Hi everyone, also new to this site and thanks so much for all you shared — here's my story to add.

24yo male, very active runner, biker, rec sports. DIII track and field athlete racing the 800m.

November 2020 I fractured my patella in a skateboarding accident. Doctor told me I probably would never run full speed again the way I used to. Had surgery the next day.

To paraphrase the surgeon's note, a small distal fragment (aka a small piece at the bottom, where the patellar tendon connects) of the patella tore off, with some comminution, medial and lateral reticular tears. Single screw fixation + ORIF.

December 2021 I raced a 54 second 400m. Now I am running about 20 miles per week with some biking as well. This is good progress, but I have a lot of work to do. My knee is still not good during runs, is very stiff before warming up, and remains somewhat swollen. I will try to return in a year with more progress. Needless to say, my goal is full recovery.

The advice I would give to anyone out there, including myself: be relentless with your physical therapy. Do all of the exercises, always work to improve your ROM, strength, etc. The knee does not get better unless you are doing things to improve it. I think to myself, "if an NFL or NBA player had the same injury, they would not accept anything but a full recovery and you should not either." the success stories shared were very inspiring to me too.

Hi,

I came across my old post and thought it might help people to know where I am at almost 12 years later.
There definitely is hope! It does take a long time, though.

I had a comminuted patella fracture (resolved w/ ORIF) in Oct 2010. The hardware was removed in June 2011.

It really took two years for me to be where I was happy with it. The knee sometimes still swells up but I really have no pain. In the last few years I have run somewhere between 30-50 mpw with no issues. Only did one marathon since, but that was due to lack of time and other factors. The knee hasn't held me back.
I had a really bad case and it sucked but I can say that it healed really well.

I know this is quite the late reply, but I'm the same age as when you made this reply and I want to say you really inspired me.

I had just turned 23 when I shattered my patella. Truck drove in front of me when I was riding my bike to school and I flew over my handlebars and landed on my knee. Broke into 5 pieces like a cookie, but miraculously I immediately straightened my leg after the accident and held it straight. I didn't need surgery, however I severely damaged the cartilage surrounding my knee.

I was also very active before, I am a lifeguard during the summer months and cycling is one of my favorite things. I also just love being active and sports in general.

It has now been about 1.5 years since it happened and I came to this forum to seek reassurance because to be honest, after 1.5 years I'm still not back to normal. Albeit, I could have been more on top of my physical therapy and maybe I'd be back by now. But I was very diligent in the months following my injury and during my recovery to make sure I healed well. But I still feel the consequences of atrophy and weakened structure. I obviously cannot pistol squat anymore, and there's just general instability with my knee sometimes, especially if I catch myself in a fall on ice or something.

You have inspired me though to continue with my training and to never give up. I am going to get my knee back and then some, I am still young and somehow, even though my strength isn't there, I am pain-free at the moment. I hope to check back in a few years to update how its doing.

Glad to provide support forward! Here is a 3 year update: my knee has continued to get better, to the point where now I can now do pretty much anything. Running, sprinting, playing soccer, frisbee, trail running, biking, lifting, etc. My right quad is probably larger than it was presurgery, but my left quad is even larger (did a lot of squatting since) and so I've accepted there will always be an imbalance.


The bad news is that my knee is still very stiff and swollen, and it requires almost daily exercises to keep it loose. but, when it's loose, it's really good. The most effective thing I have found for keeping it loose and functional is squatting and leg extensions. Some days are worse than others, but I find I have fewer worse days when I'm regularly squatting (with a long slow warmup to my max weight).

Hang in there. I shattered my patella 7.5 years ago now. It took a lot of time and being diligent with PT but the strength discrepancy between my 2 legs is within normal range and I have full range of motion; it's like it never happened and I'm over 40s. You have youth on your side.
What helped me:
- Tons of single leg strength exercises as prescribed by my PT (and when strong enough plyometrics),
- A (well calibrated) dual-side power meter has been super important for me. Really helped staying on top of keeping my weak leg engaged. Took a good 3-4 years to keep a decent balance on long rides (would keep the power ~ the same for 90min or so but gap would widen)
- I did get a set of power-cranks which I think helped but you might as well do single leg stuff on the trainer. Probably overkill.

My new toy which I wish I had then is the Mobo board. Highly highly recommend... took time for me to get it as I thought it was overpriced for a wood board but it's actually perfectly designed and revealed weaknesses I didn't even know I had.

Thanks for your replies, I have to say that it's reassuring to hear your experiences.

simonalford, I'm thinking the nature of our injuries might be different, you may have had it worse than me. My strength isn't there but I had full range of motion and zero swelling about 9 months out. However I find that my knee often clicks (not just audible, I feel the click too but its not painful), does this happen with you? I also did lots of combat sports like kickboxing and muay thai before my injury and now I actually feel more confident kicking with my injured leg because it seems the atrophy increased my range of motion.
I want to ask, what sort of things did you do to prepare your knee for more explosive movements? What exercises in general do you do to strengthen it pain free? I find that if I go too heavy on barbell squats (or basically anything requiring extra stabilization) I get mild-moderate pain.

CaliB, what sort of single-leg exercises did you do? Lately I've been doing weighted Bulgarians, or doing pistols assisted with a stool and a pull-up bar to adjust the load. I love the idea of the power meter. Not sure if I could afford one right now or if it would be worth installing on my current setup. Did you find that being able to monitor your power on each side helped you make progress quicker in regaining that power? Once again thanks for sharing your experience, one of my greatest fears with this injury was that I would be disabled by the time I'm in my 40's. You've restored some of my hope

Micro fractured my left patella a long time ago - just as I was making the transition from being a runner to a triathlete in the early 1980's. While running at tempo pace, I ran at that speed into a concrete light standard with the first thing making contact - my left knee a full extension. It was a hot day. I was running with no short and a bee had become stuck to my chest. I was attempting to carefully swat it off me, not looking up and WHAM!

I recovered from that, but that knee started to give me chronic problems. About a year later - went to see a top Sports Orthopedic Surgeon in our area and he suggested an Arthroscopy. What they found was was evidence of the micro fracture on the back side and some crap floating around in the joint. They cleaned all that up, and, while my knee has occasionally been an issue, over the years, it's still going strong at nearly 63 years old - no running anymore but tons of cycling and cross-country skiing in the winter!

I do need to periodically roll out my right IT Band pretty aggressively, when it does act up and this seem to keep it all in check

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Steve Fleck @stevefleck | Blog

Exercises: Nothing fancy and very progressive but it worked.
Started with simple leg raises (straight and side), calf raises, bridges, clamshells, then tons of lunges, Bulgarian squats/lunges, assisted pistol squats. Also lot of band exercises (master walk, etc.). Much later we started integrating plyometrics with a lot of step/box jumps and "agility" stuff (side to side jumps, agility ladder, etc.)

For the power meter I wouldn't say it made me progress quicker but it helped me stay on top of it. With PT it's easy to just stop when you think you're ok, I was guilty of that but the PM kept me honest. It was a very helpful monitoring tool; if you can find a cheap one I would highly recommend but I'd just put it in the nice to have category, not must have. If you are on a limited budget I'd spend it on a good PT.