Knee Stuff

For those of you that don’t know – I was in a bad car accident in 2003 and really messed up my right leg. I had my patella (kneecap) removed, rods inserted into my tibia and femur, which included several deck screws to hold stuff in place, I lost the small artery that runs down the leg, and month later I had a silver dollar size chunk of my femur excised through my quadriceps. I haven’t really talked about my injuries much because – well there are so many people out there with worse stuff – it just feels like I’m complaining. 

Every now and then I search the web for “patellectomy” and come up with virtually no results.  I’m basically looking for folks who have had a similar injury and how they are coping without a kneecap.  My conclusion is – not a lot of people have this procedure – generally it is considered kind of a last result to alleviate knee pain when the knee is relatively in tact (with very mixed results from what I can tell) and in most injuries some of the patella is generally salvageable.  I had three orthopedic surgeons care for me during my recovery and none of them ever did a complete patellectomy.  Well my first surgeon can now say he’s done one, the other two can at least say they had a patient that had one. So for the .00001% of you that don’t have a patella, I’m going to blog about my experiences.

This is also my cheap version of SEO to get my blog at the top of a Google search.  I’m sure this one post uses the word patellectomy more than any other site. Patellectomy, patellectomy, patellectomy, patellectomy, patellectomy, patellectomy – now it does.

Comments

[Smithy]

I came off my mountain bike 3weeks ago and shattered my knee cap. Due to its condition it was completely removed. My leg is still in a splint as the wound heels but I'm looking to begin physio treatment soon. I've done the usual internet searches to find out about the best rehabilitation, replacement kneecaps and the prospects of running and cycling again. These searches have been fairly fruitless unfortunately so I can offer little help or advice. Can you offer any advice about from your treatments to date?? Any do's or don'ts that are worth noting??
All the best
Smithy

[Lisa T.]

I had a complete removal of the R knee cap in 95. Prior to that there were 3 surgeries (first in 88) to control patella dislocation. They obviously failed. I have had my first surgery for the L knee in 2004 for the same reason, dislocation. I am 37 now, and facing more surgery, and going to see my fourth doc. I still have slipping of the L knee cap and extreme bilat pain. I am under the supervision of a pain management doc. This has been a life long battle for me, as even in childhood I dealt with this. I can walk normally most of the time. At times I have to use a cane to help take pressure off the side that is bothering me the most. Stairs can be challenging, especially going down them. Running, jogging, sports, are out of the question. I have almost full flexion and extension of the R knee, with no dislocation of the tendon. I do work full time, as a paramedic. I try to stay out of the field becuase of the my limitations. I'm in management, and function more as a desk jocky. My fear is that now next choice will be that of a total replacement. My next appointment will be on the 8-18 to set up MRI's and go from there. If there is anything else I can help you with, or if you have any questions please email me.
Best of luck
Lisa

[Dianne]

I've just had my patella removed (first I had open reduction and internal fixation of fractured patella then 2 weeks later tripped over my crutches and made everything worse). I've been looking around for recommended protective braces for after the immediate rehab, but everything I find wants to stabilize the patella, not cope with its abscence. Does anyone have any suggestions?

[Marlene]

I had my right patella removed back in 1983 due to injury that five other relocation/scraping operations didn't fix. I was told then I wouldn't have much movement of the joint, but I have almost full use of my leg. The most important thing I've learned over the twenty four years is that keeping up the strength in your thigh muscles is important. I do have to be careful going down steepr slopes and when stepping up, I lead with my left. If I get lax in my exercises, the chances of the joint giving way rises quickly. As far as activities, I was never much of a runner, so it wouldn't be right to offer any info on that, but I did some bike riding. After the removal, be careful how much you do at once, as I found out after a one hour ride, fluid filled the joint to the size of a grapefruit, and needed to be drained. I took much shorter trips after that until the rest of the leg muscles improved. Any fluid build ups now from too much activity is controlled with a few Advil and LOTS of ice. (Your body will re-absorb the fluid )You will have good days and bad, but doesn't everyone? I've raised two kids (on my own), managed a newspapaer distribution department (many physical aspects), a woodworking shop(even MORE physical aspects) and am now a production/office manager of another woodworking shop. If you loose a knee cap, yeah, you need to adjust. But like you said, how many more out there have so much more wrong with them. I hope you do well in your endevors.

