What is recovery of knee function following fracture of the tibial plateau .

[sanja1mila]

Hi all. On 26.01.2011 I had a ski accident while I was skiing off piste in France. I had a fracture of my right tibial plateau. I was operated on 29.01. 2011 fracture was enforced with 5 screws and one plate. French doctors did a good job, operation was successful. I was told that I would be able to ski again next year, however, would have to adopt to snow conditions. In addition they told me that it might be possible that n 10 years time I would get arthritis pain in my knee. By the way I am a very fit 35 year old woman. On my second day after operation I was doing physiotherapy with some machine that bends your knee for one hour. I was able to bend my knee that day by 60 degree. Had physiotherapy next day as well and could bend my knee by 70 degrees. I am not allowed to put any weigh on my leg for 3 months and not to drive a car for 4 months.

Now 3 weeks after surgery I can bend my knee by 120 degrees, however, doctor limited my bending on 90 degrees with a brace.
To say again, my leg movements are very nice and can do a lot of movement. However, I still fell peen and needles in my right foot that was not injured. I have physiotherapy just once per week, but i do small exercise at home on my own.

I would like to ask you for how long I would have to do physio and for how long my recovery will take. Will I limp when i remove brace and for how long? ( i have 2 weddings where I am a bridesmaid) one wedding is exactly on 3 months after my surgery and other is 4 months after surgery.
Another question is after how many moths I would get my muscles back( I was very fit before accident)

What is recovery of knee function following fracture of the tibial plateau, what exercise are good for my knee, how many days /months will I limp ( is it possible that i can get way without limping).

Mant thanks,
Sanja

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[sanja1mila]

Please, any advice or experience would be helpful.
Thanks,
Sanja

[AndySchmidt]

hi Sanja
A lot of these questions should really be addressed by your treating therapist, as they have assessed your knee and know the state it is in, and probably seen x-rays etc. Some general answers however are that the majority of healing takes place in the first 3 months, with further small amounts of bone-remodelling happening for around 6 to 12 months post injury. The main thing that takes a long time to come back is the full strength in the leg muscles, particularly the quads. The effects of pain and swelling inhibit or limit the amount of activity in the muscle, sometimes for even a year or two post-injury. So it's really important to keep those quadriceps muscles working as much as you are allowed at the moment, and as much as you can once you are given the all-clear (again, your treating therapist is the best at giving you which specific ones to do). Regarding limping, it's quite variable. Some people find they can walk really well straight away after they are allowed to weight bear, for others it takes a while. Once you are allowed to weight-bear, the sooner you can practice and correct a normal walking pattern the better, as the brain soon learns to pick up incorrect patterns. When you can weight-bear, you are better to take things slow and do the walking correctly, rather than try and rush along getting it wrong and doing the wrong pattern.
Overall though, if you do as instructed then there is every chance you will have an excellent recovery. The main thing I would suggest is to listen to all instructions, try and find as much patience as you can as it can be a long haul, and work those quads! Sorry it's not more specific, but to tell you otherwise would be unprofessional without assessing the knee first.
Hope that helps some and good luck with the rehab.
Kind regards
Andy Schmidt
www.albany-physio.com

[sanja1mila]

Hi,
Thanks a lot for your answer.
Just a quick update since than.
I am almost 3 moths since accident. I am recovering very well. Even doctors said that they are surprised with fast recovery. So let me tart. I was able to fully bend my knee 4 weeks after surgery. I did not have a lot of physiotherapies, however, I was exercising at home and a month ago, I have started going to thy gym. I was doing light exercises no weigh bearing off course. I don have any problem bending m knee at all. I have started walking a bit, ( 50 % weight) . I tried to walk to see how I am doing and I have noticed that on short distances I don't limp at all, however, if I am walking longer, limping would be obvious but not a lot. I can feel that my knee is weak and that cant yet stand the pressure. My body feels that I have to strengthen knee muscles if I want to do any sport or even long walking. I am planing to go for a 3 weeks rehabilitation (5 treatments included per day) so I hope that I will get back my muscle back.
May I ask you after reading all this, can you reckon after how many months I would be able to do some sport like jogging or hill walking, and will I have some serious pain when I actually start walking without crutches?

Many Thanks
Sanja

[physiobob]

Thanks for the images. The important thing here is that the alignment of the tibial plateau looks very good indeed. This is why you have had such a fast recovery. Like all fractures you are at least 6 weeks to begin with for some healing to take place. You are looking about 12 months for full bone strenght to return. In between the brain will permit the slow restore of strength (ie currently it will be inhibiting your quads) to the muscles as it deems appropriate that the joint can withstand the forces. The key here is a steady progression. It seems you should be hill walking sometime during summer. As for jogging a little hard to call that one. Pick short term goals that are progressive. Jogging is a longterm on which will come

[sanja1mila]

Thanks a lot for the replay. I am now walking with full weigh bearing. I even went for a wedding in another country for 6 days and I even danced ( I was careful though). I fell difficulties when I am going up and down the steps and cant do staff that I did before =, but its to early for that anyway.
WIll update more in a couple moths time. So all of you with similar injury just stay positive and don't be afraid to move your leg. Here is my picture while I am dancing.

Thanks a million dancing.jpg

[Cathy Winsor]

Hello, I had a tibial plateau fracture 3 weeks ago, also skiing off piste, surgery in the Rangueil, Toulouse. Have 110 degrees rotation now so prognosis is good but I would like to know how many months it was between your fracture and driving/ jogging or until both legs felt the same.