Tim in MD - I live in Timonium. The OS that put me back together is Dr. Alvin J. Detterline at Towson Orthopedics. He is 35 years old, a perfectionist and takes alot of pride in making sure the job is done right. He operates at St. Joseph's Hospital. Their office is on Bellona Avenue right at the Charles Street exit on the beltway. They also have an office at St. Joseph's Hospital. The Orthopedics floor at the hospital is very nice with private rooms. Please feel free to ask any other questions.
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Quadriceps Tendon Rupture, Repair and Rehab - Page 138post #4112 of 1080212/1/12 at 7:39amMike in MD, thanks, I may look him up. My daughter had a baby in January at St Joseph's and we liked the place, very professional staff.
How soon we're you putting pressure on the leg after surgery (standing)?
Thankspost #4113 of 1080212/1/12 at 8:47am
RE: partial tears, one word of caution. I was diagnosed with a partial tear based on exam and MRI. My ortho called it about a 60-70% tear, as I could still do a straight leg lift, and the MRI showed that degree of tear. However, I decided to have surgery anyway, as I am very active (mainly skiing, biking, hiking) and did not want any limitations physically at all. It turns out in the OR, the tear was much more extensive, probably as much as 90%.
The point is, even MRI is not entirely accurate in assessing the true degree of injury in my experience. My advice is to decide on surgery based on whether you would be willing to live with some limitation, or if you want the best chance for full functionality.post #4114 of 1080212/1/12 at 9:25am
If I had a chance to go back in time and speak to my Anaesthetist (who is responsible for the post op pain relief) I would say please give me an IVI narcotic (like pethedine) - preferably via PCA Patient Controlled Analgesia where they use an electronic pump to vary the rate and the patient can vary this by pushing a button. My mother had a hip replacement in Sydney and she said that this form of pain relief was excellent (she also has a problem with post op vomiting- so its genetic presumably). I think the problem is that this is a rare injury and they are much more used to patients who are having cruciate repairs which I suspect are much less painful post op. I think a lot of the discomfort comes from the fact the surgeon has to stretch the muscle to rejoin it to the tendon and this chronic stretch allied to the trauma of the surgery is very painful initially. Once I was through the first 24 hours the pain was quite manageable on Ibuprofen and codeine. I was just on ibuprofen after about 4 days.post #4115 of 1080212/1/12 at 10:15ampost #4116 of 1080212/1/12 at 10:58amI would get the surgery. When it goes, which it will, you will be down for the count, wherever you are. If you are hiking in the backwoods, you'll be SOL. The recovery is tough, but I think it's better than living with a ticking time bomb inside you.post #4117 of 1080212/1/12 at 11:39amHello from sunny South Africa.
I slipped on a wet deck at a wedding on the 24/11 and heard the tendon tearing, my wife thought it was the deck cracking. Scheduled for surgery on Tuesday, 4/12, only thing is we are scheduled to fly to NY from Johannesburg on the 12 or 14/12 and then board the Carnival Miracle for an 8 night cruise to the Bahamas but my wife is a nervous wreck with regards to a 16 hour flight after this kind of surgery. Any reassurance from anyone will be appreciated as she is talking about canceling.post #4118 of 1080212/1/12 at 12:03pm
I am getting the same advice from my son in laws Dad who is an ortho surgeon. He says it just delaying the surgery and I may be going down stairs or some thing like that when it fully tears. I am hoping that since it is not a complete tear the recovery may be better or at least the pain less as that seems to be from pulling the muscle back in place after reattachment. Will know more next week
Timpost #4119 of 1080212/1/12 at 8:01pmMoose44: I may not be providing the words of assurance that you had hoped for. There are a few things to keep in mind. First is blood clots. My surgeon had me on blood thinners for a couple weeks after surgery to prevent them. A 16 hour flight is not great on that front. Next is the fact that your leg will be locked straight. If you are in business class, you might be okay, but in coach you will be in tough shape. Finally, there is your level of comfort sitting so long. I can only speak for myself. My injury was exactly one year before yours, on November 24, 2011. I had my surgery on December 1, 2011. On December 10 we drove 1.25 hours to our hometown to see our nephew graduate from college. I was completely dependent on crutches. This trip took a lot out of me. Honesty, there is no way I would have been comfortable taking a trip like what you have planned so shortly after surgery. I think your wife is on the right track. With your leg locked straight, you will find that it is extremely difficult to find a comfortable sitting position. You will need to have your leg elevated. Sorry to be such a downer, but I am speaking from my own experience.post #4120 of 1080212/1/12 at 8:51pm
Moose44, I agree with tomnorth entirely. I travel for business 3 out of 4 weeks, and my surgeon at the Hospital for Special Surgery, one of the best in the US, gave me a flat 4 week travel ban. Blood clots are dangerous and there is no way you will feel comfortable. I know most airlines will provide a full refund for injuries of this sort.post #4121 of 1080212/2/12 at 7:29ampost #4122 of 1080212/2/12 at 8:27am
Moose44, I would listen to tomnorth and Boston. I would not have enjoyed flying at all, especially 16 hours. I was on vacation when I slipped and ruptured my left quad. Had a 12 hour drive home, broke it up to a two day drive. Six hours was with rest stops was tough enough.post #4123 of 1080212/2/12 at 10:49am
1. The Blood Clot issue is very real. Glad you made the conservative decision.
2. This type of injury will qualify you for most cruise insurance,with a complete
refund.We had no problems with Seabourne 100% back.