[Nancy Taylor]

I was glad to read your blog. It is so hard to find anyone "real" who has had a patellectomy - I have only seen case studies. I had mine about 7 years ago, when I was still in my 20's and I have yet to meet anyone who has ever had it done. After years of arthritis pain and dealing with a kneecap that would dislocate EVERY time I bent my leg, I went in for my fourth surgery. When I woke up my surgeon informed me that he had no other options and that he had removed my kneecap. I should have been more alarmed when I saw how upset he seemed, but at the time I was just glad to not have to worry about the patella popping out all of the time.

Well now, 7 years later, I am not certain that surgery was really in my best interest. I was able to regain complete range of motion, but my leg is still weak and often gives out with no warning. I have pain at times that is almost unbearable. Now I read that usually within 8 years of a patellectomy patients experience more problems and undergo more surgery.

What could possibly be next? I have to tell you, I admire how well you have coped and are able to be as active as you are. You must be a very strong person.

[John Hymas]

I have read the various comments on the Patellectomy operation with interest.
I had a complete removal way back in 1973 due to extensive damage at the back of the patella due to a sports induced injury.
Since then I have played both tennis and Squash at a high level with no ill effects.
I am sure the secret is intense physiotherepy straight after the operation.
I spent 6 weeks at a rehabilitation centre particularly concentrating on building up the quad muscles in that leg and achieving full bend. It wasn't easy and it was extremely painful at times but as they say no pain,no gain.
There have been no further problems since rehab except that it feels a bit peculiar when I kneel on it.

[Marianne Robb]

Its nice to read about "others" who have had a patellectomy...I had mine back in 1974 due to an injury that happened in 69'..The only problems I have had since are that my knee can give out without any warning and I am in absolute agony if I should kneel onto to an object accidentally...has anyone else had this problem?? I have raised 7 kids and have kept extremely active although I have not played much sports since the surgery because I only have to twist the wrong way and its agony and into a support bandage for a week... I dont think having no knee cap has affected me in any serious negative way......

[Summer Bleyer]

Berberian-
Let me begin by saying thank you. It has meant the world to me to read your blog. There's comfort in knowing that I'm not alone and hope in hearing that anything is possible. I had a full patellectomy at the end of March in '07 and the prognosis I received was dismal. I was told that it was unrealistic for me to ever hope that I would have a normal life. The things that I had taken for granted like running, sitting indian-style, going down steps and even standing up straight were suddenly in question. I looked for inspiration, almost obsessively, on the internet. Looking for a hospital that was performing groundbreaking research or someone who had defied the odds but I struggled to find hope anywhere. I'm 28 and have not started my family yet which is a huge fear. I worry that I won't be able to squat down to pick up my children or pass down my love of soccer. It's amazing to hear that you run with your daughter, such a lovely image.
I am curious what other people's surgeons have used in place of the knee cap? I was not a candidate for an artificial because my bone bed was deteriorated by the infection. I have a tendon that was reinforced with tissue, they made some sort of tube or something that would act as the extensor mechanism. I have full range of motion but very little strength and extreme pain going down steps.
My original injury took place while working at an institution for juveniles. I had two surgeries on my left and two on the right. It was then that the doctor introduced a staph. infection into the joint. I had to have another surgery to treat the infection. After that my knee got worse and I eventually lost mobility in my right leg. The doctor ingnored my concerns for two months and assured me that follow-up testing was unneccessary. When I went for a second opinion I was shocked to learn that I might lose my leg because the infection was so bad. I had three surgeries to try and save my knee cap but it was eaten up with staph. It seems that the most common reason for having the patella removed is after multiple fractures. I have been unable to find anyone who had it removed after a horrible infection. I'm learning to live my life again and trying to get use to the pain. I'm allergic to narcotics and have been unable to find anything to help with the pain. I would love any suggestions that you have. Especially if you are aware of any natural treatments or products.
I feel that I have a renewed sense of optimism after reading your blog. Thank you for putting your story out there. You are amazing!

