/ Full patella tendon rupture

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Hardonicus 08 May 2019

Anyone had one? I fell down some stairs on a work trip. looking forward to an uncomfortable flight back from Germany now.

What's that long term outlook post surgery for climbing, cycling mountaineering?

Post edited at 17:39
gravy 08 May 2019
In reply to Hardonicus:

Tough luck - I hope it gets better.

FWIW I know someone who completely ruptured their quadriceps tendon and split their patella in a small stumble.  They had a repair within a few days of the accident and followed by six weeks in a "cast" and then six months of physio.  A year on you wouldn't know they'd ever had a problem (apart from the scar). The first few months after being "back to normal" high steps up or down we taken very carefully but I think this was fear as much as anything else - a few months later when full strength recovered there is no difference.

I think the success partially depends on the state of the tendon which the surgeon advised could range from "clean break" (good) to "toothbrush" (more difficult) and this isn't known until the time of the procedure.

In reply to Hardonicus:

Apologies for the delayed reply here - I missed this first time. Hardonicus emailed me and I gave him an account of my injury and thought it worth posting here for others who might search.

Firstly the good news, I have made what I would regard as a 100% recovery in fact, if a thing were possible, I would say it was around 105% recovery. This is because I had bad knees anyway before the injury so I tended to get pain in both knees when descending long walks. Now the knee that suffered the patella rupture is a bit less painful than the other one after long descents. My totally unqualified theory about this is that they kind of shovelled everything around in there when operating so the sore patches have moved a bit and are slightly less sore.

Now the slightly less good news. The consultant who operated on me said that it was easier to repair full clean ruptures (mine) than ragged or partial ruptures. It sounds like you have perhaps got not such a clean tear as this though so maybe the repair isn’t perfect. I would be surprised though if it didn’t fully repair, but I guess it may take more time. The consultant definitely said to me that my injured knee was now less likely to suffer the same injury than the other one. So basically the kevlar used in the repair makes it stronger than nature. I don’t know if that is the case with a ragged rupture but I don’t see any reason why not.

For recovery I was pretty shocked at the level of physio that the health service offered which was squarely aimed at couch potatoes. I quickly talked to the right physio (a climber) and asked him what to do myself so that I could stop wasting the time of the health service. He recommended a bike turbo trainer and time scale. 

During the recovery you have a flex brace on which you add some degrees of movement each week or so starting from 5 degrees to around 90 degrees. I actually started on the turbo trainer pretty much as soon as I had enough movement to complete a pedal revolution. This was probably at around 70 degrees or so - I can’t remember exactly. I did very low level exertion, just movement, and kept that going for batches of 30 mins two or three times a day. After a week or so I was out of the flex brace. This was almost exactly 2 months since the operation. I gradually lengthened the sessions and the level over a period of 6 weeks working from 2 or 3 x 30 minute sessions, to hour long TV episodes on the iPad and pretty full tilt at the end, but only once a day by that time. 

My first indoor auto-belay climbing was 68 days after the injury, first outdoor bike was around 90 days after the injury. I went on a climbing trip at around 120 days after the injury and was climbing back at 7a having had a lot of indoor session by then, but the approach walks were difficult and surprisingly tiring. I would say it wasn’t until the summer, so a full 6 to 7 months after the injury, that I was walking back at normal. 

Now the only thing I have is a scar and the same slightly dodgy knees I had before, only the right one not quite as bad!

Alan

jon 12 Jun 2019
In reply to Alan James - UKC and UKH:

You should start an injuries, operations and illnesses forum, Alan. I'm sure it'd be well subscribed.

Post edited at 13:49
gravy 12 Jun 2019

Hardonicus:

Not my experience but someone I know:

Full rupture of the quadriceps tendon (so the tendon above the patella rather than below).  It was repaired by surgery in a few days, six weeks in a splint, 6 months physio and recovery and pretty much as good as before the accident.

The transition to full strength towards the end was gradual because of a psychological reluctance to stress the knee too much but this wore off after a few months.  The originally impressive looking scar is now hard to see 2 years later.  Caveat the rupture in this case was clean, I understand the remaining tendon can sometimes fray and this makes the repair more difficult.

Be patient, it will take sometime but the outlook is probably ok

Hardonicus 12 Jun 2019
In reply to Hardonicus:

Thanks all. My only niggling concern is that I have a ragged tear and metal implants in my tibia and I can't find any information about outcomes for this variant.

I'll post up in a few weeks/months on my outcomes for any others coming across this issue.

Post edited at 22:08

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