My TTT, MPFL Reconstruction, and Lateral Release

[JessicaO]

Hi Runner!
I am getting the same surgery on January 25th. Tibial tubercle osteotomy with MPFL reconstruction. I am 24F and have a history of problems just like everyone!
I am very scared and worried but this board has really helped me learn so much. Its also so awesome reading other people's stories because i literally thought i was the only one that had these problems! I would love to hear more about your recovery and everything so i am going to follow your thread. I am also going to start a post op diary of my own. Ive had surgeries before when i was 13 and 14 and to be honest i must have blocked it all out because i dont remember much. i dont know when i went back to school, how much PT i did etc.

Anyways, good luck with surgery and keep us updated!

[Runner1993]

I'm home!!!! They gave me antinaseau meds so I'm not feeling too sick, there is pain, but it's not to bad considering what was done.

So, I'm really tired, will just mention key events.

The IV sucked, didn't work on first try, so they put it in my elbow which they said they usually don't do. They kept tellng me don't look, don't look. I did anyways and boy was it bloody! My whole elbow and my blanket so they got me a new one.

They did saw I could have general or spinal and I chose general. Also, I could have had a femoral nerve block but at that point I was tired of needles and declined.

So, my surgeon did have to do the TTT, the MPFL reconstruction, and........ a lateral release. I was not aware of the lateral release and it wasn't planned :/ will ask why he did that when I go for my return appt in 2 weeks.

I am actually WBAT, crazy, right? No way, I can walk anytime soon though like he said crutches probably 4-6 weeks.

My brace is this one, but it's locked out straight so it looks kind of different than the bent on in the pic.

http://www.breg.com/knee-bracing/post-op/t-scope.html

thanks for all the well wishes.

JessicaO, good luck! Do you any details about your surgery? Overnight or outpatient? Hinged brace or immobilizer? When will you start rehab?

[mermaids]

Glad to hear you are home and doing well.  I had the same brace.   

Don't be surprised if you are really tired for quite some time.  Many of us had sleep problems for a few weeks after surgery.  As my OS said, your body burns up a lot of energy when it is trying to heal from trauma.  This surgery is definitely trauma.  He encouraged me to eat more protein and fat because they provide essential nutrients for the healing process. 

I agree.... IV's are awful.  That is the part I fear most from surgery.  When I was having an abdominal surgery, they tried to stick me for 45 minutes.  Many different nurses tried, but they just couldn't get it.  At that point, I was so anxious and stressed, not about the surgery, but about getting stuck again.  I finally told them to take me into the OR, gas me, then do a central line.  Without any sort of the "happy juice," getting gassed was a little traumatic, but so much better than getting a central line while fully awake.  (shudder)

Get lots of rest right now.  There will be time for hard PT later.

[oohheykate]

Glad you're not feeling to bad!!

IVs suck big time. I'm lucky enough to have really good veins, I never have trouble. I would have freaked out. I'm assuming you're at an adult hospital because I've always been given mask anesthesia until I couldn't tolerate it then I had to get an IV. Or maybe that's just their policy.

I hope you get a good nights sleep 

[Runner1993]

POST-OP DAY 1

thanks mermaids! you are right...I'm so tired, can't even sit on the couch without feeling my eyelids get heavy.

Thanks Kate! Posting on here takes my mind off my knee pain.

Unfortunately, though, I didn't get a good night's sleep. Fell asleep around 11, woke up at 1230 with lots of pain but couldn't take another dose of meds because I did not too long ago so my brother got me my ice, woke up again at 230, took 2 pain pills (lortab which is pretty much hydrocodone plus acetaminophen) and a benadryl to prevent nausea, woek up at 430, then 6, then at 8 and have been up ever since. I just took more pain pills an hour ago along with a bowl of cereal.

I'm so scared to do a quad set just to tighten it because even just moving my leg makes it feel like everything is ripping. They told me not to do anything except ankle pumps until I see my pt Monday.

Yesterday, I was using my sister's walker around the house as it's more stable, and I was able to put my foot down with it. Today, I can't even stand up without severe pain so I had to use crutches because even the lightest touch of my foot on the groud kills.