Take your time,you will recover.
All The Best,
Calhikerpost #4124 of 1080212/2/12 at 5:35pm
Quote from my earlier Post -
"Hi Quad Rippers,
77 yr old - active - 11 weeks out from Surgery on right leg quad tendon full rupture. I am out of the brace and using a cane for balance. I am at 94 degrees ROM and the Doc is pushing me to get 110 ROM in another week and 120 ROM in 2 weeks after that. In outpatient PT with a good PT guy. I am using heat as well as ice.
I am walking well but need some suggestions on increasing ROM since the Doc has told me and the PT to push ROM.
Thanks for everyone's inputs."
PLEASE OFFER UP SOME RELIABLE AND SAFE METHODS TO INCREASE ROM. I AM NOW AT ABOUT 97 DEGREES AND MY DOC WANTS ME AT 110 THIS WEEK (WK OF DEC 3) AND AT 120 ROM BY DEC 18. I AM STRETCHING VIA STEPS, FLOOR SLIDES AND USING HEAT DURING WORKOUT AND ICE AFTER.post #4125 of 1080212/2/12 at 7:45pm
I am 7 plus months from surgery and have skied 3 days with no problems. I am taking it easy,but feels good. I need to work on my strength but even that is progressing faster than I thought. I am 58 and a level 7 skier at this point. Thanks Bradpost #4126 of 1080212/2/12 at 11:21pm
I increased my rom laying on my bed flat on my back knee raised and a loop of rope around my ankle and pulled back on rope. I was using ice during work and aspirin and tylenol about 30 minutes before.post #4127 of 1080212/3/12 at 2:45amQuote:
Richard, i think you are doing really well, to be at 97 degrees after 11 weeks is pretty damn good if you ask me, I'm somewhere between 98-100 degrees and I'm 26 weeks post op. The only trouble is that I've been in this position for 2 1/2 months now and cannot get any further, I'm currently waiting for an appointment for a manipulation (without scar tissue removal) which I'm reluctant to have done without an arthroscopic procedure, as there is more chance of a re-tear of the original injury. I just wish i lived in the US as it seems your surgeons over there seem to be more informative and more interested in patients making a full recovery than just getting the surgery done and getting you out of the door!. So far the best advice my surgeon has given to get more ROM is to take pain killers and lean back on some kind of table or work surface and squat down, allowing my body weight to force the tendon to stretch, short of numbing my knee there are no pain killers that would help with that kind of punishment!, so there you go, that's our surgeons here in the UK for you!!
One more thing, i have noticed a swelling just below the patela which i think is a build up of fluid and think this may be holding back my ROM, i had fluid on the same knee 24 years ago when i first developed arthritis and at that time i could barely bend it, Thinking about it now, i can't believe he's not even considered this.post #4128 of 1080212/3/12 at 4:32am
Tim in Md - sorry to hear about your injury. For reference, left QTR "complex partial tear" Oct 10. Not sure what that means, but doc said it was a long diagonal tear and there was no question it needed surgical repair. As for pain, I found the post-op pain to be really intense. I think it was complicated a little by a bad reaction to dilaudid (sp?) so I came down off the meds and had to ramp back up on percocet. BUT - surgery on a tuesday night and took my last percocet that friday; it felt better pretty quickly. I was in a straight brace for 2 weeks, then graduated to an articulated brace with 30 degrees ROM at 2 weeks when staples removed. 45% at 4 weeks, 60 degrees at 6 weeks. Driving at week 6. Its now week 7 and I'm "walking" around the house and work without crutches, and getting to 90 degree ROM "hanging" the leg in PT. Very little realy pain other than in PT. Yes, its a long road but there is light at the end of the tunnel. Good luck,
Edpost #4129 of 1080212/3/12 at 9:12amQuote:
I am 7 plus months from surgery and have skied 3 days with no problems. I am taking it easy,but feels good. I need to work on my strength but even that is progressing faster than I thought. I am 58 and a level 7 skier at this point. Thanks Brad
That is awesome. My ortho says I should be able to do the same by Feb-March 2013, which would also be around 7 months post-op. Thanks for the encouraging bit of news.post #4130 of 1080212/3/12 at 11:09am
I really think you should push for an MRI- it is not a particularly expensive investigation and shows both bony and soft tissue injury there is a good chance it will reveal if you have additional knee pathology and an indication about might be causing your restriction. When you consider you are a working age adult with dependants, getting you back to full function should be a priority for the NHS. Unfortunately sometimes in order to get what you need in this system you need to make yourself a bit unpopular, I would lobby your GP and imply that if it is not resolved then you do have the right to make a formal complaint. In terms of stretching I found that gentle squats in the local spa pool at the gym was helpful- but if I over did it then my knee would ache the following day. Also direct application of ibuprofen gel to the knee area helped very quickly with this pain.post #4131 of 1080212/3/12 at 11:20am
Hi “Quadricepsed” friends. I am now 4 month post op. 65 old.
