TKR Patella tendon rupture

cateonthec

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Jul 19, 2017
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I had my TKR on June 13th, everything was going smoothly until the early morning of July 3 I was walking to the washroom and boom next thing I knew I was down on the floor with a ruptured patella tendon. The same doctor went in and fixed the patellar tendon on July 5. Now I need to keep my leg straight for the next six weeks which is the total opposite of what I should be doing for the TKR. Has anyone else had this happen, know of anyone that this happened too :(
 
Hello, welcome to BoneSmart. In advance of someone with direct experience, let me give some optimism. The new joint itself is unaffected. Your soft tissues will take time to recover after the six weeks, but recover they will.

And our general reading for TKR patients...

Knee Recovery: The Guidelines

1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now; they are almost certainly temporary
2. Control discomfort:
rest
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)
don't overwork.
3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​
4. PT or exercise can be useful BUT take note of these
5. Here is a week-by-week guide for Activity progression for TKRs


The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?

Energy drain for TKRs

Elevation is the key

Ice to control pain and swelling

Heel slides and how to do them properly

Chart representation of TKR recovery

Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery. While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.
 
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cateonthec,
Welcome to BoneSmart, glad you joined us!
We have members who have ruptured their patellar tendon, they have done well with with normal ROM and function. Just takes a little longer to heal.
@PegGar16 had a ruptured patellar tendon, @KarriB had to wear a brace. Both wore their braces for an extended time, they have great ROM. They will be along with their experiences.
Letting your knee heal and swelling going down is what gets you ROM.
Read the guidelines Roy left for you. Rest, Ice, Elevation, and Medication on schedule as prescribed is best right now.
 
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I did not tear/rupture a tendon, however I did have an infection in my TKR which meant a washout surgery and then 4 weeks in an immbolizer brace. I worried whether my TKR would ever bend or if I'd walk like a pegleg pirate the rest of my life. But my OS said the knee would bend when we told it to bend and it DID! It was stiff at first and my OS prescribed non-aggressive PT and I was able to return to work half days a month after the brace came off. PT did go on for a few more months, but it was still gentle until 4-5 months post op when I did some strength training due to a weak leg.

That summer I was riding my bike and swimming laps. I'm still riding my bike daily, swimming laps and walking 45 minutes (when it's cooler). I'm sure @PegGar16 will stop by as she had the same issue as you with an additional infection.
 
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I had a severed patella tendon, fractured tibia plateau, and fractured the patella bone all in my right knee in an accident. I was in an immobilizer brace and non weight bearing for 3 months and I eventually gained most of my ROM back. It took a while but I got there. While my right knee didn't match my left knee in ROM, it didn't hamper any activities. I know my situation is not quite the same, but the trauma to the knee area is and ROM will come back.
 
Good morning! Do not worry about the TKR, it will work. The priority is to let the tendon completely heal. I had the leg immobilized for six weeks and then they gradually adjusted the flex on the brace, 30 degrees every other week, so I slowly started bending it again. My TKR is working fine:) Welcome to BoneSmart!
 
Wow!! Thank-you all for your lovely responses. I don't feel alone in this and I am encouraged to hear that I will get back a pretty good ROM. I want to be able to ride a bike and go for a long walk. Not looking to snowboard or become a trampoline star, just a bike ride once in a while.
Again thanks everyone.
 
That has to be scary. It is nice that found some people with a similar experience to reassure you. I am only 3 days after you on June 16th
 
I was down on the floor with a ruptured patella tendon
Now that's rather disconcerting for you. Was it just the tendon that gave out or the bone of the patella? And if the latter, had you had a it pinned and wired? Did you have a patellar button applied to the bone?

May I also ask, had your PT been pushing on your leg to get a good bend?
Now I need to keep my leg straight for the next six weeks which is the total opposite of what I should be doing for the TKR.
No, as far as the TKR is concerned, you'll do fine. BUT the ORIF (open reduction and internal fixation) of the patella will be tough to recovery from. But don't let it get you down or feel frustrated. It will, ultimately, be perfectly okay!
 
To be honest I'm not sure, but as far as I know the tendon was the the only issue. I haven't seen the surgeon since the surgery to repair the tendon. I have an appointment this week so hopefully I will have a better idea after that. Thanks for your encouraging words.
 
I had both kneecaps removed. One in 91 and the other in 93. Without a kneecap, the patella tendon was way too long and had to be cut and shortened. Each time I was in an immobilizer from 6-8 weeks. Each knee's ROM came back just fine. You have nothing to worry about. You'll just need patience! We'll be here to see you through it.
 
To be honest I'm not sure, but as far as I know the tendon was the the only issue.
That's the answered I wanted to hear! The reason I asked was to be sure when I said that when you have the cast or brace taken off, you may find it difficult to get your knee to bend. But don't get too worried about this. Just take it gently, don't force it or allow anyone else to force it else you will cause excessive pain and swelling which will hinder the return of the flexion and may also endanger the tendon repair.

Remember this Saying no to therapy - am I allowed to?
 
Thank you all so much for your thoughtful words. I really feel better about the recovery after reading these responses. Today I saw the doctor and had my staples removed. He asked me to lift my leg but I couldn't. He lifted it and asked me to keep it up and again I couldn't do it. He said it just needs longer to heal. I have to wait 3 more weeks before trying to walk on it and 5 weeks before I see him again (he has 2 weeks of vacation in there). I will have to call him though as I forgot to ask with everything going on in there how long it should be before I should be able to lift the leg. Anyone else know?
Cate xoxo
 
Hi Cate! When you say lift your leg are you talking about the whole leg or just the bottom portion--sitting with the knee bent and trying to straighten and hold the lower leg up?
 
Hi Cate! When you say lift your leg are you talking about the whole leg or just the bottom portion--sitting with the knee bent and trying to straighten and hold the lower leg up?
Yes my whole leg while it's straight out in front of me. Like laying on the couch and lifting it while keeping it straight :)
 
Ok..the reason I asked was I really had to work on lifting the lower leg because of the tendon. The leg lifts will come with working on your quad muscle. You might want to ask the OS when you can start doing the exercises for the quad, like tightening the muscle. My doctor had me doing them at about 4 weeks and working on the leg lifts with the brace on. My surgery was different then yours so the rehab may be different. You don't want to do anything that will damage the repair to that tendon. I know it really is a slow process but you can't rush it. I went through 2 failed repairs before getting the transplant because of the infection. I know how frustrating it can be.
 
I would hold off on any exercises for your quads until your OS says it's OK. That patella tendon needs to heal first. It was 6 and 8 weeks for my knees before I even got out of the immobilizer. I did nothing before then.
 

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