Patellar Ligament Injuries: Surgery, Recovery, and Expert Opinions

Patellar ligament issues

Hello Doctor, I injured my knee and dislocated my patella on November 7th when I bumped into a chair.
The emergency physician performed a manual reduction, and the next day, an orthopedic doctor at Mackay Hospital removed the cast and drained the blood accumulation from my knee.
Yesterday (December 19), I had a musculoskeletal ultrasound at Mackay, and Dr.
Liu Tsung-Ting informed me that the dislocation caused a ligament tear, which has not improved since then.
He recommended surgery for ligament reconstruction (using either an artificial ligament or an autograft).

1.
What is the name of that surgery? (I would like to Google it.)
2.
Should I consult more doctors? (I have already seen six orthopedic surgeons, but only two performed ultrasound examinations, both of which indicated ligament injury.)
3.
If I undergo surgery, will there be any long-term complications?

Xiao Tian Shi, 10~19 year old female. Ask Date: 2018/12/20

Dr. Li Yongheng reply Orthopedics

I recommend undergoing an MRI for further evaluation.
I am not sure which ligament is torn, so I cannot provide the name of the surgery at this time.
However, in general, for ligament reconstruction surgery, given your age, autograft tendons would be prioritized.

Reply Date: 2018/12/20

More Info

Hello! It sounds like you've been through quite a challenging experience with your knee injury, and I appreciate your detailed description of your situation. Let's break down your questions regarding patellar ligament injuries, surgery, recovery, and expert opinions.

1. Surgical Name: The surgery you're referring to for reconstructing a torn patellar ligament is commonly known as "patellar tendon reconstruction" or "patellar ligament reconstruction." This procedure aims to restore the integrity of the ligament, which is crucial for knee stability and function. Surgeons may use either autografts (tissue taken from your own body) or allografts (donor tissue) for the reconstruction.

2. Seeking Multiple Opinions: It’s always a good idea to seek multiple opinions, especially for significant injuries like yours. While you have already consulted six orthopedic surgeons, it’s essential to ensure that you are comfortable with the recommended treatment plan. Different surgeons may have varying approaches based on their experiences and expertise. If only two of them performed ultrasound examinations and confirmed ligament damage, it may be worth considering their recommendations more seriously, especially if they align with your symptoms and imaging findings.

3. Potential Post-Surgical Complications: As with any surgery, there are risks involved. Common complications from patellar tendon reconstruction can include:
- Infection: Any surgical procedure carries a risk of infection.

- Knee stiffness: Post-operative stiffness can occur, which may require physical therapy to regain full range of motion.

- Re-rupture: There’s a possibility that the reconstructed ligament could re-tear, especially if proper rehabilitation protocols are not followed.

- Chronic pain: Some patients may experience ongoing pain after surgery.

- Scarring: Surgical scars can form, which may or may not be aesthetically pleasing.

Recovery from patellar tendon reconstruction typically involves a structured rehabilitation program, which may include:
- Physical Therapy: Essential for regaining strength and mobility. A physical therapist will guide you through exercises tailored to your recovery stage.

- Gradual Weight Bearing: Initially, you may need to use crutches and gradually transition to full weight-bearing as tolerated.

- Range of Motion Exercises: These will be crucial in the early stages to prevent stiffness.

- Strengthening Exercises: As you progress, strengthening the muscles around the knee will be vital for stability and function.

In terms of timeline, most patients can expect to return to normal activities within 6 to 12 months, depending on the severity of the injury and adherence to rehabilitation protocols.

In conclusion, it’s crucial to have open discussions with your orthopedic surgeon about your concerns, the specifics of the surgery, and the expected outcomes. Make sure to ask about the rehabilitation process and any precautions you should take post-surgery. Your active involvement in understanding your treatment plan will empower you throughout your recovery journey. Best of luck with your surgery and recovery!

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