Fractured Patella

Hey,

Fractured my Patella Monday night on a MTB ride.

Just interested to see if anyone else has had this injury and get some info on their recovery and rehab?

Described as a minimally displaced fracture which extends obliquely through the medial aspect of the patella with a transverse component seen within the inferior pole.

Been placed in a splint for at least 6 weeks.

I'm super keen to overcome this asap and get back out on the bike.

Any info on other stories would be great or input/ideas for rehab.

Cheers,
Laura. :help:
 

Mywifesirrational

I however am very normal. Trust me.
I fractured mine in 97, tedious injury.

May I ask the mechanism of injury? was it direct impact - did they do an MRI or CT to have a look at the cartilage and swelling/inflammation within the joint capsule? Is the rest of the knee stable - ligament damage?

There are essentially two immediate problems you'll face and one long term.

Long term, you are now at high risk of patellofemoral arthritis - nothing you can do about that.

Short term you suffer loss of range of motion (ROM) at the knee and quads strength loss. ROM will come back following the removal of the splint and when there is a reduction in swelling and pain. You will need to stretch this a few times a day once the specialist/GP gives the all clear.

The loss in quads strength is a more serious concern if you want to return to normal function/riding (quickly). Also depending on the level of trauma under the patella kneeling might be painful for many months.

Due to the trauma in the knee you will undergoing some neural inhibition of the quads muscle group due to the knee trauma initiating spinal reflex activity - basically you brain makes your leg weak so it isn't put under load and used as much, to help it heal. Although, neural inhibition often results in bilateral strength loss - ie. the good leg will actually get weaker too. During the immobilisation phase do some exercises of your good leg like single leg squats - it has to be hard, so go as deep as you can. This will help keeps the good leg good and also reduce the amount of strength loss to the immobilised limb.
 
Thanks for feedback.

Thanks for the reply.

The fracture happened as a result of a direct blow to the patella, I fell clipped in directly onto rock. Then tried to get back on and couldn't apply pressure down or upwards with that leg. I had to walk/hobble out of a National park about 6kms to get home and rode a bit of it just using my right leg to pedal.

I presented at the emergency department only to be sent home and told I had bruising on my cartilage. The next day when I woke up in agony and couldn't weight bear or bend past 90 degrees I went to the GP and onward for an Xray which confirmed the fractures.

My MR showed that all my ligaments and meniscuses are intact with significant post traumatic joint effusion. I also had straining of the Medial Collateral Ligament.

The patellofemoral problems ill face are a kick to the head as i've spent thousands of dollars and worked for a year on correcting alignment issues on the other knee to finally be getting somewhere with it, I was back running pain free. So to now be facing issues on the other leg is just devastating.

Im hoping to use my tens machine to keep the quad partly active and awake, I hold great fears for the wasting that will occur. I have been trying to continue some exercises on the other leg to keep it active. The motivation to do this is hard to find.

Out of interest what was your injury mechanism like and recovery time for each phase (splint off, walking, fracture healing) etc???

Thanks again,
Down and Out.
 

Mywifesirrational

I however am very normal. Trust me.
As long as you stay as active as possible keeping the 'good' leg going and if possible do some other aerobic exercise to help maintain general fitness - trying to think of what one can do with a leg in a splint without specialist equipment? I used to swim with both legs stapped together with a small kickboard between them.

Mine was medial impact translating the patella laterally/outwards - MCL and VMO strained. It happened from losing control of a manual on a small flight of stairs, seemed like a good idea at the time.

The main problem I had was osteophyte formation under the patella due to the impact bruising the cartliage underneath, which took well over a year to disappear - could not kneel, but was riding happily about 4 weeks later (ignoring the specialists advice), as long as i didn't 'push' the pedal too hard it was comfortable, so i stuck to bike track type riding for a while.

Since then had two dislocations on that knee - I doubt it ever got back to normal and managed to smash the other on the front of a 4X4.
 

MJS

Likes Bikes and Dirt
I shattered the lower portion of my left patella after a run in with a boulder a few years ago. Surgeon basically removed the pieces and smoothed out what was remaining. I've permanently lost some sensation in the area, but the knee functions 100% now. Physio was super slow, and my first physio was useless, basically wasting weeks of what could have been progress. I would suggest finding a good physio and sticking with them, be diligent with the exercises they give you to do between physio visits, and be patient with the recovery. 6 weeks can feel like a long time, so find something to occupy your mind while you recover, I picked up the guitar again after not playing for years.

Best of luck with your recovery!
 

armara

Likes Bikes
Hi Laura,

I fractured my patella back in 1995 whilst in the Army. It was an open fracture (exposed Bone). Being the super hero that I was, I dressed it and went into the field for an exercise and it became infected. The infection then started eating away the damaged cartilage behind the patella. Five operations later and one 13cm DVT in my calf, I was still walking with a limp. In 1999 even with daily rehab, my left leg was still much smaller than my right. My quad (20cm above the centre of the patella) was 2.5cm smaller in circumference and the calf (same distance) was 2cm smaller.

