Chronic Patella Tendonosis (help)

[Fists of Steel]

I am 25 year old PE teacher living in country N.S.W and before this year I have never had any knee problems. I was over snowboarding in whistler in January for 4 wks. About 2 wks into the trip I experienced pain in both knees just below the knee cap. This went on for the rest of the trip. I returned back to Australia to start pre season footy training and could only last 20 min due to the pain. I went to the local physio in town who prescribed orthotics. I lasted two games, after the last game I could barely walk for 2 wks.

I returned home (central coast) for the school holidays and saw a sports doctor who prescribed a rehab program(stretching, lunges etc), iontoferesis and nitrate patches.

After a few months I wasnt getting anywhere so I was referred to a sports doctor in Melbourne (closest major city). Where I had cortisone injections around the tendon. I now know this has the potential to weaken the tendon. It felt fine for a few wks then back to square one.

In July I went toNorth Sydney Orthopaedic and Sports Medicine Centre to see Dr Leo Pinczewski where I found out I had a condition called patella alta and a rather large tear in my right patella tendon. He recommended surgery to remove the damaged tendon. At this stage I was told I would be able to snowboard/surf by xmas no pronblem. Since the surgery in August I have been back a number of times. My knee has a large lump the same size of the cut it looks more like an elbow. Through my own research I now know surgery is the very last result which I was not told.

I live in rural N.S.W where there is limited resources in regards to obtaining treatment along with not enjoying my time in the country cause the town revolves around sport (no cinema, pool etc). The gym in town is 3rd rate which doesnt help rehab.
I havent ran pain free since xmas 06 and havent ran since April 07which has result ina weight gain of about 15kg. My whole life is sport and recreational activities even my job being a PE teacher is suffering. Its been a frustrating year!!!!!!!

Is it possible I will return to previous level of sport/recreation pain free?
Could I get some names of physios in Sydney who are experts in patella injuries and rehab?
Would it be worthwhile to see Dr John Orchard?

Any advice would be appreciated!!!!!!!!!!!!

[hmlb201]

I have had this problem for 2 years in both knees, from rugby, am now 22 was 20 when the problems started. Was playing for 2 sides with games on wednesday and saturday proved too much. Have had curtisone injects in both knees which does noughing. About 10 months ago i had surgery in my right knee, which was worse at that time. They cut the tear out of the patella just below the knee cap. Recovery takes ruffly 6 months. I tryed to rush it to get fit for my yearly indo trip surfing. Wasn't fit, need to give it the respect it deserves.

This particular surgery in my case didn't work that well, saw another specialist about my left knee this time, one month ago I had the position of my patella moved. It was screwed on further down my shin bone. Patella tearing just below the knee cap can be due to the knee cap being high riding, which it was in my case. Just started the recovery, hopefully the problem will be fixed.

In my opinion you should definately go for the operation. I tryed to build up the quads over one summer at the begining of the problems, came back to pre season jumped for a high ball and put another tear in. There comes a time when an operation is the option if you want to continue your sport.

The best of luck, if you do go for the operation don't make my mistakes. Treate your knee with respect. I hit the beers, didn't bother with a physio and tryed to make a magic come back too early, not good. My right knee is still weak and had to have a bigger op on my left.

[Rob N]

Fists of Steel:
I am trying to sort out what exactly was done to your knee in surgery. Was this a partial patellar tendon rupture. If the surgeon was removing the torn tendon, did he/she just remove/repair the torn section or did you get a nicy shiny (and swollen) reconstructed tendon. Functioning without any tendon certainly wouldn't do much to resolve your patella alta problem. What did your MRI say (did you have an MRI because it sounds like you needed one)? If you had reconstructive tendon surgery, then you should read the patellar tendon rupture section of this website (lengthy recovery, but full recovery can be there with hard work and a bit of good fortune). I'm not sure of the potential outcome for partial patellar tendon repair jobs.
A lot of the rebuilding of your quad can be done with a stability ball (squats, lunges, etc against the wall with the ball at your back), lots of cycling or spin class training, a leg press machine, free weights for walking lunges, etc). I suspect that you have access to this kind of thing in your rural area. It's nice to have a high tech gym in town, but the basic training post-physio can be done with the above noted items.
Rob N

[lanasweetio]

Hello,How are you doing today and i hope you are doing i am new member i am Lana you