Distal Femoral Osteotomy - Pre & Post-Op Diary

[KCuman]

First, I want to say that everyone seems to be making great strides, no pun intended :-)  I realize now that progress is progress and we are all different and will improve at different rates and that each little bit of improvement is a step toward being in a better place than before our surgeries.  Chereb, I’m sorry to read that you are having problems but hope for you that it all works out. 

I pretty much dropped out of the post after about week two post-op of my DFO but wanted to step back in and fill you all in on my progress.  Aturpin, I hope you don’t mind me adding all this to your page.

I had my DFO on March 23rd by the same Dr. as Aturpin, I think the main difference between she and I is that I’m 20 years older. 
•   2 weeks I returned to work, a desk job, for ½ days (~4 hours).  I drive myself since surgery leg is my left leg.  That first week at work was tough staying comfortable.  I spent allot of time with my leg on my desk.  I also started going to outpatient PT that week and was put on a recumbent bike the first day for 10 minutes.  At first it really hurt to bend through the peddle stroke but after a few times around the pain subsided.  That week I continued taking a combination of Tylenol and ibuprofen, throughout the day. 
•   3 weeks after surgery I was back to work full time.  I was riding the bike at PT for 15 minutes and started a leg press with just 15 lbs.  I was not taking the Tylenol or ibuprofen regularly during the day but noticed, especially after PT days that I definitely needed something at night to try and stay comfortable.  I was still waking a few times a night to get comfortable.
•   Week 4 I saw my Dr. and was told my x-rays looked good and I could throw the brace away, which I did there in the office.  I was also told to continue using two crutches for 2 more weeks and at week 6 go to one crutch.  He says my ROM  was excellent and flexation, almost all the way, he was also impressed with.  My directions are to strengthen my quad muscle. Leaving his office without the brace on was kinda scary, I was worried I would bump or catch the leg and it would hurt.  One thing I did notice a few days after not wearing the brace is that the majority of the swelling that I still had, mainly behind my knee, subsided substantially.  PT started me on the elliptical for just 5 min. the day after I see the OS.  The second time at PT I go forward and backward for 5 min. each.  I do feel some pain, mainly in the medial side of the knee but not enough to stop me. 
•   Week 5 – I’m just now taking a shower without the sitting on a stool.  I still just get in there and stand in one place and am barely putting weight on my leg, which I think I may be able too but am not supposed to be yet.  I’m supposed to be 30% of my weight.  Thinking ahead to what it would be like using just one crutch I try to focus on my gait and to put more weight on my surgery leg so that at week 6 I can function on one crutch.  PT says I can ride a recumbent bike for 30 min. the days I’m not seeing him.  When there I do 20 min. on a bike and 16 on the elliptical 8 ea forward and backward.  The elliptical is getting easier this week.
•   Week 6 – I’m using one crutch and it is surprisingly easy.  By mid-week my PT says for short trips in the house, his office or work, I don’t even need it.  I do find myself walking next to something to provide support just in case.  By the end of the week I go camping and directions from OS were to use both crutches on the uneven ground.  Which I do although short walks between tables and chairs I am ok without any.
•   Week 7 – Most of the time I’m not using my crutch around the house and office.  Outside and longer trips at work I do still want the support.  My leg feels very week.  PT I’m up to 20 minutes on the recumbent and 20 on the elliptical and 75 lbs on the leg press and trying to focus that both legs are pressing to build back up that quad muscle.  No more over the counter pain meds probably stopped them a week ago.
•   Week 8 – See the OS this week and show up crutchless.  I have not used my crutch for about 3 days when I see him and he is pleasantly surprised.  Says he only has one other patient (Aturpin I assume) that is doing this well.  He says I have slight swelling around the plate, which he told my husband after surgery, that the plate stays in unless it causes me problems.  My surgery leg still does not hyperextend as my good one does.  It does bend as much as the good one.  He releases me to activity other than jumping and running.  Says to increase at 15% a week and to see him in 8 wks.  I went swimming for the first time last night and I was surprised how poorly my leg felt and that that freestyle kicking did not feel as comfortable as a light breast stroke kick.  SO, I did what I could then went to the pull-bouy. 

WELL, I realize this is long and I do apologize.  I’ve meant to get on here many times in the past several weeks to see how everyone is doing and haven’t.

[KCuman]

Here is a pic during my surgery of my plate.  I've been told it has a 7.5mm gap

[KCuman]

Me again....has anyone tried swimming??  I've tried a couple times, starting at about 8 wks and am suprised how much pain I feel in the knee area doing the basic freestyle kick.  I can do the breast stroke kick, very gingerly, and that doesn't seem to bother the surgery leg.  I'm not sure if it is muscle fatigue or bone, I wouldn't think it is bone at this point but am not sure. 

