Derotational Femoral & Tibial Osteotomy (Right: 7/8/10 & Left: 6/16/11)

[NickiAnn]

I really appreciate you sharing your thoughts with me, Beth.  The dilemma of how to balance work with this surgery is very real.  It sounds like you will have a lot of balls in the air next year with your internship.  You will ultimately have to do what feels right for you based on how the left leg feels and how well the right leg recovers.  Personally, I'm starting to think that the earlier these surgeries are addressed the better.  I spend half the time kicking myself for not having them done in my early twenties when I was still living at home, but I can't change history, and I had no way of knowing that I would come to a point where my knees would ache constantly.  But here I am facing my 34th birthday with a ticking biological clock and aching knees.  For the past decade, I have been able to avoid persistent pain by carefully monitoring my activity.  If I didn't run or do anything that put too much pressure on, I was able to keep things status quo.  In fact, it's somewhat shocking to me that the situation has changed so much just the past six months. 

It will be great if you can return to work on schedule in September.  Did Dr. Teitge say anthing to you about not driving?  I had read in someone else's post that driving was forbidden for a year, but I'm not sure if that was for that particular individual or a general post-osteotomy rule.

My school doesn't have a problem with teaching on crutches.  Heck, they encourage it!  Anything  to avoid paying a sub!  I broke my foot a while back and spent a month on crutches.  It was miserable but possible.  The worst was when we had a fire drill and all my students ran out and left me behind.  They told me that they knew it was a drill and had it been a real fire they, of course, would have carried me out.  Yeah right! 

That's good to know that weight can be so detrimental to the joints.  I always suspected as much but had no idea it was 7 lbs. of pressure per pound of weight!  I am watching my diet very carefully.  Of course having a jab of knee pain is a fantastic reminder not to eat a cupcake or plate of fries.  I haven't been this motivated to drop ten pounds since I was getting my wedding dress fitted!


Best of luck to you, Beth, as you approach the date of surgery.  Try to think of the positives.  I bet it will be fantastic to look down and just see a straight leg.  From what I have read, Dr. Teitge does a great job taking care of his patients post-op, so you will be in good hands.  Just imagine, by fall you might be on your way to stable, healthy knees!  Of course, I don't blame you for being nervous at all.  My surgery is completely hypothetical and i'm already nervous.  I think it's great that you are taking charge of your health now so that you can have a more active future.

Nicole

[Teacher2Many]

Hi Nicole...

Am hoping that my thoughts and 'two cents' are helpful!  I totally agree that the dilemna between fixing the knees, balancing work, pursuing more education, and devoting time to your family is not easy to rectify.  And unfortunately, knee issues leave a lot to the 'unknown'-we can do our best to prepare ourselves, create plans based on what we know, but one little kink in the agenda and all is changed.  So in that regards...here's to hoping for an uneventful recovery for all!  It does still amaze me how quickly things change with the knees and like you have noticed, 6 months can make a huge difference.  Heck, with me, things have greatly worsened in a matter of 2-3 months and sometimes every week is a little bit more uncomfortable and things you used to be able to do are now still doable but with marked increases in pain.  And I'm sure none of these surgeries would have been possible if I wasn't still living at home...have had plans to move out for the past 4 yrs. or so but but when the time came when I was recovered enough from the surgery to be independent on my own, it was time to sit down and talk about another surgery.  This fall was supposed to be the fall to hit the road-last summer's ACI was supposed to be cured all the pain and surgery was not even planned for the future but things of course changed and the huge rotational issues weren't noticed until April of this yr., with it confirmed by Dr. Teitge in early May.  I have longed to do Christmas day dinner but fear that that dream will have to wait for yet another year!  That's okay though...will just have to make it as spectacular as possible when the dream finally becomes a reality!

Fingers crossed about returning to work...wish mine was as 'accepting' as yours re: letting you come back on crutches.  I think the biggest part with our district is the liability factor...much more likely to injure yourself when on crutches than when not so am sure they probably figure it's better paying for a sub while you recover and can return to work without restrictions than dealing with a workman's comp scenario.  Of course then there are those teachers, like myself, whose students crave and require the structure that only their teacher can provide, due to their severe disabilities, and having a sub just creates utter chaos!  Funny, never thought 3-5 yr. olds can be intimidating but to the subs, my little guys are!   

Dr. Teitge has not mentioned anything about driving so maybe it's best it's left as something that's not asked for fear of the answer.  Past surgeries have always said that once you are in control of your leg wtih adequate muscle strength and not on narcotic pain meds anymore, they give you the okay to drive.  Even given the okay to drive with a brace on my leg last year but then I had right wrist surgery less than a month after my bilateral ACI procedure due to a torn TFCC which left me in a full arm cast, casted in flexion.  Needless to say, driving didn't occur until that cast came off....about 10-12 weeks after the knee surgery!  But that was just for the safety (and partially due to having a rental, as a pick-up truck backed in to my car coming home from PT one day and didn't think insurance would think highly of it if I got into an accident while driving a rental with bilateral knee braces and a casted arm)!!!  But the thought of not being able to drive for an entire yr.-oye vie!  That simply will not work!  Guess maybe I should have started with doing the left leg so that driving wouldn't have been an issue, aside from getting into the front seat!

