Patellar Tendon Rupture.....

[Rob N]

mham:
I was not allowed to use an active quad for concern that it would tear the reconstructed tendon. I did not have a wire, but I had a hamstring graft. The recon tendon including the graft is fairly fragile for a few months. The wire may very well help reduce the chances of a tear - but there are no guarantees. You have to stick to what your doc tells you to do. We have had some unfortunate incidents of re-ruptures, so use great care.
Rob N

[mham]

Thanks, Rob. I understand that my surgeon is fairly aggressive with the rehab. My wife tore her ACL and meniscus 5 years ago and he did her surgery also, so we are experienced with his protocol which is to get you up and moving ASAP to avoid muscle loss.

In this instance, the surgeon is adamant about the cable protecting against retear (and said he's never had a retear with the cable--knock on wood!!). But, I must admit that reading all of the posts on this site gives me pause at least to a certain extent. I cannot imagine the burden of going through that surgery twice, mentally or physically. I guess all I can do is follow his guidance but also take great care to avoid falls, etc.

I do wear the brace all of the time except when I'm doing the sliding heel exercises (6 x per day). My wife thought I may have had 60 degrees late yesterday during my final round of these excercises. I'm sure the lack of grafting makes me more comfortable now than you would have been at this stage--the only really painful part for me now is when I'm doing the ROM exercises. Otherwise, just general discomfort. I take a tylenol from time to time but that's about it right now. Also finding that I can walk without crutches around the house fairly well now. The bad leg can take full weight without much pain--just not as good balance yet.

My biggest issue right now may well be sleep. I am having a hard time getting comfortable since I'm either on my back or rolling slightly onto each side, at which point the metal on each side of the brace creates pressure points and gets tangled in the pillows, blankets etc. Any thoughts as to positions, pillows, sleep aids, counting sheep, etc? Would be great to sleep through the night for once (don't think I've done that since I tore the tendon two weeks ago tomorrow).

[Rob N]

Mham:
I slept 100 straight days on my back before things were comfortable enough to sleep on my side. Trust me, you will get tired enough to sleep on your back after a while. I had a soft smaller post surgical brace (no pins for ROM setting) that I switched into at night for sleeping. I found the larger brace with pins very uncomfortable for sleeping and I never slept with it on. I used a couple of small thin pillows around my leg to try to make things more comfortable. Let's face it, its going to be uncomfortable for a while. There isn't a miracle solution other than time.
Rob N

[boderek]

Hey Everyone -

Just want to do a progress report, so far so good according to my surgeon - From everyone's posts, it seems like I'm in the range of where most people have been at this stage.

Jun 5 07 Rupture patella tendon playing soccer
Jun 13 07 Surgery to repair/reattached tendon - no wire, no graft necessary
Leg locked in full extension with cast
July 12 07 4 weeks post-op - 30 degrees ROM
Remove cast - Leg remained locked in full extension
Goal: PT 60 degrees max ROM and 20% weigh bearing (w/ crutches)
July 19 07 5 weeks post-op - 52 degrees ROM
July 26 07 6 weeks post-op - 70 degrees ROM
Leg locked in 0-30 degrees; Walk with single crutch
New Goal: PT full max ROM and 100% weigh bearing (no crutches)

I was very excited that my surgeon allowed me to start trying to walk and up my PT. Pain has been minimal during PT, but it's early so I am sure that will change.

[Rob N]

Boderek:
Nice progress. Concentrate on building ROM. Slow and steady. I did three sessions of passive ROM each day at home - logged it in a book day by day. When you start doing the tin can exercises, then your beginning the quad rebuild. I only spent a week with a cane before starting walking with only a brace. Once you get around 120 degrees (hopefully by week 10), then you will likely be allowed to start spinning on the bike without resistance, which will also help build ROM and let you burn some calories at last. It's nice to be able to walk to the table and carry a plate of food with you. Or to stand in the shower with full weight bearing on both feet. We get a chance to appreciate the simple things.
Rob N

[bluetitanfive]

Hey peter

My name is David and im from Melbourne. 2 months ago i injured my knee in a soccer i game. I was holding the ball with my right leg and pivoting on my left when i went to far with my right leg towards the left and i heard a snap. I went to the hospital in a ambulance and they didnt know what it was. I then went to a GP and he sent me to the physio where it was a waste of time because there was no progress. I then went and got a MRI where it was then discovered that i tore my patella tendon and strained my ACL and tore my cartilage. ("sounds like i was in a car accident not a sunday game of soccer") Today i went to see the specialist two months later..........("because no knew what it was") and he told me not to play soccer again and he said that i may not be able to get 90 degrees ever again. He also said that i am prone to deep bone thrombosis, infections in my knee and lungs etc I was wondering did your surgeon say any of this to you or tell you that you couldnt play basketball again. Can anyone also tell me of any good surgeons in Melbourne??????