Anyone??

[jumpi5d]

I've been swimming if that's what you want to call it since 2 weeks out. I started trying to kick around 9-10 weeks and its still a big no no at 12 weeks. Dr. T told me that when it was comfortable for me to swim thats when I could again, but didn't give me a set time when I should be able too. Sorry I'm not much help

[aturpin]

KCuman,

Nice to hear from you again and thank you for sharing your experience.  I am super interested in your progress since we had the same doctor so I am curious to see if there are any differences in our PT protocol, progress or healing...so, of course, I dont mind you posting here at all, the more information the better. I think its interesting that you were allowed to do the elliptical so soon.  I didn't start the elliptical until I was at least a month into full weight bearing. I am really glad to hear you are doing so well especially since, as your post mentioned, that you are 20 years older than me.  I think a lot of people assume that age slows the recovery timeline and they curb their expectations.  You are showing that that isn't neccessarily true. I am also glad you shared your experience about going back to work.  I was fortunate (or unfortunate) enough to get laid off shortly after surgery and had the benefit of taking more time at home before returning to normal life.  I couldn't provide the experience you did.  Also, I am due for another surgery in the near future and I will likely have to return to work after two weeks; now I know a little bit about the discomfort I can expect.

As for the swimming, I have been swimming for a while now but I dont do it more than once or twice a month.  I remember when I first started swimming (before I was full weight bearing so maybe 8 weeks ish) I could only get in 6-7 freestyle laps before my knee started hurting.  Then I put the floaty in between my legs and just freestyled with my arms.  I also got in a few flip turns too before the pain set in but after and few laps it became progressively more painful.  I didnt have much success with the breaststroke kick, that was more painful for me.  One thing I did do that was  an intense workout and also was painfree was aqua jogging.  Depending on your level of fitness you can have a floating belt of some kind of floaty on you or nothing at all.  I would alternate burst of sprinting and jogging in the water, just like you would on land, and got gassed pretty quick.  The good news is that by 12-14 weeks swimming no longer hurt and now I can swim for an hour no problem.  Like most things with this surgery, it just takes time. I don't know what to attribute the pain to, whether it is bone or muscle or just getting a new alignment though.

Congrats on your progress so far, the more success stories we can get the better.  Keep up the good work and best wishes for continued progress. Keep us posted if you can..

[chereb]

Hi KCuman, Good to see you back and doing so great.

Another update from me. Well my allignment has changed again!! My leg looks a total mess and not the nice and straight one i had after surgery. The bottom of my leg bows inwards and it really is horrid. Whatever caused the new movement i have no idea. I was in severe pain for 5 days and i could feel the plate moving through the tissues with any bend of the leg. It seem to be starting to settle down pain wise so im assuming the plate has made new space for itself. The pain in the medial side shows no sign of abating and to be honest i am starting to think that this is a failed op. Time is going on now and at almost six months post op i would expect some degree of the pain lessening. My  knee/thigh is still quite badly swollen and there are minor irritations/pain through the rest of it. I am not due back to see the OS until July 20th. I hope im wrong but my gut feeling is telling me its so wrong. Anyway i am off on holiday on the 11th. The crutch will join me. So looking forward to getting a break(no pun intended) I am so doom and glom,lol. Beleive me i try to be positive and still hope for a good outcome. I just want to post honestly \and accurately. 

[Tailwind]

Hello all,

I'm back. I needed a break from this forum. I was getting obsessed with the topic and with my surgery being so far away and being super busy at work, I decided to step back.

But tomorrow is my diagnostic arthrscopy to measure my chondral defect and assess my "good" side to confirm I am a good candidate for my DFO, OAT and MAT. If so I will have the real surgery in August.

I hope you have all made much progress. I will report back after my surgery and after I have caught up on all of your posts.

Keep the faith.

TW

[nikkiluv]

Hi Tailwind,

I completely agree and know how easy it is to become consumed by your surgery and want to look up anything and everything about it. I did the same thing, and for quite awhile I didn't even know when my surgery date would be. It's nice to have you back though

I recently just had my DFO and tibial plateau ACI on May 18th (15 days ago). I started a post-op diary in the <100 diary section and my diary is titled "Nikki's Post-Op Diary for Distal Femoral Osteotomy & Tibial Plateu ACI - 5/18/09/" I've been trying to stay faithful to it and catch up (I've barely finished the first week), but it's been a bit hard with everything that's gone on and especially being so exhausted from the pain meds. But, I do plan to catch up with it and I've been extremely detailed in my experience and many have found it helpful. Hope you'll check it out sometime.