I haven't tried to do a straight leg raise either, will wait for pt. But I have to either grab it by one of the straps of my brace to move my leg (nurse told me to use it like a handle) or have someone else lift and hold my leg like when I go to the bathroom.

My brace has a strap that goes right across my tibia below my knee I have to wait until Pt on Monday to remove the dressings (ace bandage, etc) so i have yet to see my knee.

On my pt insructions, it says for the first 3 weeks I'm allowed only to bend to 45 degrees. After 3 weeks, it's either talking about the brace or my range of motion, but whatever it is my pt can increase by 15 degrees a week. I think it's about my ROM since my brace is currently locked out.

I can't see really how swollen mhy knee is because of the dressings. But i have been icing 20 minuts every hour with a garbage bag full of ice. However, even though I do ankle pumps and elevate, my ankle and toes are swollen.


The day after surgery last time was the worst time for me so hopefully after today, it gets better Surgeon told me parents I have a long recovery ahead though because I'm pretty much back to square one in termes of healing, strength, and rom. But i'll get tehre.

Sorry for spelling/gramar errors. I'm too lazy to correct it.

[oohheykate]

I really hope your pain has improved or improves in the coming days! I feel bad 

But we both know that it'll get better, eventually!! Just think about the future and all the things you'll be able to do.

How long do you plan to sleep on the couch? I slept on mine for two months. Haha.

[Runner1993]

Here's a pic of my leg, actually looks worse in real life, picture realy doesn't show the swelling or bruising.

Start pt tomorrow, kind of nervous.

Still can't put my foot on the ground without really bad pain.

Doing okay, not feeling too sick.

Surgeon also undid the medial reefing from the last surgery by removing the suture things inside, not sure why.

[oohheykate]

Whew! That's a good amount of blood on your steri-strips!

Make sure you take your pain meds before PT! I'd hate for you to be in more pain even though you shouldn't be doing that much, right?

I think, I may not be right, you're surgeon probably undid your MR because you basically got a new MPFL so the sutures weren't needed any more. So the ligament is doing what the sutures were doing, maybe?

[JessicaO]

Hey Runner how are you doing? Havent heard from you today. My surgery is just one week away. Im getting really sad about it. Anyways im going to try and work out everyday before tuesday. Just to strengthen.

My surgery is outpatient, and my PA said i will be in a brace for 28 days and crutches for 6 weeks. Not sure if its a hinged brace or immobilizer? When are you going back to school? I wish you luck. I will be off work for 6 weeks.

I also start rehab after 2 weeks he said. And im not getting a CPM machine. I am reading how some people get one and some dont. He said they only use it on patients who get cartilage work?

[Runner1993]

I'm trying to wean off the pain pills now just because of how they make me feel. Got really sick yesterday morning.

Yea, it was a lot of blood so I'm guessing he just closed the cut with glue or the strips, not sure if there's stitches in there.

True about the whole MR MPFL thing Kate. My pt is going to call the doctor and talk to him about exactly what he found and did. My pt also thought that when they did MPFL, they just put a few stitches in it to keep it together tighter, and we aren't sure if he did that or reconstructed it (although that is what the script says). He says it's usually not torn all the way so he thought they didn't really "replace" it.

Hey JessicaO, I'm not doing too bad. I'm on Post-op day 4 (surgery on Friday). I'm still on pain meds, not sleeping through the night, need assistance to get up and go to the bathroom, etc. I hope to be back to school Monday at the latest as I can't really miss my Anatomy midterm.

You'll do great, no worries. I was nervous about having it outpatient, but the day of surgery is the easiest one for me and I survived fine on my own at home.

Luckily, my school had a snowday today so it's one less I'll have to catch-up on!

Yea, I think the CPM is really based on surgeon's preference and protocol.

