Hardware Removal- Tibial Plateau Fracture

[canchaser]

I would like to know what to expect when my hardware is removed. I had surgery June 1 of this year to put in a plate, pins, and screws for TPF. I am doing pretty good, but at my last doctors visit he said that after about a year or so the hardware needs to come out. What will happen, recovery time, will it be as bad as my last surgery, will i have to go through the stiff knee and physical therapy again? Very scared

[MeTazDvl]

Canchaser...Rest easy!  Removal is a SNAP compared to your first surgery!  I had mine removed at the 6 month mark because the placement of the plate was rubbing on tendons and it would have been dangerous to leave it in.  I had a pretty bad break (3 seperate ones actually) and had to take it easy for a few weeks after the removal not just for the holes to heal but to also continue the originally breaks healing process.  I had the surgery to remove everything on a Wed. morning, used a walker for that afternoon, was up and around the house unaided with minimal DISCOMFORT....not really pain...by the next day.  Went back to work the next Monday and have never looked back.  I could actually feel the hardware gone as soon as I woke up from the surgery!  It immediately felt better!  My discomfort came from having stitches and not from the bone.  Very slight muscle soreness...equated it to the soreness you feel after heavy exercise.  It was gone within a day or two. 

Don't worry about removal....concentrate on healing now.  Work on your strength in that leg as much as you can.  That is the best advice that I was given and it was SO true.

Best wishes!

Juli

[vichall]

Thanks for that encouragement on the hardware removal, Juli! I had surgery on April 8, and I'm having some issues that may be hardware related. When I saw the surgeon a couple of weeks ago, he suggested we'd give it another couple of months to get past the 6 month mark, and then it could come out if necessary. I'm a bit concerned about the idea, because I have foot drop from one of the original incisions, and I worry that I'd have to fight back from that again. At least the hardware removal itself is not so big an issue.

[TaniaSki]

Thanks so much Juli - that is so helpful.  My hardware removal is coming up in the fall, and I am already worrying about it!

Tania

[pattyb]

Hi Everyone,

I have a love/hate relationship with my hardware. 
It took me ~weeks~ before I could bring myself to even touch it!
I was very fired up about getting it removed ASAP because it symbolized all that was wrong with my leg.  But now, after some though, I have come to appreciate how important hardware is for me to get back to a normal life.  So I don't hate it as much but still look forward to getting it out, if the doc says okay.

Patty

P.S.  I also wear braces (orthodontia at age 52) and have a love/hate relationship with them, too.  Braces and a broken leg within 5 months...life isn't fair! 

[Grandhoux]

I'm seeing my original (French) surgeon on Monday and hope he's going to come up with some plan to get me walking properly again. My original tpf (plate and 7 screws) was December 2008 but I slipped and fell 11 months later and broke my femur on the same leg. That really hurt! There's a difference of opinion on why it broke so easy; the insurance doctors say demineralisation from lack of use but my physiotherapists says weaknesses and fracture lines from the original accident, which was a bad one! I tend to go with the physiotherapists view.

The hardware for the femur fracture (plate and 10 screws) is really painful and is impeding my flexion by about 20 degrees. I had to have one huge screw removed after about 5 months as it was coming out on it's own but I'd like to have the rest of the femoral hardware out now, too. The tpf hardware is fine (even though one of those screws had to be removed after about 8 months for the same reason) and doesn't seem to impinge at all. I've been told that I'll probably need a replacement knee sooner rather than later and they may wait to see about that and not remove the hardware; hopefully I'll find out on Monday.

Whatever, hardware removal is a bit painful but nothing like your original operation. I've had two very big screws out now under local anaesthetic and it was fine. I'm not looking forward to a full knee replacement, though, even though it should get rid of most of the pain I get from arthritis, now.

Dave

[KartBoy]

Hardware removal is nothing to worry about, I had mine out a year after accident, I ended up spending two nights in hospital but that was mostly because the wound was still bleeding a bit too much. It was painful but for a fairly short period and although I came out of hospital on crutches I ditched them within two days. I was full weight bearing the whole time and did need physio as ROM suffered a bit temporarily.