Thanks

[debbied]

Wow you only have to go away for the weekend and look at all the posts!!


Haven't had much time to read in depth but looks like people are doing ok.
mham, the issue of sleep is a big one. Like rob I spent a considerable amount of time sleeping on my back, for the first 2 weeks I had sore points on my back, as I am quite slim, however the body did reajust, loads of pillows helped. Even though my surgeon told me to take the brace off at night, I did not dare for 8 weeks, I did find it helpful to loosen it though as it gave me a bit more comfort.

Hi eugene, sorry about your injury, when I did mine it was at the end of the athletics season and I also had good quad strength, however 10 months down the line my injured leg quad is not fully recovered and is still without the nice thigh sweep of the left leg. With your physio and surgeons ok, I would suggest you do as much walking/ weight bearing as you can if you want to return early to running. There appears to be 2 schools of thought on repair and rehab of the patella tendon, some have full rom but cannot walk well or weight bare well, some don't actively work extensively on rom but are able to walk and weight bare well. I fell into the latter category, from the first 3 days I was hobbling around on crutchs and would gradually build up my steps I have to say at this point extreme caution when using steps,stairs, slopes etc and listen to your body. ( i had a wire to strengthen the repair which was removed at 12 weeks and leg brace during this time). At 10 weeks I could walk without crutches and keep up with my 10 year old for 3 miles.

When it comes to running you will definately do it again and do it well. If you are a distance runner then you will be fine. I started running again after 5 months building it up slowly 100m at a time, its scary to start with and it feels so wrong but running will strengthen the patella , in addition to building up your running make sure you work on knee stability exercises, in order for your knee to take the additional forces of running this will have to be done daily. 10 months down the line and I am competing in athletics again, although not in the distances and events I did previously, I will have to wait another year before I will be trying long and triple jump. I did a 100m just to see where I was, last season I ran 13.7 which is ok for a 40 year old woman on saturday I did 15.1 I cant get down in the start position yet but when I get going I am almost back to normal. I also had to run a 1500m which is definately not my distance, unbelievably I bettered my previous personal best by more the 4 seconds and I wasn't last! So you see certain parts of my running have improved and I didn't even think I would ever get my spikes back on. I am confident that by about the 8 month stage you will be almost training normally if you are sensible now and listen to your surgeon and physio.

All the best to everyone

Debbie

[eugeneowen]

Thanks Debbie,

It's fantastic to hear how you have return to athletics. I do endurance sports (triatlon, ultra marathon, mountaineering) so I'm not too concerned about my 100m time but it's excellent to hear how you can still run fast. And that I may run a marathon again. Cycling is my favoured part of traithlon so I will take a long time off running and just swim and bike initially anyway, as Rob (and the surgeon) suggested. But it is good to know the running will be possible even if only in 9-12 montsh time. I can't believe you want to tripple jump - just watching the UK trials on TV made me nauseous to think about it after my injury. My ankles are to screwed from rugby anyway to even attempt that type of activity! Very brave!

I am now starting week 4 post surgery and I have no pain (never had bar day one) and discomfort at all, and can weight bear on the leg in the cast (even without cructches). I was advised not to load fully so I am using my crutches full time. Since the swelling has gone down I have been doing quad contracting excersizes with straight leg and was told by surgeon this is OK in moderation - I have no tendon pain when doing them, maybe on rep 3 I can feel where he stitched my capsule back together on the sides from the secondary capsule tear, but the tendon is pain free touch wood. I can't wait to get out of this cast in 3 weeks time and start PT.

All the best everyone and good luck with the rehab.

[Rob N]

Bluetitanfive:
My surgeon also said that I would have 90 degrees ROM and would not cycle competitively again - if I could cycle at all. I have basically full range of motion (heel within 2 to 3 inches of my behind) and I am riding personal best times and even hitting the podium. I plan to return to playing some ice hockey in the fall. So far, so good. I just ignored the surgeon's gloomy statements and kept believing that I could come back if I worked really hard on the rehab. It is working out for me, and hopefully will for you too. Most people who are somewhat athletic and work hard on their rehab that have been on this website, seem to make close to full recoveries. Realistically though, it tends to take 1 to 2 years to rebuild the quad if you have substantive atrophy and the rehab takes a lot of effort and especially commitment. You can do most of it on your own with proper direction from a rehab and later a kinesiologist/training plan.
Rob N

[mcneilltj]

Hello Guys,

Well I have surgery tomorrow to remove this cable, wish me luck. This completes another stage in this saga. It's time for quad building.

McNeilltj
Seattle, Washington