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Partial patellar tendon tear.. Rehab, Surgery?
I have recently been diagnosed with a tendon tear in my knee, and more specifically the patellar tendon, the doctor said he does not want to do surgery due to the 6 to 12 month rehab time with this procedure and since it is not completely torn, but without surgery it looks like i will not be 100 percent again and get back my capabilities. since it is not ruptured or completely torn im wondering if i could rehab the tendon and if theres anything i can do to rehab the tendon toward bringing it back to strength without surgery.. basically i was told not to play basketball without a knee brace, refrain from certain excersizes and types of motions or it would get worse and tear completely... basically is there anything i can do to improve it without surgery, is there any way to get it back to 100 percent (with or without surgery) thanks.  also i was told arthoscopic surgery would not be sufficient, open knee surgery would have to be used.
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Hello Dear,
The treatment  of partial patellar tendon tear is immobilization in full knee extension for 3 to 6 weeks  in a cylinder cast.For  partial patellar tendon tear maintenance of patellar height, cast or brace immobilization in full extension for 6 weeks followed by a therapy program to regain motion and strength may be appropriate. Progress must be slow to allow for tendon-to-bone healing. Strengthening exercises should be delayed for at least 3 months.You should go for the conservative treatment as surgical repair is done for complete ruptures.
Refer http://www.emedicine.com/orthoped/TOPIC246.HTM#section~Treatment
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Just to follow up, Its been about 6 months and my knee has not gotten better. It still displays weakness and is nowhere near the strength it should be. My doctor told me after an MRI that the tear could not be taken care of with arthoscopic surgery but only open knee surgery and he did not reccommend this due to the serious rehab that would be required following the surgery. I went on to ask if there was anything else that could be done to rehab the tendon and he said unlike a muscle you cannot strengthen a tendon and that I could not do anything to help my cause UNLESS it is the surgery. From your response it sounded like I could rehab the tendon with a cast and later with strengthening, I'm wondering how close this will get me to 100% strength in that knee, and who I could talk to for a second opinion (another orthopedic surgeon?).. What are my options right now, if I did go through with open knee surgery how long will it be til I start walking, until I start flexability, until I start strengthening the leg and knee again, and how long until I really will be back to a place where I can go about with activity like sports and excersize without worrying about it... any information would be great, thanks doc.
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Hi peterjrrr.. im just wondring.. hows your knee now? Because I have an injury too but a bit different from yours, I have 50% torn quadriceps tendon and my orho gave me 2 choices... surgery or non surgical are both ok but the healing process is different.. now Im confuaed and can't decide :(
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Just to follow up, Its been about 6 months and my knee has not gotten better. It still displays weakness and is nowhere near the strength it should be. My doctor told me after an MRI that the tear could not be taken care of with arthoscopic surgery but only open knee surgery and he did not reccommend this due to the serious rehab that would be required following the surgery. I went on to ask if there was anything else that could be done to rehab the tendon and he said unlike a muscle you cannot strengthen a tendon and that I could not do anything to help my cause UNLESS it is the surgery. From your response it sounded like I could rehab the tendon with a cast and later with strengthening, I'm wondering how close this will get me to 100% strength in that knee, and who I could talk to for a second opinion (another orthopedic surgeon?).. What are my options right now, if I did go through with open knee surgery how long will it be til I start walking, until I start flexability, until I start strengthening the leg and knee again, and how long until I really will be back to a place where I can go about with activity like sports and excersize without worrying about it... any information would be great, thanks doc.
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Pete:

If the tendon is partially torn away from teh bone it is unlikely that it will heal without surgery to the extent that you would like. It will require open surgery to remove the damaged area of the tendon and then to re-attach it back to the bone. Afterwards you will need a brace or cast to keep the knee straight for 4-6 weeks followed by physical therapy to regain motion and strength. It is hard to predict how long it will take you to get back to basketball but likely at least 6 months.

