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Limitation of movements after patellar fracture

Q: I am 28 years old Indian unmarried male working in Kuwait since 4 years. I have problem in my left knee actually it got fractured in a road accident in Nov 1988 in India causing my Left knee fish bone (Patella) broken into 8 piece and Doctor removed all pices of patella from my knee and did not put any artificial stuff and advised that I can bend my knee more than 80% by Exercise. Then I started exercise but I couldnt bend it even 50%. Though it doesnt pain but I want to know is it possible at any cost that it can be moved till 80% or more? Please let me know if it is possible?

A:It is a long time since your fracture. It is unlikely that you can gain back full range of motion after such a long time, without any intervention. Physical therapy may help a bit, but may not alter it significantly. Surgical treatment is recommended, only if the loss in motion, significantly affects your activities of daily living. In that case, arthrofibrosis (or breakage of adhesions) can be tried through arthroscope. But it may not be enough, since it has been a long time, and there may have been significant fibrosis. A surgical procedure like quadriceplasty may be required, but may not be justified if there is no sufficient morbidity or limitation in routine activities.

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