Good luck with your diagnostic scope tomorrow. I hope all goes well and you get the information you're hoping for. Keep us up to date and let us know how everything goes

Nicole

[KCuman]

Hello out there
Chereb, if it were my leg and I was feeling like it was a mess, as you put it, I would get back in to see my OS prior to July.  Something may want to set itself in place if you wait that long.  Good luck.  Just my two cents worth.  How many weeks post op are you now? 
Nikkiluv, glad to hear your surgery is over and you are on your way to recovery.  I'll have to check out your diary post too.
I'm 10 wks now and am walking pretty good most of the time.  My PT says I should try to strengthen my quad and to do TINY single leg squats and to ride my bike.  I have been doing the recumbent but will try a spin type bike at the gym and see if that works my leg more or even try riding outdoors.  The squats are pretty tough and I'm toe touching with the good leg or I can't do them at all.

Karen

[Tailwind]

Hi all

Not the news I expected today. I am not a candidate for the cartilage plug or meniscus transplants. My arthritis is too advanced and my tibial plateau is damaged from too much bone on bone. I will still go through with the DFO in late summer. My medial side cartilage and meniscus are pristine and I should get good benefits from the DFO. I will continue to post here until I start my own diary closer to my surgery date.

Thanks all!

[chereb]

KCuman I am 5 months post op. Os has said from the last set of xrays that the joint has moved. I think it has also moved again as i have been having some real issues with the plate. Its as if it was bedding itself in somewhere else and the pain was unbeleivable. I could not even bend the knee it was that bad. I am off on holiday next Thursday and reluctant to go back to OS before. It is different here anyway on the NHS. You only get consults every 8 weeks and for 10 mins. When i go back i am going to lay my cards on the table. I dont think i should be having the same amount of joint pain this far in. At this moment in time i wish i could go back and not have had it done. Maybe i am just a slow healer? Im 37 so not overly old,lol. I am really tired of the continuous pain now. Its getting a bit much. Nothing really gets me down much but the longer this goes on the more frustrated and upset i am getting.

 

[lady]

I'm so sorry to hear about your troubles. I wish there was more to say to cheer you up. You all have helped me so much with your stories I wish I could help you. I will keep you in my thoughts and hope all is well soon.

[aturpin]

Chereb,

I am very sorry to hear you are having such a tough go of it and I hope your holiday allows you some reprieve to decompress and enjoy yourself. Try and stay positive for an easy fix; Maybe you just have a screw loose . Try not to think failed op unless they tell you so, there are a lot of what ifs to think about and worry yourself with. I hope you get this all ironed out and situations improve...hang in there.

[chereb]

Back from my holidays!!! Had a great time despite the leg, should have left it at home,lol. Disney parks required use of the crutch which was a pain. Had my last physio session on return. Physio says we cant do anything else and he has got the best out of the leg. 120 is my ROM and he is pretty sure something is blocking it going further. He also says that i am probably looking at getting the allignment redone as its pretty bad! My thigh to knee is straight and then the knee sits forward and the calf curves inwards. Its very noticable and will never get a correct gait should it remain this way. I kinda knew that anyway! The joint pain is still as bad and no improvement there. I am back at OS in 2 weeks so will see what is said. Not impressed so far. I am hoping my leg can still be salvaged and there is an answer to what has happened. Its almost as if my knee has collapsed down on the realligned side. My husband finds the leg shape quite shocking. Got used to the stares with shorts on,lol. The plate also continues to be a pest. Eventually it will come out though so at least one problem resolved! Will update when i have seen OS. Hope everyone is doing great.   

[nikkiluv]

Hi chereb and everyone else here

Chereb, glad to hear that you had a nice vacation, but sorry to hear that your leg isn't getting any better I hope that when you see your OS he will be able to provide you with some answers as to why this has happened to you and what your next step will be in finally resolving your leg and knee issues.

As for me, I've been doing pretty well. Today officially marks me being 7 weeks post-op, yayyy! The first 6 weeks were definitely rough and I wondered if I would survive, but I did, and to look back at what I made it through makes me feel empowered and so much stronger. I feel that there are very few people that are able to go through what we do and make it through the other side stronger and better, since it is such an emotonal and physical experience to go through.

I did post an update in my post-op journal overviewing the last 6 weeks of my journey. It's located under the <100 post-op diary section and is titled, "Nikki's Post-Op Diary for Distal Femoral Osteotomy & Tibial Plateu ACI - 5/18/09" if any of you are interested.

I know that I still have a very long road ahead of me in order to hopefully be fully recovered at the end with a new and pain-free knee, but I have made it this far and don't plan on stopping until I've reached my goal and I'm at the end. I'm hoping that the worst is officially over and now I'm just on the up and up from here

Hope everyone else is recovering well!

Nikki