What Causes A Swollen Knee After Patellar Tendon Repair?

Posted on Wed, 11 Jan 2017

Question: Hi. I ruptured my patellar tendon on July 7 2016. My orthopedist repaired the tendon on July 22. My knee was immobilized until the first week of September. I commenced rehab and have been rehabbing for approximately 14 weeks. My one concern is that the knee is still quite swollen despite my attempts to elevate the knee and ice it after workouts. My physiology mentioned this to the surgeon who doesn't seem concerned and has suggested nothing to alleviate the swelling. Is this continued swelling 5 months after the injury normal? When will swelling go down? Is there anything that can be done?

Answered by Dr. Klarida Papaqako (2 hours later)

Brief Answer:
Not normal. Swelling means there is fluid or blood underneath

Detailed Answer:
Hello,

Thank you for using HCM to post your question.
I read it carefully and I understand your concern.

I don't think it is normal to have a swollen knee after 5 months of surgery.

Swelling means that there is either fluid or blood under the knee cup, which apparently is more then normal since you compare it with the other side.

The question is where is this fluid coming from ?

Is it because the exercises of physical therapy damages the tissues which causes fluid production and blood leaking? If that is the case then you should slow down with those exercises and do just enough as to be helpful.

A little fluid/swelling is okay because the body will reabsorb those fluids, but if it is evidently more swollen then you should talk with your doctor again so he/she can examine you and rearrange the physical therapy exercises.

To help lower the inflammation I would recommend using an anti-inflammatory painkiller like Ibuprofen (Motrin) 400mg 3 times/day after food for 3-4 days. Afterwards, if still there's pain, you can take Acetaminophen (Tylenol) 650mg three times daily after food.

Also using an analgesic cream (eg. Diclofenac) during massage will help.
Of course icing, compression and elevation will help too.

Hope this is helpful.
Let me know if you need more clarifications.

Regards,
Dr.Papaqako

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Klarida Papaqako (1 hour later)

Thanks Doctor. Apart from the options you have advised ( i.e. Compression, elevation etc ) does draining the knee appear to be an option? It's a bit of a catch 22...if I don't exercise I won't be able to walk as the quads have atrophied following surgery. What could be causing the swelling? Regards

Answered by Dr. Klarida Papaqako (12 hours later)

Brief Answer:
Exercising its important but need to do the right exercises.

Detailed Answer:
Hello,

Thank you for the follow up question.

Yes, use the elevation, compression...but also the medicines I recommended are helpful because they lower the inflammation and help heal faster.

I would not say to not exercise. It is absolutely very important to exercise, to keep the muscles from atrophy. But on the other side you should do the right exercises. So what I was saying is that because of extensive exercising the knee tissues may be getting damaged instead of getting more help and that is causing the swelling. So talk with your physical therapist that maybe you need to slow down with some of those exercises or adjust to other ones.

You need an examination from your orthopedist so he can evaluate that how much fluid there is under your knee cup. Depending on the amount that is there, he would indicate if it is necessary to drain the fluid or if it is just a small amount that does not need draining.

Hope this is helpful and answers your questions.

Regards,
Dr. Papaqako

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Yogesh D