Hardware Removal- Tibial Plateau Fracture

[TaniaSki]

Thanks all for the info - my hardware removal is scheduled for this Friday.  I am very excited to get it out - it feels like the beginning of the end of this whole TPF ordeal.  Any recommendations/tips for what to do pre or post-surgery would be appreciated! 

[Valinla]

Hi Tania,

I think the best advice I can give is to stay relaxed.  Sounds as though you're in a good state of mind approaching surgery, and you should be.  This procedure is nothing like the first one.  I shared your view going into surgery, hoping this step would be the beginning of the end to this long TPF road. 

My hardware was in for a long time, two and a half years.  One of the screws was stubborn, didn't want to come out (I was warned about this), and my doctor had to partially core the surrounding bone to remove it.  Even with that, my leg is feeling pretty good.  I am shuffling around the house unassisted and expect I'll have a decent gait back in no time.

I changed my bandages yesterday.  My new incision appears to be about an inch to two inches shorter than the original one.  The swelling in my foot has all but disappeared.   I've taken no pain medication in the last 12 hours . . . just don't feel the need.

Don't forget to take a stool softener for a while after the surgery.  I don't know if that is something your doctor will mention or not, but you will need it if you are taking certain pain medications, specifically Vicodin. 

Good luck on Friday.  You will do great !!

[pattyb]

Hey Valinla--great news about your HWR progress.  I'm glad it wasn't that bad for you!

Tania--best of luck in your HWR on Friday, if I don't get back on the boards.  I'm sure you will be happy once it's all over. 

And ladies, I found while I was on the vicodins I drank a glass of Sunsweet Plum Juice with extra fiber--it worked 100% of the time.  Just don't do like I did and drink a pint at once...try running to the toilet with a broken leg. A smallish glass will work nicely.  And it tastes good too. 

As far as my own HWR, my OS told me yesterday at my visit that since it doesn't hurt now, there is a good chance it will stay in.  She said if I had hardware issues, I should have known by now.  She did promise to talk to me at the one year mark if I was adamant about removal. Other than that, things are going well for me, and hope for all of you too!

[rainbowonthefly]

Hello Canchaser,
I had the hardware removed from my TPF last week, with no ill side affects. I walked out of the recovery room, only concern was the leaking of blood for a couple of hours. This settled over time, by following morning.
I had the hardware in for just over 30 months, biggest delay was that I work in the woods and Dr. commented I would need about 3 weeks for wound to heal, so surgery had to be scheduled in early winter.
I was full weight bearing and currently walking up and down stairs at one week unaided, little or no pain, the pain is from the steri-strips and pinching. The steri-strips will be out at ten days. I have been using ice to control the swelling but other than this all is well.
Sleeping at night is okay if you don't mind sleeping on your back, with knee elevated with a pillow, my partner can't wait to have roll over onto my side to quell the snoring.
You will be surprised at the size of the hardware as the larger of the 6 screws was 8 centimeters, and smaller was 5 centimeters, with a 10 centimeter plate, together these titanium trinkets, made for a very nice tree ornament.
You should be up to normal in no time, I hope to be walking 30-40 minutes once the s/strips are out.
Regards,

[KartBoy]

I specifically asked the surgeon to see my hardware after it came out but wasn't allowed to, I understand it was incinerated after the operation so all I have is the xrays but glad it has gone.

[rode1981]

I just got home from the OS.  I have a non union tbf.  I have another appointment in a month to x-ray it again and I am being scheduled for a scan. The hardware will be coming out as soon as the bone is healed completely.  As of now, the bone behind my knee is still not healed.  Then, he recommends a total knee replacement.  The best scenario would be to do it all at once but he is leaning towards the conservative side and doing the hardware removal, letting it heal and then do the knee replacement. I am so over this injury.  Any advice from anyone?  He told me to continue with PT to keep strenghtening the knee and surrounding muscles and soft tissue.  RIght now, my knee feels so constricted, actually I should say from my knee to my shin. I have had enough.

[KartBoy]

Depending on your age are you a MACI/ ACI candidate like me. I am now 48 and way to young for a knee replacement and so far at nearly five months its doing the job. I'm still in a bit of pain and need a cane to get around if out and about too long but its still healing and its way better than before the operation.

