My fiance suffered a fall in 2000 which resulted in four subsequent surgeries, ending with the last in 2003. The outcome was total patellectomy - complete removal of the left knee cap- and reconstruction of the patella tendon, which had been accidentally severed during the first surgery. The last surgery in 2003 left him facing 12 weeks of physical therapy and little optimisim for lessening of pain or much range of movement of the left leg. Against doctors orders, he took a job where he had to walk 9-10 hours a day on concrete, in 28 degree temperatures, lifting 80 -100 lb. boxes! This resulted in the building up of muscle in the left quad but also re-tore the patella tendon and now it is split into 3 separate sections, causing him severe pain, but not limiting his physical motions. I do not understand why there can be full knee replacements, but we cannot find an ortho or anyone who can do a patella replacement. My fiance is in constant pain, unrelenting and yet refuses to give in to the pain; he doesn't let the lack of a knee cap restrict his physical activity unless it drops him to the floor, as it does sometimes.