11 more days...time is quickly approaching!  Am nervous but I think mostly because of the numerous surgeries in the past which provided minimal relief if any and thinking...what if this doesn't cure all the pain and limitations?  Then what?!  But I always like to be prepared for worst case scenario than assuming all will be fine and then discovering it's not.  And I have heard the same about Dr. Teitge's care with patients post-op and know that I'm in great hands between his care and the care of my surgeon in Chicago who's doing the majority of post-op and follow-up care, to alleviate the need for frequent trips to MI (will only head up to MI for the major post-op visits, which I think he told me were at 6 wks., 3 months, and a yr.-the others will be done in Chicago with info/images/notes/etc. forwarded on to him).  I've got a great team on my side...couldn't ask for anything better!

Sending warm wishes for less painful knees (esp. during the summer when we are supposed to be enjoying our time off from work)!

Beth

[crankerchick]

I'm 8 months post-op from my derotation of femur and tibia and distalization of the tibial tubercle to correct patella alta. I didn't have my surgery with Dr. Teitge, but I did consult with him prior to my op. I've read his literature on the topic also. You all are definitely in good hands, which you already know.

I have never heard of the 1 year to drive doomsday limitation. I'm pretty sure none of the ladies on here had such a restriction. I certainly didn't. Of course it is my left leg, but even if it was my right, given how my leg feels now, I know I could drive and I'm 99% sure my OS would allow it.

My knee feels pretty darn good. The patella hasn't once gone out and the pain I used to experience hasn't resurfaced. I'm dealing with some irritation in my hip still as well and some hip flexbility issues that I'm trying to work through, but I still already consider myself better off for having had the surgery. Prior to my op I was severely limited, as the patella was just going out all the time. Now I can do anything I want, it's just a matter of strength and flexibility holding me back.

[NickiAnn]

I'm very reassured to read that a big driving limitation isn't the norm.  I'm not sure where on here I read it; there are so many threads that it gets confusing to backtrack and figure out where I saw what.  Crankerchick, I'm glad that you feel so much better.  I will have to ask Dr. Teitge about the low profile hardware.  Does it have a specific name?

Do you ladies have any tips on how to alleviate the knee pain while I wait for my appointment?  I'm in shock as to how different my knees feel even compared to a month ago.  It's like as soon as school let out, they decided to go haywire.  It seems that they hurt if I'm standing still, hurt when I'm sitting with them bent, and hurt when I have them straight out while sitting on the couch.  My husband and I are going overseas for a wedding at the end of July and had hoped to sightsee.  Now I'm scared I will be handicapped.  I'm trying Alleve, but so far it doesn't seem to help much...

[jumpi5d]

Totally random, but omg I hate the low profile(tomofix) hardware! I have one leg done with and one with out.  The one with hurts 9 months later. The other one I don't feel what so ever. Go figure right? 

I'll post more this evening, just popped on to check things out, suppose to be working.

[crankerchick]

That is interesting! And odd! Go figure indeed LOL. But there are some differences here we should note. Paige you had DFO, so your osteotomy is just above the knee rather than below the hip correct? That has to make a difference in just how much the hardware is bothersome in and of itself, since there is less stuff around that area for "cushion" (for lack of technical terms--hey i never claimed to be a doctor lol).

Was your osteotomy for knock-knees or something else? Because I didn't think it was common to do the derotation as a DFO.

Just curious as to how much the location of the hardware effects whether we can feel it or not. Still begs the question of why your lower profile plate is more bothersome. But then again, why does the same person have the same surgery with the same hardware and have different outcomes on the 2 legs. Maybe it's more complex than just the hardware anyway.

Are you having your plate(s) removed?

[jumpi5d]

LOL crankerchick .....I would agree to the less cushion. I still laugh about how I don't feel the blade plate that sticks up a ton and the other one bugs me constantly.  I am getting them out, and soon! Dr. T offered to take the one out of my left leg at 8 weeks post op. He wanted me to hold off as long as possible, and lifes sort of gotten in the way. He said if I made it to 4-5 months he would be happy. Its been since November, I just haven't been able to work things out to get back up there. I'm calling tomorrow to schedule.

I had DFO because my femurs weren't straight. They bowed toward each other and my rotational numbers were off some. First concern was that they were bowed and that gets greater correction distally. (according to the super genius?! hah)

[Teacher2Many]

Less than one week to go until surgery (okay, about 5 more days to go)!  Getting more nervous and anxious at the same time!  Got the pre-op call from the hospital on Wednesday and felt like I was dictating a chapter in a book when they needed ALL the past surgeries, not just those relating to the knees!!     Getting things ready for recovery at home and will, inevitably, forget about something.  Early part of next week will be spent getting things organized and ready so that when I get back from MI, all is in place!  Happy 4th to everyone (or 3rd if that's when your town is celebrating with parades and fireworks, as a lot of ours are)!