vic goradia
http://www.goortho.net
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619343 tn?1221363107
Get a 2nd, and 3rd or 4th in person expert opinions from well experienced orthos.  And then pick the best one to get your surgery, if you REALLY need it.  I went into surgery for a torn ACL and I came out worse off.  Now I have to have 3 surgeries to 'try' to repair the damage from the first surgery.  I have had 2 so far and I have severe nueritis and a growing nueroma as well as severe atrophy below the knee.  Make sure your doctor is wellllllllllllll experienced and specializes in your particular injury.  Best to you.
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I have the same thing. My left knee gives out all of the time. I play softball and I can not run around the bases anymore! I am 32 years of age and I am so depressed. I used to run and now I cannot run. I finally went to the doctors today and he said I have a partially torn Patella Tendon. Surgery is not an option. He wants me to have ultrasounds to the tendon to break up the scar tissue. Once the tissue is broken up, physical therapy for 6 weeks. Have you heard of this? I am making the call tomorrow to set this up.

Eric
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You should go ahead and have the open knee surgury.  I was diagnosed with patella tendonitis last December and was prescribed the patella brace which i wore playing basketball for 6 months.  However, the knee continued to be really sore.  I'd gently work it out after bball with leg extensions on the nautilus machine which seemed to help.  However on June 30, I completely ruptured the patella tendon going up for a layup.  Surgury was on July 1 and I started PT on July 13, less than 2 weeks later.  I'm on a walker for a few more weeks but I can put 20% weight on my repaired knee.  It sounds like having the surgury and doing the PT afterwards will be quicker than imobilizing the knee for 6 weeks and hoping the tendon regrafts to the patella.
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If by conservative treatment, aka Physiotherapy will help you heal the tear it is always good to go for immobilisation and Physiotherapy. With age and with movements the healing for tendon tears, ligament tears takes time.
If you need surgery after that you can always go but do not go for surgery immidiately and try to help your body and give a chance for natural healing. Take care!
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Hi dr. Vinod, great advise you got there.. I just had an injury too but a bit different.. i have a 50% torn quariceps. My ortho gave me 2 choices, i could go for surgical for faster recovery or non-surgical conservative treatment but a bit longer process... can you please give me an advise.. I really appreciate your help. Thanks in advance
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I am 14 weeks post patellar tendon debridement surgery.  I have been to 16 PT appointments.  I have somewhat recovered from scare tissue issues and other pains, but my original area that was/is injured still hurts (10+ when any weight is placed on it).  I can swear that I am still injured, I am back to the point of where I was before surgery.  Oh ya, I forgot to ad, I was injured 12/2008 and didn't have sugery until 7/2009.  Its a workers comp situation.  I went to 4 doctors who all were specialist, but didn't perform surgery anymore.
I can't kneel down, I can't crawl, I can't have really good sex with my wife, I haven't slept through a complete night since my injury back in December 08.  I can't go up and down stairs unless I hold the hand rail and go one step at a time.  I am depressed.  I just wan this thing to heal.
I have 4 kids too, I can't even have them sit on my lap.  20 mins. of sitting and my knee is in pain pain pain.  I find myself laying on the couch most of the day.  I ice 4 to 5 times a day, I take Tramodol for the pain.  I AM TIRED!!!!  
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dont despair , keep working at it , dont sit around , exercise as much as u can , im 16weeks after op and its ok , still not right but hopefully goin right way , still cant do the stairs tho, its a confidence thing i think , knee still gets sore after exercise and is still swollen but not as bad plus i get spasm when i wake every morning until i stretch the leg , its a long haul thing so stick in there and keep the chin up.
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I had arthoscopic surgery fo my torn meniscus, and 3 weeks later while crouching down, I partially tore my petellar tendon.  Could my surgery have weekened my petellar tendon?  Wouldn't the MRI have shown any previous tear?
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My son, who is 20, plays football and has had chronic right knee pain... he just had an MRI and was diagnosed with a patella tendon tear and tendonitis... he was given a cortisone shot and said the other day some of the swelling has gone down... I do not believe his tear is from the bone but instead some fibrous tear in the middle... he have been in extreme pain and it would just start hurting for no reason... he put off getting it looked at until coming home from college... he has been playing intramural basketball and dunking the basketball prior to examination... he is very active walking 4 plus miles everyday at work... he is on anti-inflamatories and giving it rest...he bears weight easily and goes up and down stairs... he has set up an appointment with a local chirapractor for ART treatments...we hope this helps and he is capable of beginning football in August for his college.
