Bone breaks around the knee :
Tibial Plateau Fracture "collapse" and "uni-knee" - - Posted by debby17 (debby17), 20 April 2003
Hi,
I fractured my lateral tibeal plateau (12/26/02) while skiing. I was told it was a VERY bad fracture, the bone having imploded into the lower tibea, and the lateral part basically pulverized. I also had a tear in my miniscus (sp?). I had surgery in Vail, and went back to Tucson, AZ to recoup. I had a hinge and 6 screws put in my knee. I was put in a brace, and was non-weight bearing for ONLY eight weeks when my OS told me I could go down to 1 or 2 crutches and take off the brace (which I did). I was doing PT 3x's a week, got up to 125 degrees rotation..then last week....
I started noticing that my leg was rotating inward, and on my last visit to my OS last Thursday (4/17) was told that I had 10 degrees rotation (vergas?) I am severely knock-kneed, AND that my fixed knee has COLLAPSED! I'm in pain again, and my knee is doing weird things (snapping, creaking, etc.). As most of you know (by my reading other postings), I too have a lot of trouble with stairs, get very stiff when I get up after sitting/sleeping, and wake up with a lot of stiffness and pain.
The OS has suggested getting a UNI-KNEE replacement, that's where only one compartment (in this case the lateral tibial plateau) will be replaced with an artifical "something".
Since this is the first time I've broken anything, and don't get the lingo, how to communicate with OS's etc., I would love some help! I'm a 52 year-old, very active, live alone...(Hate asking for help) and feel pretty scared.
Any help and information (or questions to ask) will be greatly appreciated.
Thanks from sunny Tucson,
debby
Posted by Bo (Bo), 21 April 2003
Hi Debbie,
can't give you much advice, I'm still learning myself..after three years it doesn't get easier but you do get to manage things. Pain management and movement managment...knowing what you can and cannot do get easier. Don't push your friends away and don't get too down. There is always some light at the end of the tunnel although sometimes it seems a little dim.
Above all keep trawling this site...I have learned oodles since finding this site and it has to be the best research tool out.
You take care and keep your chin up.
Kindest regards
Bo
Posted by debby17 (debby17), 21 April 2003
Bo-
Thanks for the kind words, you're right...sometimes it just gets so frustrating I tend to isolate and not be a burden to anyone.
I'm trying to keep with the positive attitude, things happen for a reason...and I'll figure that reason out...at the time I'm supposed to.
I've gotten some great info and replies from this and the broken-leg site, it's amazing how different my life has become in 4 short months.
Take care, and keep smiling yourself!
Debby
Posted by hmaxwell (Heather M.), 22 April 2003
Debby,
Do some research on the web--the best thing you can do is educate yourself so that you can ask the right questions of your surgeon. Your keywords to use would probably be 'unicompartmental knee replacement' and partial knee replacement or partial knee arthroplasty. Try www.google.com and see how many hits you get.
Also, it's a good idea to get another opinion if you can, because then you'll be sure you've covered all bases. You are not that far from Phoenix (where I live) so you could head up to the Mayo Clinic and see one of their joint specialists. I would recommend Dr. Beauchamps, he's supposed to be one of the absolute best. I had not so great luck with another doctor there....(I'll be PC and not name him publicly, but let me know via private message if you want the scoop 
)
It sounds like you have a pretty traumatic injury, but if they can replace the broken stuff with metal--wow. That would probably really improve your mobility and quality of life.
Heather
PS Who was your doctor in Vail? Dr. Steadman did my most recent surgery in December.
Posted by debby17 (debby17), 22 April 2003
Hi Heather,
I had my original surgery done my Dr. Janes in Vail. I really didn't have any choices, I broke my knee...and he was "it".
I don't have insurance for Mayo Clinic, but maybe a consultation would be a good idea. How do I ask who is the "no" Dr. there (not sure how to email you w/o being on the website).
Thanks,
Debby
Posted by lizl (lizl), 22 April 2003
Debby,
Welcome aboard!