So, yesterday, I had my first pt appt, more or less just an evaluation. He did some measurements and compaerd to my other leg, everything from above my knee to my ankle is very swollen. He moved my ankle up and down (did ankle pumps for me) which will move the fluid around. So, for exercises, it's a lot of ankle stuff, moving it in a circle, ankle pumps, writing the alphabet, etc. Then, quad sets, you can still see my quad, it survived!!! and one where I dig my ankle into the table and it will work my hamstrings. And then (this is the only one I have to do with the brace on) put a ball between my knees and squeeze with my legs straight. PT thinks I will be in the brace 6-8 weeks as he is the one to unlock it each week and I wouldn't ditch it until it got unlocked to 90 which will take a while. Also, crutches, he guesses using both for at least 6, although during that time period, I may be putting my foot down and walking. My leg is also red around my knee and down the shin, says it's from increased blood flow to the injured area. But if it spreads or gets really warm, to call the doc, could be sign of infection. But it hasn't spread. Also, my ankle is very sore to touch especially at this one bony point, which my pt said is actually my tibia. When one part of it gets traumatized, the whole thing sends out pain signals.

Pt says he guesses I'm wbat because it has been show that weight bearing can promote bone growth and keep the nerves from getting overly sensitive to pain. He wants me to try and put as much weight on my leg as possible when using the crutches, but it's okay if I have my foot completely off the ground for now.

We're doing 2 times a week so I go again Thurs. There's not much I can do at this point he says, he doesn't really want to bend my knee at this point.

I'm so tired all the time still...wiped out!!

[mermaids]

Definitely follow your PT's instructions on exercises.  My leg felt so strong, pain free, and ready for action, but the PT guys begged and pleaded with me to not push it.  You have a broken bone in your leg.  It needs time to heal.  All that soft tissue needs time to heal.  The ankle stuff may seem like nothing, but it will really help with the swelling.  When the swelling is under control, it will be so much easier to move your knee. 

As for going back to school, don't rush it.  I know it is hard to catch up, but how much good will it do to be at school on pain meds?  Also, a fall or stumble would really, really bad.  Does your OS think it is okay to return to school so quickly?  Also, the energy you use trying to go to school is energy that will not be used towards healing. 

[Runner1993]

Ugh, I'm so frustrated. I'm nearly a week out and thought it would be improving. I'm still on pain meds which make me feel awful and I'm so dependent on everyone.

My whole leg is bruised; it's quite nasty. Despite my elevating, ankle exercises, and icing, my pt said blood is pooling in my calf since it has nowhere else to go, which causes my calf to be extremely tender and painful especially when working the muscles. Of course, my shin and knee hurt, too.

At pt, we also do medial patella mobilizations and today, he would push my leg in various directions and I had to resist it by keeping it in the same position in the air (working the hips). He also massaged my calf but it was so painful. He bent it, too. Didn't look like it, but he measured and said it was at 30, which is as much as we are allowed to do.

He also spoke to my doctor who was very pleased with the way my kneecap was situated after the work he did. He did the lateral release because there was scar tissue on the lateral side that was titling my kneecap.

My doctor also wants me putting weight on my leg when I walk with crutches. He told my physical therapist that I need to to do it. However, it's so painful for me to bear weight on it and put my foot down. My pt told me if I don't do it, my doc will yell at me at my next appt

My OS told me I'd probably be out of school a week at least until I'm off the narcotics, but I'm not off them yet although I really wish I was.

[oohheykate]

Awl Runner, I hope things start improving for you soon!

It's a long recovery, you just have to be patient.

[pauz79]

Hi Runner,

just read your post an i feel for you, i had mine done at the end of october  It's a long recovery but it does get easier.

Don't worry too much about the swelling as it takes ages to go down an don't stop your meds until you are told to as i did an had to get back on them as i imflamed a tendon which is now holding back the rehab.

The first three weeks is very boring (for me anyway) but your healing so just try to chill an watch a few of your favourite movies

Keep your chin up an good luck

[Runner1993]

One Week Post-Op

Woke up this morning, calf was hurting more than ever despite elevating all night long. It was warm and very tender. Called surgeon, he was in surgery, nurse advised us to go to ER to check for blood clots.

So, I went. Waited forever, had blood work, xrays, and an ultrasound.

No blood clots, doctor said "I'm just sore." However, I did learn something new; I have three screws, I thought had 2 like most I see.

This is tough, no lie. I will try and upload pictures of the bruising eventually, it's bad.