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peter826

In the parking lot (formerly "At the base lodge")
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Frank, I do have full ROM. I do need to stretch it a bit more than the un-repaired side though, if I'm going to do something like pull my heel all the way back to my butt when standing (I forget what this stretch is called). If I sit down on the floor, I can pull my knees all the way back to my chest. I can also kneel on the floor and sit back on my heels. My PT emphasized ROM over strength because he said after ~6 months, I wouldn't gain any more ROM. I'd have to dig back through this thread to see when I hit it, maybe about 15 weeks? We got to a point where we stopped measuring because I was past 130. I did keep working on it for some months past that point though, on my own. I ran out of PT visits rather early in the process, as my insurance only covered 20 visits. So much of my later recovery was done on my own.
 

n0ragrace

On the slopes once again
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Ben, so sorry to hear of your reinjury. That's something I think all of us in this "club" are afraid of. Did the reattachment surgery happen with the same structure as your first surgery? Is it a suture anchor in the kneecap?

Sometimes I'm worried that as the original sutures fade (I think the anchor in my patella is dissolvable) my muscles won't be ready to support me as much as they need to, or the tendon itself won't have widened enough.... hopefully it's just a fear and not a possibility.
 

martyg

Making fresh tracks
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Ben, so sorry to hear of your reinjury. That's something I think all of us in this "club" are afraid of. Did the reattachment surgery happen with the same structure as your first surgery? Is it a suture anchor in the kneecap?

Sometimes I'm worried that as the original sutures fade (I think the anchor in my patella is dissolvable) my muscles won't be ready to support me as much as they need to, or the tendon itself won't have widened enough.... hopefully it's just a fear and not a possibility.

According to peer reviewed, scholarly articles, re-injury is a 2% thing.
 

Old Runner Frank

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Agreed, fear of re-injury is a real concern. Besides Ben, this thread contains a few other cases of that devastating outcome. While finding the mental strength to get through this injury once is manageable, I can't imagine what it must take to endure it a second time. Ben, curious to hear how you are progressing, both mentally and physically. It's great to hear reports of returns to normal life and activities from those who have recovered, so thanks for that.

I saw my orthopedist this week for a three month (13 week) evaluation. He is happy with the apparent strength of the repair, and described my ROM as about the middle of the bell curve. He seems confident that I can make a full recovery over the next couple of months, and be back to running sometime in there. He pointed out that the ROM required for recreational running is not great, the issue being more the ability of the quad and tendon on the injured side to be able to absorb the considerable eccentric forces generated on landing. Seems like it's more important to make the best recovery than the fastest one.

I'm going to pare back on my PT appointments to two a week as I approach the limits on my coverage. I'm still doing acupuncture and laser therapy a couple of days a week, and continuing to work hard on my own. Hitting the elliptical trainer most days, which elevates my HR and gets me sweating a bit, and still doing a lot of walking. I can kind of make it around on an exercise bike (with a slight bit of cheating out of the seat), so I anticipate doing more of that. My ROM was just short of 120 degrees on Friday, and I now have tangible progress like being able to put on my sock on the injured leg, tie shoes, and walk up stairs with both legs, so nice to see some real-world improvement.
 

n0ragrace

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Frank, 120 sounds like a great place to be. My ortho told me that if I didn't have my full ROM back by the 2-month mark, I was never going to get it. He really scared me into those exercises! However, at the end of my PT, I was only back around 90% of what my uninjured leg had in terms of ROM. Interestingly, in the last two years, I've actually enhanced my ROM through quad stretches, strengthening, and rolling. I think a level of ROM has a lot to do with muscle flexibility rather than tendon length. It's good to remember that uninjured people can also have quad tightness, knee pain, tendon-induced weakness, etc.... and that you'll continue healing far after what you think the "healing stage" is!

A personal win for me has been successfully doing (and kind of enjoying!) lunge squats for the first time since my surgery. The isometric lowering seemed impossible for so long, but I've been doing them consistently for a week and am feeling super strong. Ever forward!
 

Old Runner Frank

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Thanks n0ragrace! I feel like I'm almost back to "normal," but my knee still feels tight, slightly numb from the surgical incision, and a bit weird. I would love to get to around 135-140 degrees ROM to match my other leg. You raise a good point that I have pondered: Where does the increased ROM come from? Seems like the ability to lengthen the tendon is quite limited, so one would need to lengthen the belly of the quad muscle by stretching, foam rolling, massage, etc. At your convenience, would you kindly explain what you mean by "lunge squats." Glad to hear of your continued progress.