[Doug Lerner]

Just had patellectomy 2-3 weeks ago after a motorcycle accident. Nothing on the internet about this (except this website), and I'm still in complete state of shock of the entire incident. Before I was in the accident, I was very active. I'm not sure what the future brings, and I am looking to speak with fellow patellectomy recipients ASAP. I am a police Detective, and I am not sure if I can even work again. Could someone please contact me at dougl200@verizon.net, or call me at 845-721-9503. Thanks for posting your stories. I hope to hear from someone soon. Doug Lerner

[Niall Donaghy]

Like all of you here I have had a patellectomy performed..and am a little worried by the apparant rarity of the procedure.
I was involved in a car accident and my left patella took almost all of the impact from a 50mph crash into a wall. The force transmitted through my leg actually went on to give me a comminuted distal femur fracture and also a talus fracture. I was in surgery for 7 hours, and as it stands, I have been in a long leg cast for 6 weeks with at least another 6 to go.
Just posting to say that, like Doug Lerner, I too would like to talk with fellow patellectomy patients about the recovery process. I can be contacted at scorpionstudios@gmail.com.
Thank you all for sharing your stories. Regards, Niall.

[nadine russo]

I just had a complete removal of my left Patella 18 days ago. I had a silly home accident and hit my knee cap with full force on a corner wall.The kneecap was shattered and into several pieces , couldnt save it. I am 64 yr old female and was extremely active before this happened. Gym 2 hrs a day lots of biking. Now I was given strict orders to keep still, leg elevated and no PT for possibly another week. totaling almost 4 wks. then we start the exercises and possibly swimming pool therapy might be a little less painful.
I am anxious. and so happy to have found this blog. I appreciate it and read every word. No one has heard of this kind of removal and finding this blog is really helpful.
If anyone wants to exchange more I am certainly available nadou@comcast.net I am fortunately retired from the business world but keep myself very busy with profitable hobbies.The key to getting better is attitude in my opinion. Yes it hurts but I find ways to accept this situation. I have good days and bad days but we all do ...thanks for organizing this blog.
Nadine

[Andre]

Hi all.

Like everyone else that has posted here, it's great to know others that have had to deal with a patellectomy. I'm happy to add my story if only to alleviate the fears of people who may have recently undergone this procedure.

So, in August 1997 i was 19 and had motorcycle accident. I hit a truck. I became conscience perhaps about a minute after the accident thinking that i could just pick up the bike and continue home. I quickly realised that i wasn't going anywhere. Other than my bike being in almost two pieces, i later discovered in hospital that i had a broken and dislocated left wrist, compound fracture of my right femur and had shattered my right patella.

After three weeks in hospital i came out with a partially rewired patella, a titanium rod in my femur, a wrist cast and a lot of muscle damage in my upper right thigh (due mainly to the nature of the fracture, the doctors had to hack my leg apart to get it back together).

The rewiring of the patella didn't go well so after 3 months, what was left came out. Being 19 i felt immense fear and sadness, wondering what would become of me. I was convinced that i would be the guy that people avoid on the street because he can't walk right. And at the time, there was hardly any information regarding the long term effects of such a procedure.

I'm now 31 and can tell you now that as much as i'd love to have a patella back, i wouldn't change the past. The whole event has changed me and made me a stronger person. It forced me to deal with everything that life threw at me and never accept that i couldn't do what i wanted to do. I was always an active person but i was never aiming to be an athlete, so i don't feel that this has really limited me at all during last 12 years. I'm an avid snowboarder, love hiking and am a regular rock climber (indoors and outdoors). During my recovery i found swimming laps in a pool (or at the beach if you are near one) was the single best method of regaining strength and mobility in my right leg.

I mention these things as these are activities that i regularly do mostly without issue. (Sometimes when snowboarding my leg can get tired but a short rest and coffee fixes that)

Currently my knee doesn't really give me any major problems. Some exercises can be difficult but not impossible. I basically try to avoid exercise that puts too much strain on the ligament and opt for a different workout style for the right leg (i find cllimbing good for this as you can approach a move from many angles). You kind of figure this out automatically anyway.

I still have fears of problems later in life and believe they will come in some form but what ever happens at least i'll know that i did the best i could with what i had.

All i can say to anyone that has had this done is, don't let it stop you from doing the things you want to do and if at some point you have no choice but to give in then fail gracefully and move on to the next challenge. Always move forward.

[elliptical reviews]

No offense, but i suggest admin adding a google+ button for easy share!