I ‘v got full flexibility after 2 month (I am lucky). Now walking almost without limping, able to go up and down stairs without support but far away to return to play tennis.
Oldbumper I am happy for you. Did you try to compare strength in injured and healthy legs?
Recovery for everybody
Sampost #4132 of 1080212/3/12 at 3:08pmQuote:
This worked great for me too. I would bend the leg as far as I could on my own and then finish pulling with the strap.post #4133 of 1080212/3/12 at 3:19pmDear catinthehat,
Thanks for your advice, I totally agree with what you are saying and honestly I did ask my surgeon for an MRI but he just fobbed me off saying "we'll we could do an MRI but...." At that point I realised he just doesn't give a damn, I would have stood my ground a bit more but the whole situation had me feeling depressed as it was and this just made me feel worse. Now though, you have inspired me to fight a bit harder and I will be writing to my local MP tomorrow as I'm not willing to put up with it anymore , even more so when I see that sam65 has full flexibility after 2 months, I'm really pleased for you Sam and thanks again cat,post #4134 of 1080212/4/12 at 1:35pm
Hey Moose! Hope your surgery went well. I have to agree with what the others have said here about traveling. I was in Colorado when I tore my left quad completely and they gave me blood thinner injections and I rode home to Texas in a motorhome but they were extremely concerned about blood clots. Nevermind the fact that I doubt you'll have any kind of fun on the cruise. Hope you had insurance for the cruise 'cuz it just isn't worth it! Good luck!post #4135 of 1080212/4/12 at 2:10pm
So, I now have three slightly different opinions to think about
Today I visited a well recommend surgeon and he did an extensive physical exam. He recommends trying to do physical rehab first and see if I can strengthen the leg an avoid surgery which surprised me. The last doc wanted to operate (arthroscopic) and if the damage was minimal clean it up, if major, do the full repair. Amazing the difference in opinion.
I have a family member that is an Ortho Surgeon and he recommended the full surgery as he does not believe you can rehab a tear.
WTF! So I may try the rehab but I wonder if I am just kicking the can down the roadpost #4136 of 1080212/5/12 at 12:06amHello all, I'm very happy to report that the surgery went very well, the tear was not as bad as originally thought, the inner quadricep muscle tore off the tendon and only a small tear to the actual tendon itself. So back home and not too significantly medicated. We are still in massive debate about whether to go or not, as we had planned a few days pre and post cruise in NY and after just walking to the car on crutches I realized that I'm going to be useless for that part.
PT seems pleased with the 1st session and will work with my personal trainer to make sure I do the correct exercises. My leg is locked straight for 6 weeks, although I am allowed to put as much weight on it as I can handle.post #4137 of 1080212/5/12 at 4:40ampost #4138 of 1080212/5/12 at 6:43am
Here is my story, partial tear 1/11 doc basically says stay off it see if it heals by itself, end of april/11 standing on temporary stairs on construction sight, stairs wobble and knee blows apart on way down left knee (original injury) 95% quad tendon tear right knee 100% pattellar tendon tear. My suggestion would be that recovery for you would be quicker now rather than waiting for more damage, my surgeon said that sewing together 4 months of random scar tissue was like trying to sew cotton candy. Good luck whichever way you go.post #4139 of 1080212/5/12 at 3:27pm
Old Runner Guy,
I had kneecap surgery yesterday and it was not the walk in the park I expected. The break was along the left drill hole from the quad tendon repair. Fortunately, the break was not displaced and two screws and wire got the kneecap back in what is almost perfect position. Will start ROM rehab in two weeks.
You might find this interesting. When he was in there he scoped out my knee and found degeneration of cartilage. He told me that I have to start cross training and only run twice a week or I will use up the cartilage and have problems later in life. He said the issue is genetic and from 50+ years of running. I guess it's like the tread on a tire that gets worn down over time. Tires can be replaced, cartilage cannot.
Based on your issues getting back to land running I wonder if you also have cartilage issues within your knees. You might want to explore the that issue with your knee guy.
I'm going through a lot of pain post op but trying to avoid pain pills. I want to know my limits and pain tells me that but that bottle of pills is starting to look pretty good.
All the best,
PS, I just relented and took the pain pills. This thing really hurts!!! Ouch! :-(
- Quadriceps Tendon Rupture, Repair and Rehab
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