Met a new member of the club in PT yesterday. He said he slipped going down a step and felt the dreaded pop. Made me wonder if it's the leg that slips that ruptures, or the other that suddenly supports ones full body weight. Mine happened so fast that I'm not really sure, but I would suspect it's the latter. Offered him some encouragement, telling him how much better I'm functioning at three months than I was at one.

Martyg, haven't seen you check in with a progress report in awhile. Things coming along OK? Hope you and everyone else are doing well.
 

peter826

In the parking lot (formerly "At the base lodge")
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Just checking in, one year after surgery. Life is pretty much back to normal. I have noticed a continual improvement in the last few months. Now, I am mostly trying to unlearn things I was doing to protect my repaired knee. For example, when getting in a car, I had picked up a habit of backing in, sit down, then swing legs in. Now, I'm climbing in per normal. I think my recovery would have been faster with more effort on my part, like more time in the gym. That wasn't really possible due to covid and having a family member at high risk. Got my first Moderna shot today, so maybe that is nearly over, as well. Good luck everyone.
 

Ben304

In the parking lot (formerly "At the base lodge")
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Feb 16, 2021
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8
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Iowa
Agreed, fear of re-injury is a real concern. Besides Ben, this thread contains a few other cases of that devastating outcome. While finding the mental strength to get through this injury once is manageable, I can't imagine what it must take to endure it a second time. Ben, curious to hear how you are progressing, both mentally and physically. It's great to hear reports of returns to normal life and activities from those who have recovered, so thanks for that.

I saw my orthopedist this week for a three month (13 week) evaluation. He is happy with the apparent strength of the repair, and described my ROM as about the middle of the bell curve. He seems confident that I can make a full recovery over the next couple of months, and be back to running sometime in there. He pointed out that the ROM required for recreational running is not great, the issue being more the ability of the quad and tendon on the injured side to be able to absorb the considerable eccentric forces generated on landing. Seems like it's more important to make the best recovery than the fastest one.

I'm going to pare back on my PT appointments to two a week as I approach the limits on my coverage. I'm still doing acupuncture and laser therapy a couple of days a week, and continuing to work hard on my own. Hitting the elliptical trainer most days, which elevates my HR and gets me sweating a bit, and still doing a lot of walking. I can kind of make it around on an exercise bike (with a slight bit of cheating out of the seat), so I anticipate doing more of that. My ROM was just short of 120 degrees on Friday, and I now have tangible progress like being able to put on my sock on the injured leg, tie shoes, and walk up stairs with both legs, so nice to see some real-world improvement.

Just had my 6 week follow-up and Doc wants me in the immobilizer leg brace for 8 weeks this time (was 6 first time) so a couple more weeks to go before I start getting some flex / physical therapy. He thinks it's looking OK but not sure what you can really tell at this point from the outside. It has definitely been some dark days this 2nd time around...maybe more so the first few weeks when I was in kind of a state of disbelief / depression that I'd done it again. I guess kind of a numb acceptance at this point, but it does also kind of do a number on the rest of the body too (hip / back) after hobbling around so long. Definitely looking forward to starting to walk "somewhat normally" in a couple weeks....at least we're to the point in the midwest where I shouldn't have to worry about slipping on snow/ice then!
 

Ben304

In the parking lot (formerly "At the base lodge")
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Feb 16, 2021
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Iowa
Ben, so sorry to hear of your reinjury. That's something I think all of us in this "club" are afraid of. Did the reattachment surgery happen with the same structure as your first surgery? Is it a suture anchor in the kneecap?

Sometimes I'm worried that as the original sutures fade (I think the anchor in my patella is dissolvable) my muscles won't be ready to support me as much as they need to, or the tendon itself won't have widened enough.... hopefully it's just a fear and not a possibility.

Yes, the surgeon said he used heavier duty sutures the 2nd time (did kind of make me wonder why not just use those to start with / the first time, but whatever...I'm no surgeon...). Cut right through the "old scar" / re-did holes the kneecap, etc. He said he had some cadaver achilles tendon on hand if needed, but apparently the tendon looked good enough that he didn't need to incorporate it. I guess I'll find out in the next couple months how round 2 goes, but do kind of feel like I've aged ten years in the last 6 months.
 

nighthiker

In the parking lot (formerly "At the base lodge")
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Harrisburg, Pennsylvania
Hey Gents, Nighthiker here. 15 months post rupture/surgery. Doing pretty well. I see some new guys have joined. Welcome. I hope you recover quickly.