I had constant pain in and around my knee even though I had physio nearly every second week and sometimes weekly until I had my last operation in Nov 2010.

The surgeon informed me about a new procedure that had just finished the trial stage. It was a decision between the known procedure of removing cartilage from behind the patella and having it grown in a laboratory and than replaced or the new. I went with the new one.

He drilled holes into the back of the patella where the cartilage was missing causing the bone to bleed and then calcify (like a healed fracture). This calcification fills in all the spaces void of cartilage reducing free space and smoothing out the surface where irritation and inflammation would occur. The best part of this surgery was when the surgeon drilled the first hole into the patella he noticed a large amount of fluid escaping. I had had bone oedema that had not shown up in any of the many scans I had received. Within hours of the operation, I had less pain then beforehand even with the pain of the surgery.

Since then my muscle growth has improved greatly and is not as noticeable even though it is still a little weaker and smaller. I also have very little pain but can tell if it is going to rain or get cold a couple of days beforehand sometimes.

Good luck,

Mark
 
As long as you stay as active as possible keeping the 'good' leg going and if possible do some other aerobic exercise to help maintain general fitness - trying to think of what one can do with a leg in a splint without specialist equipment? I used to swim with both legs stapped together with a small kickboard between them.

Mine was medial impact translating the patella laterally/outwards - MCL and VMO strained. It happened from losing control of a manual on a small flight of stairs, seemed like a good idea at the time.

The main problem I had was osteophyte formation under the patella due to the impact bruising the cartliage underneath, which took well over a year to disappear - could not kneel, but was riding happily about 4 weeks later (ignoring the specialists advice), as long as i didn't 'push' the pedal too hard it was comfortable, so i stuck to bike track type riding for a while.

Since then had two dislocations on that knee - I doubt it ever got back to normal and managed to smash the other on the front of a 4X4.
Thanks for the reply again. Everything seemed a good idea at the time hey?
Is there any way to avoid the osteophyte formation?? Hoping the specialist can give me an idea of what i can start doing and when.
How are your knees now after all this trauma? Can I ask how old you are?
Really scared of bending the knee at the moment, day 5 after fracture.
Any ideas for activities with one leg ???
 
I shattered the lower portion of my left patella after a run in with a boulder a few years ago. Surgeon basically removed the pieces and smoothed out what was remaining. I've permanently lost some sensation in the area, but the knee functions 100% now. Physio was super slow, and my first physio was useless, basically wasting weeks of what could have been progress. I would suggest finding a good physio and sticking with them, be diligent with the exercises they give you to do between physio visits, and be patient with the recovery. 6 weeks can feel like a long time, so find something to occupy your mind while you recover, I picked up the guitar again after not playing for years.

Best of luck with your recovery!
Hey, thanks for the reply.
so was the rest of your patella intact?? Can I ask what point did you start the physio work? 1,2,3 weeks in??
Good to hear you got back to 100% - there's so many horror stories out there..
Cheers.
 
Hi Laura,

I fractured my patella back in 1995 whilst in the Army. It was an open fracture (exposed Bone). Being the super hero that I was, I dressed it and went into the field for an exercise and it became infected. The infection then started eating away the damaged cartilage behind the patella. Five operations later and one 13cm DVT in my calf, I was still walking with a limp. In 1999 even with daily rehab, my left leg was still much smaller than my right. My quad (20cm above the centre of the patella) was 2.5cm smaller in circumference and the calf (same distance) was 2cm smaller.

I had constant pain in and around my knee even though I had physio nearly every second week and sometimes weekly until I had my last operation in Nov 2010.

The surgeon informed me about a new procedure that had just finished the trial stage. It was a decision between the known procedure of removing cartilage from behind the patella and having it grown in a laboratory and than replaced or the new. I went with the new one.

He drilled holes into the back of the patella where the cartilage was missing causing the bone to bleed and then calcify (like a healed fracture). This calcification fills in all the spaces void of cartilage reducing free space and smoothing out the surface where irritation and inflammation would occur. The best part of this surgery was when the surgeon drilled the first hole into the patella he noticed a large amount of fluid escaping. I had had bone oedema that had not shown up in any of the many scans I had received. Within hours of the operation, I had less pain then beforehand even with the pain of the surgery.

Since then my muscle growth has improved greatly and is not as noticeable even though it is still a little weaker and smaller. I also have very little pain but can tell if it is going to rain or get cold a couple of days beforehand sometimes.

Good luck,

Mark
Hey Mark, thanks for the reply, holy shit what a horrific story.
That's amazing what they did with the cartilage, so if it wasn't for that in '10 do you think you may be in a different place now?
I'm pretty sure mine has remained undamaged thankfully.
How's your actual patella now? I'm wondering if anyone who replied now wears knee pads out riding?

-Laura
 
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