See the little icons under Heather's name (on left side of the page)? Click on the one that looks like a little sheet of paper and an envelop. That will let you send her an Instant Message or IM. It is a private post and she will then be able to respond to you in private. You can also click on her name in most views and find the Instant Message option from the profile page.
LizL
PS: Are you sure that your insurance will not let you go out of network for a second opinion? You might at least ask. It's the Mayo Clinic, after all!
Posted by gimpy (gimpy), 22 April 2003
Hi - I am new to this little club. I am 48y/o woman and suffered a severe lateral tibial plateau fracture while skiing on Dec 31. Drove myself home 3hrs and had to wait a week for surgery because of the holiday. I had a buttress plate (L-shaped plate) 3 screws and a large bone graft on January 8, 2003. Being an RN who has worked in Rehab and the operating room I was very aware (I thought) of what I was in for. Immediately upon recovery from anesthesia I started isometric exercises. At home 2 days post op I used the continuous passive motion machine 6hrs daily and was non weight bearing for 12 weeks. I progressed from partial weight bearing with 2 crutches to full weight bearing and I tossed the crutches last week because of back pain due to the un-natural gait with the 1 crutch. I go to PT 2xwk and do modified yoga stretches, isometrics and additional range of motion type exercises at home. I have full range of motion - painful but within normal limits. I was shocked by how much pain I was in with the full weight bearing. I limp severely because of severe pain over the ankle area and top of my foot and varied degrees of knee pain. I try to pace myself (I returned to work 2 weeks ago part time) I am having a lot of leg swelling and wear compression hose. (I keep the crutches in my car in case!) I don't sleep well as the joint stiffens quickly and wakes me up every 1/2 -1hr. I was getting very discouraged - however after really thinking about the injury and speaking with a few others it seems clear this type of injury (especially in us who are not spring chickens) will take a long time to heal. I expect that I was initially quite aggressive with stretching and may have less scar tissue and more flexibility than others. I really think that flexibilty and muscle strength is absolutely key - along with pacing activities. I know I came close to falling a number of times in the afternoon when I was tired. Your term "collapse" is unclear - my understanding of bone healing is that usually this type of weight bearing bone takes a minimum of 10-12weeks to get to the hard callous stage which is then considered fully healed. With the bone graft only the xray can show if the graft itself is successfull. The bone graft itself (if not your own) acts like a little scaffold for your own bone cells to grow on and around, eventually surounding the graft with your own living bone - did your graft fail? This can happen with donor graft. I think you need to get more info and a second opinion ASAP. 3 opinions are even better - call your nearest large medical center ask for the head of orthopedics and a knee specialist - your insurance company should pay for at least 1 more opinion and I would do it ASAP! You current orthopod may be 100% correct but this is serious stuff it is best to get as much info as possible.
Posted by kgrosskurth (Kathy G), 22 April 2003
Hi, Debby - glad to see you found KneeGeeks! (I have to thank LizL for enlightening me about this site!!). I would follow Heather's advice and see about getting that second opinion from the Mayo Clinic. Couldn't hurt anything, and the sooner the better it would be for you to get whatever is not right repaired as quickly as possible.
I read Gimpy's response - she has a good point in that it usually takes a weight-bearing bone about a good 3-4 months to usually heal to the point where you can start putting weight on it. As I said in my earlier post on MBL.com, I think that 8 weeks' weightbearing may have been too soon for your type of injury. I am not a Dr or lawyer, but I think if you suffer problems as a result of this first OS apparent incompetence 
, you may have a basis for a suit (or at the very least the means to at least apply for temp. disability). I know it's a lot to think about, but this injury is potentially something that can affect the rest of your life, so you must know what your options are and be ready to act on those options - particularly if this will cause you to be out of work for a significant time period.
Anyhow, I am glad to see you here, and I pray you will find what you need to fully recover. 
Kathy
PS: I myself am about 7 months into this, and I am healing at about the rate I was told by my Dr. (1 yr. to 18 months), so just be aware that we are in it for the long haul and we cannot give up!