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I thought I was the only one feeling this way. I'm 22 years old and I just had my patella tendon repaired surgically. Let my start off by saying that my accident was on june 2009 and now its September 2010 and I just had surgery. It all started with a hairline fracture on my patella I was put in an immobilizer for what was supposed to be 6 weeks instead it ended up being 3 months. After the 3 months I started physical therapy which made my pain worse and I just couldn't take it. I couldn't do a lot of things such as bend my knee, straighten my leg out, put weight on my leg or even take baby steps because my knee would start to buckle and give out. Through the months I was referred to neurologist and another orthopedic doctor that still couldn't figure out as to why I was still in so much pain and unable to do many things with my leg. Finally in july 2010 I was referred to a sports orthopedic doctor in which he started my case all over. He disregarded all past mri's and xrays and started from the beginning. It was then that he found out I had a partial tear on my patella tendon and the only way to fix it is by surgery. Ill be honest I was scared because I knew I was going back to the first stages of my injury. I knew that this was my last chance of getting my leg back to normal and being able to live the life I used to have. So on sept. 10th I went through with it. During the surgery my doctor repaired my tendon but also found that the knee cartilidge was also rippled which of course causes pain and will lead to arthritis. At the moment I'm recovering this is my third day home and ill be honest is painful and it brings me down. I have to be on ice therapy all day and laying in bed all day with my leg elevated. Its uncomfortable and annoying because I can't do anything for myself. Anyways I was told I can't do any activities for 42 days and then I will start therapy. This is my last chance of getting my old life back so I'm hoping this works out. I'm glad to know that I'm not the only one going through this type of situation. May god bless everyone because I know its not easy its depressing being home all day not being able to do anything. Good luck to everyone and I hope you find a solution to these pains.
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I'm 31years old.  I was playing basketball a couple of weeks ago and while going up for a dunk, I heard a pop in my knee area.  I took a ride in an ambulance to the local hospital and had a few x-rays.  I was diagnosed with a fractured patella and a ruptured pateller tendon. I had surgery to repair the ruptured patellar tendon on Nov. 11. 2010.  I'm in an immobilizer brace, with my leg at full extension and I start physical therapy on Nov. 28. They say the road to recovery is a long one, but i plan to stay positive and surround myself with pure motivation.  I'll pray for your successful and speedy recovery!
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I had knee surgery in December of 2010. It's now June 2017 new my knee has started having slight issues. I slept lying on my side (Knee pressed in to mattress). I woke up in some serious pain!!! It really is sore. I'm hoping that I didn't cause some kind of injury. It  is tender and I try rubbing and icing the area as well.
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Well, it must have been about 1997 that I was riding my horse when my best friend cantered past me and her horse kicked me slightly below the knee. (imagine being hit by a sledge hammer right below your knee) To make a long story short, I was told by the local hospital that I had a bad laceration. (it took 3 subcutaneous stitches and 5 outside to close the wound) After going through 2 prescriptions of pain killers and still in pain and much swelling, I asked my PCP to refer me to a specialist. He sent me to Shadyside Hospital in Pittsburgh and the Orthopedic doctor told me they had read the MRI wrong and that I had a torn patellar tendon.( He had come from Philadelphia where he said he saw a lot of that sort of injury in horse people from getting kicked) This was well over a month after the injury. He said by then it was too late to do surgery and showed me some exercises to do. I have no problems with that knee other than arthritis; which is present in the inner part of both knees. Other than the first two months or so of the injury; I had no residual problems.
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I had knee surgery in December of 2010. It&#39t;s now June 2017 new my knee has started having slight issues. I slept lying on my side (Knee pressed in to mattress). I woke up in some serious pain!!! It really is sore. I'm hoping that I didn't cause some kind of injury. It  is tender and I try rubbing and icing the area as well.
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Its been 7 months since my operation. I had a 5 % tear, but enough to make me hobble rather than walk. Went through the operation and they ended up reattaching part of it to the thigh bone, stitching the tear in the middle, excising part of the Bursa and a clean up of debris.