Its a good idea to get hardware out first as any metal in the leg makes things like MRI's very tricky. The hardware op is no big thing and gettign it out and seeing if that helps is a good step forward.

[rode1981]

Hi!
Thanks for writing back.  I can't wait to get this hardware out.  I can feel it and as you can see on my x-rays the location makes it even mor constricting.  It's still not healed compeletely though and since my bones are so soft it's going to take a bit longer I think.  I've taken a lot of Prednisone over the years and it's done on a job on my bones.  What are MACI/ ACI?   I'm 56 and so far we going with the removal and then when that heals we are doing the TNR.  I honestly can't wait. My PT and surgeon said I will be much better off and feel better quicker.  The whole process is still going to be a year when all is said and done.

[Grandhoux]

Hi, Rode, (?)

I'm 56 as well and hoping for a tkr later this year. I had my hardware (2 plates and 15 screws) ut in November last year (2010) and i's far better for bending and overall movement with less pain. The downside is my knee now has all the weight and I can walk a half mile but my limp gets progressively worse and I can feel the bone-on-bone until it just gets too much and I have to stop. More fatigue than pain but it hurts, too. Unfortunately it's getting worse so the cartilage is shot and not recovering.

I've also had problems with the scar: one part wouldn't heal and got infected, then still wouldn't heal. Last week I went into the A&E epartment and was seen by my surgeon who dug around in the wound (without anaesthetic), told me to 'tais toi' (shut up!) and eventually dug out 3 undissolved stitches as well as assorted bits of meat! Hopefully it'll heal OK now!

I'm hoping for a tkr later this year (same surgeon!) as not only is my cartilage shot but my knee is set in a bend and my left leg is now at least an inch shorter than my right. I'm told the surgeon is the best around here (in this part of France). Lucky I don't live where the surgeon is really bad, eh! 

[KartBoy]

MACI/ ACI is cartilage transplant. They do keyhole surgery to remove a  small bit from a part of the knee that isn't load bearing, send it off to a lab and grow a few million new cells (on a matrix scaffold if its MACI) then in a second operation 6 - 8 weeks after the first they patch the damaged cartilage. They have been doing extended research at Stanmore for almost ten years with 400 + patients, I had mine last August. The recovery is very long and not guaranteed, anywhere between 50 - 80% depending on how much damage you have and where in the knee the damage is. They carefully evaluate every patient and not everyone is suitable as its still experimental and probably will be for a few years yet.

[djjaydee4883]

I had 6 screws and a plate inserted on Sept 20,2011 as of January 2012 my fractrure is fully healed and range of motion is 131 degrees, my strength is great. my doctor told me that the hardware should be removed in Sept of 2012, and I will eventualy need a full knee replacement. I would like to know how the surgery is comparied to the first one, and is the recovery time the same as the orginal surgery.

[KartBoy]

The hardware removal is nothing to worry about, it doesn't involve any period of non weight bearing and although it might be a bit painful your only talking about a couple of days and some physio after to restore ROM if the knee tightens up which is common to any knee surgery but again relatively short term.

Don't be too quick going down the TKR route, my ACI surgery at Stanmore was done to test out the limits of ACI to correct traumatic damage to the cartilage, it helped and while I'm still having plenty of trouble with the knee and ongoing pain we are still buying time and delaying my TKR, a good thing if your only 49 (45 when hit by car).

[morgana]

Hi Gang
     I'm looking for who had their hardware removed after it had been in the longest.  As of May my hardware will have been in 4 years.  My biggest issue is & has been the same all along - the screw on the inside (there's only 1 there) hurts at pressure.  It wakes me up repeatedly thru the night.
     At this point the only thing I can't do is a prolonged unsupported catcher's squat - I still need something to do a light touch balancing.  And I truly believe that I am within weeks/months of being able to do that again.
     But, I haven't slept longer than 2 hours without being awakened by the inside screw.  My guess, although I haven't confirmed with the dr, is that if we're removing 1 then remove the whole thing.  At the last dr appt (Nov 2009) he indicated that removal is optional, contact him when/if I wanted it done.   Since it has taken so long to get to teaching full time again, I really haven't wanted tp push it.  But after reading & rereading - I'm thinking...