Andrew

[Grandhoux]

Looks like I'm about to find out. I saw my original French surgeon today. He has definitely decided I need a new knee within 2 or 3 years but recommended a two-stage approach: all the hardware out now and then the new knee when it's stabilised. He then gave me a date for the hardware to come out allowing a year since my second lot of hardware was 'installed' after the femur break. So I now have a hospital appointment with an overnight stay booked for the 16th November. Xray to hospital appointment in an hour ... try that in Britain! 

I'm not exactly worried but there is rather a lot of hardware to come out and some pretty big screws, 2 plates and 15 screws at the last count, but I'll be glad to get rid of them!

[pattyb]

Oh Grandhoux, that is a whole lot of hardware.  I'm so sorry for you.

I cried like a baby the first time I saw my xray at the doctor's office. 
I wasn't prepared for it and it was the first time I saw a xray with pins and a plate--and the worst part it was MY leg!
Best wishes for you--I know from past posts that you've had quite a journey!

Hugs,

Patty

[KartBoy]

Dave

I can fully understand the removal of the Femur hardware but are you also taking the TPF hardware out at the same time because that's got to be a huge operation, do you really need the tpf hardware out now or is it harder to get it out in 2 - 4 years time closer to when you get knee replacement, or is it the case that once hardware comes out the holes will get a chance to fill in before the knee replacement happens.

Andrew

[TaniaSki]

Did any of you TPF'ers have audible clicking caused by the hardware?  Whenever I bend my knee in a certain way, there's a click that I can hear and feel.  It doesn't hurt, but it's uncomfortable.  I am hoping it's the metal and will stop when hardware is removed.  Anyone else have this?  Thanks!

[Grandhoux]

Dave

I can fully understand the removal of the Femur hardware but are you also taking the TPF hardware out at the same time because that's got to be a huge operation, do you really need the tpf hardware out now or is it harder to get it out in 2 - 4 years time closer to when you get knee replacement, or is it the case that once hardware comes out the holes will get a chance to fill in before the knee replacement happens.

Andrew

Hi, Andrew, it's the femur hardware that seems to be causing the pain and loss of movement but I think he wants to do the lot to be ready for the tkr. My tpf set wrong due to a bad decision without an Xray by a locum in Britain and the bottom part of my leg is out by a couple of degrees. The only way he can do this, he says, is with tkr. I'm not looking forward to the 'hole filling' period, I'll have to be careful, maybe they'll use some more French cow grafts? 

It certainly seems a better idea that was put to me before by the insurance doctors of the removal and tkr in one operation. I'd rather have the holes healed before they saw the bones off! 

[Valinla]

It's been a long time since I've posted.  I joined the bad-knee club back in January of 2008.  A skiing accident left me with a medial TPF.  I am scheduled for hardware removal in an hour and a half:  A plate and five screws.  It's been in there now for two years, seven months.  My doc told me it is harder to take out the longer it is in there, but I don't expect there to be any problems. 

I will post again after surgery to let those anticipating hardware removal know what they can expect.

[Valinla]

Hardware removal is truly a walk in the park compared to the original procedure.  Less than 48 hours after surgery and I am already able to bear full weight on the leg.  The calf muscle is rather painful, though, and doesn't tolerate regular walking movement, so I'm using crutches.  I will probably dig out the cane later today or tomorrow.   Foot is rather swollen.  I am able to (carefully) sleep on my side without causing pain to the incision.

They did keep me overnight because of an anesthesia complication.  I haven't looked at the incision yet, but the doc told me it would be about the same size as the original scar.

Happy to respond to any questions.  And best wishes to all my TPF brothers and sisters.

[pattyb]

Thanks for the update, Valinla.  I am scheduled to see my OS tomorrow (only my second visit with her--almost 4 months post -op) and one of the few questions I have for her is when/if hardware removal is in the cards. 

My question for you (after a few weeks anyway) is does your leg move freely instead of feeling like you are wearing a brace on it all the time?  I swear it feels if I have rubber bands in my leg that restrict my movement.  I hope that makes sense...

Glad you are doing well!  Please post again, if you can just for an update or two.

Patty