Went through everything like I was supposed to including PT. -- Kicker was I have a job where I have to stand and walk for 8 hours a day. Back at work 2 months later with restricted hours...Things were looking good and then 7 months later I tried the treadmill... All hell has broken lose.

They dont want to operate again because of the damage it will do.. So now Im worse off than before.  I can barely walk right now.
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This is how I fixed my partial tear of the patellar tendon.

My diagnosis 8-2-10: Partial tearing of the patellar tendon at its origin with associated bone marrow edema in the inferior patella. These findings are consistent with jumper's knee. Tendinosis of the popliteus tendon at its insertion.

I had knee pain from 12/07 - 1/11. Before my injury, I was never a good distance runner (I would get shin splints if I tried to run too far) but I was an active person playing soccer, Frisbee and hiking. By mid 08 I could do very little physical activity from the knee pain. Some days it was worse than others. Walking up and down stairs hurt and jogging across the street hurt. I couldn't do any hard surface running (grass, concrete, dirt trails) but I could run barefoot in the sand and I could bike. After shutting my body down for two years trying to do specific weight training and physical therapy, I wasn't getting much better. Stretching helped but it didn't solve my problem.

In Jan of 2011 I went for a jog after doing some research on proper running form. Before my injury, I would run with a heal strike and poor upper body form (I was a "head chaser"). I walked and ran loudly and running HURT. After reading about the correct stride length, upper body form, tempo, and landing on the ball of the foot I decide to put it to practice. I went jogging barefoot for one mile with absolutely no pain.

I decided to go barefoot because it forces you to run with proper form. I have now run barefoot for six months. I completed a half marathon in June (2hrs 20 min) with my Vibram shoes. I play soccer and Frisbee again and I have no pain in my knee.

I would recommend you find a rec center with a grass field and run around it a few times barefoot to see how it feels. Running on grass feels good and you don't have to worry about getting cut. Make sure you read about proper running form, and put those lessons to use. Even if you don’t go barefoot, proper form is important. TAKE IT SLOW. I've read of people breaking bones in their feet or tearing tendons or muscles in their feet because they try to do too much. Your feet are weak, give them time to build up strength.

Hope my story helps.
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I do not know how far along you are now, but I too have a partial tear in my patellar tendon. First off, a Cortosone shots are bad because they weaken the tendon.My doctor told me my surrounding muscles were to strong to undergo surgery. There is this new innovative procedure called PRP (platelet rich plasma) which helps stimulate tendon growth. Basically the doctor will take a needle of your own oxygen and platelet rich blood and inject it into the knee. The ideology behind this procedure is that platelets are responsible for growth, so bringing them to the site of the damage will help. Also the tendon lacks a strong blood flow of oxygen so that also is brought to the knee. The great part is there is no transfusion or graft so the body's adaptation is more fluid and it is non-invasive.
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I had a partial tear of my left patellar tendon on June 3, 2011.  My daughter was recovering from a major surgery and went out to play with some kids at the Ronald Mcdonald House.  I jumped and when I landed my knee popped and then...pain.  After 7 weeks of pain and difficulty I had an MRI that revealed the tear.  I  had surgery on August 1, 2011.  I am 35 years old, married with 2 little ones.  It has been a little rough since Monday.  The first 3 days were filled with a lot of pain.  I used the pain meds for sure.  I'm not sure the degree of tear I had, but I don't think it was too bad because I can already out 100% weight on the leg.....as long as it it fully extended.  I am experienceing numbness in the lower area of the surgery and it is a little red around that spot.  Did anyone have this?  I go for post-op on Friday so I'll see where I should be.  
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I have been reading about all posts. I wanted to add my own question I was just told myself that I have a 60% tear of my patella tendon.  I ride a motorcycle and bend the knee almost all the way back and after a while it may hurt.  Walking and everything else it fine.  The doctors I have seen haven’t told me anything about how to take care of it or how to help it heal.  Anyone know what’s best to help it heal?
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