So January 3, 2020 was my 1 year post op date (right knee). My other knee had been bothering me. Last follow up with the surgeon was 1/13/2021. I was complaining about knee pain/stiffness in both knees. He gave me a cortisone shot. It worked great. BOTH knees felt better (I guess it gets into your blood stream). Both knees started bothering me about 6 weeks later, especially my left knee. Saw surgeon again. Gave me a cortisone shot in the left knee. It felt good for about a day. Made another appointment with the surgeon. He recommended PT for the left knee and sheduled MRI. MRI result is a torn meniscus in the left knee. Going to talk to the surgeon in 5 days.

I think kneeling down on my left knee on our hard wood floors was the issue. I cannot kneel on my repaired knee. It is still too tender even 15 months post op.

The good news is when I did PT a few weeks ago they measured both knees. Left knee was 135 degrees. Right knee (repaired knee) was 134 degrees. Not bad. I'm leaning surgery for the left. Hopefully it is a quick recovery. I am 55 with some arthritis.

The quadricep tendon recovery was like inching my way through a marathon. Still not 100%, but getting there slowly.

Stay strong guys. You will get through it.

Blessings to you guys,
Nighthiker
 

n0ragrace

On the slopes once again
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Yes, the surgeon said he used heavier duty sutures the 2nd time (did kind of make me wonder why not just use those to start with / the first time, but whatever...I'm no surgeon...). Cut right through the "old scar" / re-did holes the kneecap, etc. He said he had some cadaver achilles tendon on hand if needed, but apparently the tendon looked good enough that he didn't need to incorporate it. I guess I'll find out in the next couple months how round 2 goes, but do kind of feel like I've aged ten years in the last 6 months.
Godspeed in recovery #2, Ben! If you've done it before you can do it again. Hopefully the time will move by faster this time around now that you know all the benchmarks to hit and how it feels when you get there. One of my favorite things about that immobilizing brace is how easy it feels to walk around everywhere straight-legged with that tight brace acting as a muscle. I hope your hip is well enough to help out with that - I definitely got some good walking in with that brace when the weather turned nice two springs ago.
 

n0ragrace

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Thanks n0ragrace! I feel like I'm almost back to "normal," but my knee still feels tight, slightly numb from the surgical incision, and a bit weird. I would love to get to around 135-140 degrees ROM to match my other leg. You raise a good point that I have pondered: Where does the increased ROM come from? Seems like the ability to lengthen the tendon is quite limited, so one would need to lengthen the belly of the quad muscle by stretching, foam rolling, massage, etc. At your convenience, would you kindly explain what you mean by "lunge squats." Glad to hear of your continued progress.

Yes, by lunge squats I mean the split-leg squats that are often done in a lunge-like stance... if you google "split leg squat" you'll see the results I was talking about.

I think a lot of ROM is limited by swelling and stiffness around the knee joint. After surgery I had some pretty constant swelling that I managed through a gameready ice machine at PT, but when it went down more permanently, I noticed those extra few degrees of ROM in my knee and the flexibility just felt so much smoother and easier in everyday activities. When I overwork my leg and get some soreness or swelling, I notice that the same ROM limit comes back. I'd try comparing ROM before and after icing to see if you have a similar situation going on.

As for the numbness, there are a few things you can try to "re-sensitize" the area of incision, like running different textured fabrics lightly over the skin to try and stimulate the nerves again (a rougher towel, a brush, etc) that my PT tried with me. However, I have a patch of skin that is still desensitized and can't feel heat nor cold. It's weird and I'm still not used to it, but it's possible that those cells will regenerate on their own in the future.
 

n0ragrace

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Hi folks, I don't mean to overload with posts, but I'm a little worried. I'm 2 years post-op (had the surgical repair in March 2019) and I think I overworked my knee over the weekend as I started to experience swelling and stiffness that wouldn't go down. I saw my ortho this morning and had some x-rays done, which showed that one of the drill holes where a suture attached has actually expanded, possibly due to an inflammatory reaction. Doc says that the hole was originally 1/16th of an inch and may have expanded up to 1/4 inch, and he's worried that if it continues to expand, it'll fracture the patella.

Have any of you run into this before? I'm disheartened and worried about whether I did something wrong, whether I might need surgery again, whether they'll have to take out the suture and redo the repair...

I have a CT scan next week and will revisit the doc in a week. I don't want to have to go through this all again - it's one of the hardest things I've ever done.
 

Old Runner Frank

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I want to express my appreciation for all the "alumni" who check back here to offer their support and advice. I hope to be able to do the same someday.

N0oragrace, I feel for your new issues, and wish I could offer advice, as you have been particularly encouraging, but I have no knowledge of how or why that could happen. Coincidentally, I had a discussion similar to this with my orthopedist at my last visit. I asked him if the holes in the patella weaken it, and he assured me that they are only 2 mm in diameter. I did not ask how many they make, but it seems they would have to create weak points, particularly if they start to enlarge, as in your case. I'll be interested to hear how your situation plays out.

