fulkerson procedure, patella graft, joint spacer

[ELLEN]

am having all of this done on 9/27/02.  need input on what to expect.  I am service advisor at car dealership and want to be back to work in 1 week doc says maybe 2.  I have had 4 L. knee surgeries goldwiath (?), lateral release and 2 scopes for torn cartlidge.  I think I'm pretty tough to handle going back to work soon after surgery,  but I am a little freaked out about the fulkerson procedure.  Dr. is seeing if bone growth stimulant that they use on spine fusions is available in place of bone graft for cutting tibia.  Also I am confused on grafting of the patella (what is involved)

please help me I am a little confused about all these procedures and the severity of them

thanks in advance for your input

[opal]

Ellen,

I had JUST the Fulkerson done on 5/23 (without all the other stuff you describe) and work at a desk job.  I was ok'd to return to work after 2 weeks (it turned out to be 2 1/2) and I was very glad I took the time.  Even after 2 1/2 weeks, I worked shortened days, sitting with my leg propped up.  If you are on your feet all day, and it sounds like you are, you're crazy to try to push back after only 1 week.  I was also on crutches for 2 solid weeks and in a straight leg brace for 8 weeks.  Fulkerson is a seriously MAJOR surgery and requires lots of rehab.  I can't imagine being back to work that soon.  You don't want to put that amount of time and effort into a procedure, and then find you pushed too hard and too fast.

Was it worth it?  Definitely, but take it seriously and take it slow.  At 15 weeks, I can now walk with no limp and stairs are becoming less problematic...but still have a ways to go.

Best of luck and let us know how you do.

Opal

[ELLEN]

Hi Opal:

Thanks for the response.  What country do you live in?  I am in U.S.  My Dr. says he'll send me home with a novacaine pump and after 3 days I have to go back to him to have it removed.  Were you in alot of pain prior to your surgery?  I am so sick and tired of pain pills!  I admire you for going back to work so soon.  I am on straight commission at my job, and we don't have disability insurance.  So I have to try to get back as soon as possible.  

What caused your Knee prob.  My Dr. says mine is from one to many surgeries.  A year ago august my knee just started bothering me after a 3 hour road trip.  I waited 3 weeks and the pain did not subside, I saw 5 ortho's and they all told me I needed total k. replacement but I was too young and they wouldn't do it.  I had 3 synvist injections, cortizone injections (which I strongly disagree with) P.T. and no releif.  Finally I saw this O.S. in Illinois who looked at my xrays and mri report and he told me I need fulkerson. He assesed this in about 1/2 hour and then spent another 1/2 hour with me going over the situation.  Very Caring and Knowledagble guy.  Will go out of his way for any of his patients.  He even gave me a handicap parking permit.  That was in march that I saw him.  Saw him again last week in august to confirm surgery date.... that is when he told me my knee had gotten alot worse and  I needed all the other stuff done.

I really didn't think this procedure would be that major.  My husband & I were a little surprised to read the responses I had gotten, (he wanted to go to mexico 4 days after surgery I told him we was nuts).  I think he realizes that was a bit unrealistic.  I hate to say it but I am really looking forward to surgery.  Hopefully I will be able to ride my snowmobile in january. .

Sounds like recovery is long.  Did you have pt before surgery???  I cant even tighten leg muscles causes tooo
much pain for days.  If exercise prior to surgery will speed up recovery I should just try to grin and bear it.  It helps knowing that the end is near.

Thank you for your input I really appreciate it.  It helps to have first hand knowledge.  Thanks again.  I hope going upstairs becomes systematic for you soon.  I know how hard it is.  Especially when you really have to concentrate on something that use to be effortless.  Good Luck to you, and keep your head  up Kiddo  

Ellen

[opal]

Hi Ellen.

Sorry it took so long for me to get back to you..  I have no time on the weekends to 'chat'.  I am in US, Massachusetts, actually.

I originally fell down the stairs a year ago and tore the lateral meniscus in 2 places.  My quads never recovered from the arthroscopy and that's what was holding my patella in place.  Dr. told me that my patella tendon attaches to the tibia off-center (the way I was born) and if you take away the quads, there's virtually nothing holding the patella in place.  In the 6 months from the original injury, I had really done some serious damage to the articular cartilege.  It got to the point where I limped 24/7 and had, several times, caught myself before falling down the stairs.  Pain was a normal state of being for me and I couldn't sit for any length of time with my leg straight because of the amount of pain when trying to rise.

I did not have a novacaine pump, but I know of others who have and they say it does help.  I was really surprised that I didn't have the severe and unrelenting pain others have described.  Don't misunderstand, the first 2 weeks, my Percocet was my best friend, but I don't remember it as being horrific.  Sleeping was probably the most difficult because of the brace and being a side sleeper, but I finally found with lots of pillows braced around my leg and back, I was able to catch a few zzzzs.

As regards PT, I spent from November (just after the meniscus scope) until March (6 weeks after 2nd scope) in PT.  We suspended the treatment 'cause it just wasn't helping.  I did, however, continue to do all the exercises at home in an effort to at least maintain what quad strength I had; that way, when the TTT was completed, it wouldn't be quite so difficult to get it back. OS told me to work to the point of pain, but not through it.  

If you have a handicapped tag, guard it with your life!  I wish I'd though of having one after the surgery.  I was in a straight leg brace  and one crutch for 8 weeks and while I had someone to chauffer me around, parking a hundred feet from a store and having to walk, seemed like a hundred miles.

Yes, recovery is long and tedious.  Most movement causes you to have to think about a) whether its worth the effort and b) how you used to do it.  But it is definitely worth it.  I haven't walked without pain or limp for over a year, but I'm on the road now!  Matter of fact, I see OS tomorrow (almost 16 weeks) and I really believe my time with my physical therapist is limited, maybe 3 or 4 more weeks, then I'm gonna be free!!    I had to stop my 'walking 3 mi. a day a long time ago, but if OS gives the OK, I'm going to resume this coming weekend.

Again, I cannot stress patience and perseverence enough.  It is a long recovery, but try to keep in mind that you'll be able to walk pain free and get on with your life.  Try to have enough 'hands-on' projects as you can; knitting, crocheting, reading, even crossword puzzles..they can be lifesavers.  

Best wishes on your upcoming surgery!

Opal