Beth

[NickiAnn]

Beth,

I want to wish you the best of luck as you prepare for your surgery.  I don't blame you for being nervous, but it must be satisfying to know that the root of you problems if finally being addressed.  My thoughts will be with you on the 8th.  If you feel up to it, I would love to read about how your recovery goes and will look forward to any posts you can manage. 

I am headed to Northern Michigan for the next few days, but will check in when I get back.  I'm hoping to do a little swimming since my knees are pretty much telling me that walking is out of the question!

I will be looking forward to reading about  your successful surgery!

Nicole

[Teacher2Many]

For those who are interested, am leaving for MI in a few hrs. for tomorrow's surgery.  Apparently I am super nervous, as my stomach is so not feeling well (which usually doesn't happen until the day of surgery) and find myself in tears for no apparent reason.  Just keep telling myself that all will be okay~it has to be, right?!  Off to finish cleaning so all is done and ready when I get home and then to finish packing those last minute necessities.  Not looking forward to the 5 hr. car ride home but hopefully, the pain will be well under control making the ride a little more pleasant!

Hope all are enjoying their summer thus far and had a wonderful 4th of July!

Beth

[crankerchick]

We are definitely interested! Good luck to you! Everything will be fine you are in great hands with DrT!

Maybe your stomach being upset today instead of tomorrow is because you are leaving today. Hopefully you can get the nerves under control and enjoy the rest of your day. Eat something yummy tonight :-)

Looking forward to hearing from you once you are on the other side.

[Becs3740]

Hi Beth,

I had left derotational femoral osteotomy just over a year ago and will possibly be getting the right done either later this year or next.

I will be thinking of you tomorrow.

Good luck

Becks x x

[crankerchick]

Just a note of good luck for today!

[Teacher2Many]

Just an update...

Thank you to all for your warm wishes of good luck and good outcomes!  Surgery was this past Thursday, July 8, and I was discharged from the hospital on 7/11 and arrived back home around 5:30 in the evening.  The 5 hr. car ride home was not pleasant but the blanket and pillow were a great help!!!

Surgery went well-a total of 7 hrs. in the OR, in addition to the pre-op and post-op time.  Finally went in for surgery around 10/10:30 in the morning, EST, as they couldn't find my original rotational study and didn't want to go in to surgery without it.  So they redid it and then, of course, found the original one.  Anesthesia was done via epidural, which was a bit concerning for me due to the herniated discs in my lower back, but my surgeon reassured me all will be fine and that side effects, such as nausea, etc. would be greatly reduced with epidural versus general anesthesia.  And man, when those drugs kick in, they kick in fast!!  Anyway, didn't get in to my room until about 8:30 pm that night, maybe even later.

They did the femoral rotational osteotomy, tibial rotational osteotomy, and also did a lateral patellofemoral ligament reconstruction using donor tissue, which reversed the lateral release and would alleviate the constant subluxations and dislocations.  The epidural was removed early Friday morning, drains on Saturday.  4 blood transfusions were done-2 were autologous and 2 were from the blood bank, and my hemoglobin is still really low, but am sure a lot of that is due to my history of anemia.  Major bruises on my arms due to multiple attempts to start the various IVS, most of which were unsuccessful so they'd try again in a different spot!

So I'm home now with crutches and crutches only-no ice machine, no CPM, no brace, etc.  Can partial weight bear to about 20-30 lbs. when walking and was advised to ensure my foot is kept flat when weight bearing to help with the foot drop and peroneal nerve issues.  Yep, on top of everything else, I can't control movement in my big toe and sensation in the medial side of my foot and ankle is greatly reduced, if existent at all.  The swelling is extensive-this is the worst it's ever been and am hoping that with constant ice use and elevation, that would decrease but seems to be getting worse and not better.  Trying to give it time but the more time it remains swollen, the more time I can't do my exercises (heel slides, ankle pumps, etc.), the more the muscles atrophy, and the worse rehab is going to be. 

I go see my surgeon in Chicago on 7/26 and will get a script for PT at that time and then head back up to MI in mid-August to get the okay to be full weight-bearing.  Am sure that by the end of the week, things will be looking better-pain will be decreased, swelling down, etc.   At least, I'm hoping so!  Pain is pretty intense with the majority of it at my right hip, which makes sitting, etc. difficult but again, am hoping that as the swelling decreases, things will be a bit more manageable!

Am off to enjoy some lunch as my appetite is starting to come back and need to eat before I take the pain meds!

Until next time...

Beth

[NickiAnn]

Oh my Beth!  The swelling does not sound pleasant.  I sure hope it subsides soon and that the sensation in you leg begins to feel more normal.  I guess you won't be able to tell much until the initial trauma to the tissue and bone begins to reduce.  I hope you have some good movies to watch and books to read to take your mind off the pain while you heal.

I can't imagine your frustration to find out the CT scan was missing.  After getting your nerves all in a bundle then having everything delayed at the last minute, you must have been at your wits end.  I know I would be!

I hope that you feel a bit better every day.  Keep us all posted!

Nicole