat and can't push it by standing on my pedals yet, it was a pretty good ride. It can be a bit of a task to get on the road bike. I clip in with my rehab leg and then push off with the other to get going. I had a doctor recommended biodex test last week which indicated that I had only 30% on leg extensions and 55% on ham contractions compared to my non-rehab leg. My rehab didn't think much of the test since the ACL protocols recommend staying away from this type of open chain leg extension exercise until your leg gets stronger. The test at least gives a baseline to measure improvements.

                          But I am pushing 110 lbs with my rehab leg alone on the seated leg press (230lbs both legs), 50-60lbs one leg seated hamstring machine and 135 on the squat rack, so my strength is improving on the closed chain exercises. 10lbs on the rehab leg seems heavy right now on the open chain leg extension machine. That will need a lot more time to come around. I can climb stairs okay, but I need big wide non-steep stairs with a good railing to practice going down stairs. I will work on that at the Y again tomorrow since they have 6 flights of good stairs to practice on. I am pleased that the intent of all is to get my leg back to full strength. I have extra work to do since I had a long layoff period and consequently substantial atrophy. Most of the rehab work (90%) is up to you to do on your own. The physio just lays out the exercises. I recommend documenting your rehab (date, activity, sets, # of reps) and make sure you don't leave physio until receiving and writing down the list of exercises, sets and # of reps per day that match the changing limits your orthopod gives you as you progress through the rehab period.

                          As for your circumstance now, I needed the painkillers every four hours for the first four days post surgery and then I was fine without them. They probably will have you take some sort of aspirin once a day for 3 weeks to prevent clots. Keep that knee from getting jostled around or hanging unnecessarily (the weight of the leg will bother you for a while if it hangs off the floor). The first change of the dressing can be tricky since some blood may dry to the dressing. Soaking the dressing repeatedly with a wet (warm water) face cloth and gradually peeling back the dressing as it softens worked well for me. I only had to do that once.

                          After your wound has completely healed, a punctured vitamin E gel capsule spread on top of the seam once per day with a bit of moisturizing cream has worked well to make the scar fade. Range of motion is key so work hard on your physio. I hope all goes well for you.
                          Rob

                          Comment


                          • #14
                            Jonatan

                            Hello everyone!

                            This was a good site for me to read. I ruptured my tendon three months ago, and then i did it once again after two months when the worst part of the recovery was over. I managed to fall on a wet spot, of course it had a really big impact for my motivation to recover. The surgery I had was similar to what many of you other have described, and the rehabilitation training as well. I live in Norway by the way, make my living as a proffesional handballplayer so an injuery of this magnitude has of course a big impact on my life. My fysio tells me that if I do my training, I will probaby recover and be able to play handball again, at proffesional level.
                            Anyway as I wrote in the beginning it was very comforting to hear that the injury existed somewhere else and that it is possible to get back to an active lifestyle again.
                            Hopefully Im can write again in a few months and give some pointers to a fast and full recovery.

                            Comment


                            • #15
                              Is this normal procedure?

                              I ruptured my PT while playing basketball on May 25 of this year. I had surgery a week later, and had a follow up exam a week after that. At the follow up I was told to keep the leg straight, and the knee brace locked for 1 month. I read of others on this site beginning rehab much earlier. Is it normal to begin rehab a month after surgery? I'm curious to know, since I'm worried about loss of motion in this knee. Also does anyone know about bromalene, and it's ability to breakdown scar tissue. This is my first venture at any sort of rehab, so I don't know what to expect. Will a CPM be used in rehab, or will I be forced to bend the knee on my own? I have so many questions, and not many answers. Can someone help me to understand how big this battle will be?

                              Comment

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