Any Orthopedic Advice for a Broken Patella?

[qjetha]

From reading posts and replies in this forum (I am pretty new to the site) I have gathered that there is a huge wealth of knowledge from the members so I thought I would ask for some advice.

I shattered my knee cap on July 31st in a crash in a local crit. The patella shattered into three pieces, however they were not displaced so I was told I would not need surgery. I was put in a leg brace and was told not to put weight and not to bend the leg at all. It has been a month now and I still have not been bending the knee or putting that much weight on it (I can rest my leg on the floor but that is about it). I am 22 years old and am a fit cat 2 roadie (definitely not fit now though :()

I guess I have two questions, first does the ortho's decision not to bend or put weight on the knee even four weeks later make sense? I have an appointment on Wednesday for further x-rays and he might change his advice but for now recovery seems really slow. The knee is still quite swollen but the pain level is low (off meds). Should I be doing something that I am not?
The other question is I guess the million dollar question for me, and that is when do you think I will be able to ride again easy on the trainer? I know this is tough to answer but I am dying to spin the legs!

Thanks for any insight given!

[Dekonick]

I can't say anything about a knee injury like what you are describing... BUT I did fracture and dislocate my ankle in June of '09. I was told to stay off of the limb for several weeks, then start GENTLY adding weight... about a 6 month total rehab for me. One thing to keep in mind: Your therapist is going to rely on you to follow directions. Do exactly as they say and DON'T over-do it. On a couple of PT visits, I tried to be super human and all I did was set my rehab back each time. DO what they say, not more... not less...

Hang in there! It sucked being off of the bike but in the end you will be back before you know it.

Rehab - it works IF you follow directions!

:beer:

[qjetha]

I can't say anything about a knee injury like what you are describing... BUT I did fracture and dislocate my ankle in June of '09. I was told to stay off of the limb for several weeks, then start GENTLY adding weight... about a 6 month total rehab for me. One thing to keep in mind: Your therapist is going to rely on you to follow directions. Do exactly as they say and DON'T over-do it. On a couple of PT visits, I tried to be super human and all I did was set my rehab back each time. DO what they say, not more... not less...

Hang in there! It sucked being off of the bike but in the end you will be back before you know it.

Rehab - it works IF you follow directions!

:beer:

Dekonick - thanks for the advice, especially about following the therapist and not trying to be a hero about it, which is definitely something I would do. The orthopedist I am currently seeing said that depending on how I heal I may not even need physiotherapy which, to be honest, makes me unsure if I have a good doctor.
I think I was under having delusions of grandeur that I would be able to be almost normal and spinning in three months time. I guess I gotta settle in for the long haul and like yourself expect a 6 month recovery:(

Thanks again for the reply!

[pbbob]

I can't remember that far back.
I suppose you could google "does flexion and weight bearing make sense after a fractured patella"
So what would make you sure you have a good doctor/surgeon?
no need for pt or surgery seems to be a win/win.
I predict that because your young and you'll heal you will race again.

[Gothard]

You are lucky enough tthat here is no displacement of the fragments, and you need to preserve that situation at all cost. If there is displacement, the articular surface will become irregular and act like a planer on the femoral trochlea, grinding cartilage off.

As long as the bone is not considered stable (i.e. quadriceps muscle contraction won't displace the fragments relative to each other), use of the quad is indeed forbidden. Then as the healing process gives strength back to the patella, you can increase loading it.

You are WAY better off losing 6, even 12 months now, to gain a life of pain-free cycling. The alternative is gruesome for cartilage.

[Dekonick]

You are lucky enough tthat here is no displacement of the fragments, and you need to preserve that situation at all cost. If there is displacement, the articular surface will become irregular and act like a planer on the femoral trochlea, grinding cartilage off.

As long as the bone is not considered stable (i.e. quadriceps muscle contraction won't displace the fragments relative to each other), use of the quad is indeed forbidden. Then as the healing process gives strength back to the patella, you can increase loading it.

You are WAY better off losing 6, even 12 months now, to gain a life of pain-free cycling. The alternative is gruesome for cartilage.

See? An expert agrees!

Take it easy. Follow instructions!

[rice rocket]

I skipped rehab on my shoulder when I was 17. 10 years later, I'm reminded of that pain every single day. :crap:

[qjetha]

Sorry for taking long to reply. Thanks to all for the responses, especially Gothard for the specialist advice. Will take all of it to heart. Have got an orthopedic appointment on Thursday and then off to University on saturday. Hope it all goes well, and will commit to being patient and doing the physio.