Posted by lizl (lizl), 22 April 2003
You're welcome, Kathy!
When I read your journal on mybrokenleg.com, I saw that you were going through some of the same things as others here. The interface that MBL uses makes it difficult to simply lurk, but I do go there from time to time. It's impossible to tell who has knee injuries, just by reading the title of each journal. Nevertheless, there is crossover, and some MBL people can benefit from the active discussions here.
Are there some specific journals over on MBL that you think might benefit Debby?
Debby: Did you mean that you have NO insurance or that your insurance is some sort of HMO?
LizL
Posted by kgrosskurth (Kathy G), 22 April 2003
Hi, Liz! I totally agree that, though MBL is a great site for encouragement and support, it is difficult to find out without considerable effort who has what type of injury, which makes it difficult at times to get specific information from people with specific fractures. Which is why this site is a Godsend!!
In regards to someone in particular who can help Debby at this point, I cannot think of anyone off the top of my head (she actually posted a msg. there but I think most of those responses were from those with other type of injuries). But if I do run across a diary which may be helpful to her, I will be sure to let her know.
Again, Liz, I appreciate this site - it has helped me more than you know!! Thanks again for the info!!
Posted by debby17 (debby17), 27 March 2004
Hi-
This is from Debby a year later. Wanted to let you all know that I ended up having a unilateral knee replacement in June, 2003...then after that too failed...I have a TKR on Feb. 10, 2004. For the FIRST TIME in 14 months I can walk again.
I have my surgery done by a Dr. Martin that uses IGS or Image Guided Surgery, meaning...a computer lines up the knee to your ankle and hip, therefore leaving very little room for human error (an average of 4-5% off).
My only problem right now is scar hypersensitivity. When anything touches my scar I go through the roof...it's such a bazaar feeling.
Anyone else have scar hypersensitivity? What to do about that?
Seven weeks after surgery I have 122degrees ROM and I'm almost 0 degrees straight. I'm able to swim, bike, walk without a limp, cane or crutches.
I feel like this is a miracle, although the surgery was not a walk in the park.
Debby
Posted by kgrosskurth (Kathy G), 27 March 2004
Great to hear your update, Debby - sounds like you are on your way back to normal!
As far as Scar Sensitivity, I had it, and what worked for me was a combination of using Silicone, Vitamin E, and Hydrocortozone creams rubbed into my scar for about 3 minutes each day. And until that all "kicked in," I was prescribed some pain pills which helped me put wt. on my leg and took the edge of the scar pain (mine felt like a skewer was being stuck through my leg at the scar site 
) I underwent that routine for a better part of 4-6 months. I am now just using the Band Aid Scar Therapy strips to lessen the appearance of the scar.
At any rate, Debby, I hope this helps, and please keep us posted on your progress! 
Posted by debby17 (debby17), 27 March 2004
Kathy-
Thanks for the update. Do I need a RX for the Silicone or Hydrocortozone? Where can I buy them? I never heard of this Band Aid Scar Therapy strips
I've been using Mederma and Vitamin E until this hypersensitivity kicked it...it's driving me crazy! And just like you said, it's like a poker...I'm walking and all of a sudden...OUCH!!!!...but at least I can walk
Debby
Posted by lizl (lizl), 27 March 2004
Now this is just awesome, Debby! The scar sensitivity must really suck, but the fact that you are finally on two feet again is cause for celebration, at last!
Thank you for coming back to let us all know.
LizL
Posted by kgrosskurth (Kathy G), 27 March 2004
No prescription is needed for either the Hydrocortozone cream or the Silicone cream.
I am not sure how it works, but it appears the combination of the ingredients together works to lessen the hypersensitivity. It is also supposed to lessen the scar's appearance as well. It helps to massage it in the skin for about 3 minutes (and that in itself may help to alleviate the sensitivity itself).
Hope that helps - and glad to hear you are walking!
Updated Thu Apr 29 2010