I'm away for a few weeks, on a hiatus from PT. I just passed 16 weeks post-op, and am probably about 85% back to normal movement and ROM. It still hurts to kneel on my injured knee, but I was able to run/jog a little bit a couple of days ago, and am looking forward to trying more of that over the next few weeks. Like nighthiker, I feel that progress seems to be happening at a glacial pace, and I'm happy to hear that improvement is still possible past the four month mark.
 

Ben304

In the parking lot (formerly "At the base lodge")
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As a bit of an update after my re-tear / 2nd surgery.....doc had me in an immobilizer brace 8 weeks this time (although I admit to cheating just a slight bit out to about 20 degrees flex the last week as I just couldn't take it anymore...). 8 week post-surgery checkup today and in a more functional brace. I know I've got a long ways to go, but it sure feels good to get some flex...maybe about 50-ish degrees before it starts to feel really tight. If your the religious type....I'll accept any prayers for a full recovery and to never ever ever ever ever ever ever ever ever have to go through this a 3rd time... Best wishes and further healing to all of you battling though this injury!
 

martyg

Making fresh tracks
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As a bit of an update after my re-tear / 2nd surgery.....doc had me in an immobilizer brace 8 weeks this time (although I admit to cheating just a slight bit out to about 20 degrees flex the last week as I just couldn't take it anymore...). 8 week post-surgery checkup today and in a more functional brace. I know I've got a long ways to go, but it sure feels good to get some flex...maybe about 50-ish degrees before it starts to feel really tight. If your the religious type....I'll accept any prayers for a full recovery and to never ever ever ever ever ever ever ever ever have to go through this a 3rd time... Best wishes and further healing to all of you battling though this injury!

Best to you Ben. Check every box. Every day. For the next 12 months. Progressive and intense workouts while respecting the cell division process. Be a Ninja about recovery so you can hammer in the gym: 2g of protein / kg body weight, clean diet, stupid amounts of sleep, optimize your hormone levels to speed cell division and cell growth.
 
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Tricia

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Yes, the surgeon said he used heavier duty sutures the 2nd time (did kind of make me wonder why not just use those to start with / the first time, but whatever...I'm no surgeon...). Cut right through the "old scar" / re-did holes the kneecap, etc. He said he had some cadaver achilles tendon on hand if needed, but apparently the tendon looked good enough that he didn't need to incorporate it. I guess I'll find out in the next couple months how round 2 goes, but do kind of feel like I've aged ten years in the last 6 months.
Nice fatbike in your profile pic.
 

Old Runner Frank

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Checking in here to see how everyone is doing, and to provide a report on my progress.

I've been "running" again now for the past three weeks. It's slow, but thankfully not painful. Just happy to be back to my 40+ year routine, which includes functional strength and core training. Got back to PT and acupuncture last week, and saw my orthopedist for a four month check. I'm probably still around 10 degrees short of full ROM, and really tight. He expressed optimism that I can still recover full ROM, first by active movement, and eventually passively. I've been diligently working on stretching my injured knee and quad, plus foam rolling a few times a week. I find that if I stand facing away from a staircase and put the foot of my injured leg behind me and up a few steps, I can get a good stretch in my knee and quad, so I'm going to work that really hard for the next few weeks to see if I can continue to improve.

Hope everyone else is doing well. Please post your progress, as it's good to hear of everyone's journey.
 

Don379

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Hello everybody. New to this board. Had a quad complete rupture about 12 weeks ago. Repair done right away (next day) and rehab has been good but slow.
Visited the Ortho yesterday and was notified the repair was not done right. There is a gap between the quad and the knee which prohibits the lower leg from lifting, like the good leg.
The remedy is another surgery to fix. Very depressing to learn that. Getting a MRI and will look at other opinions. Rehab for another 12 weeks to get to where I am at now is awful.
 

martyg

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Hello everybody. New to this board. Had a quad complete rupture about 12 weeks ago. Repair done right away (next day) and rehab has been good but slow.
Visited the Ortho yesterday and was notified the repair was not done right. There is a gap between the quad and the knee which prohibits the lower leg from lifting, like the good leg.
The remedy is another surgery to fix. Very depressing to learn that. Getting a MRI and will look at other opinions. Rehab for another 12 weeks to get to where I am at now is awful.

Uggg! Buffalo. Now wonders. Originally from there. Escaped at 18 years old. Get an MRI. Book at The Steadman Clinic. Get on a plane.

This should be a simple repair / simple recovery.
 
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