NOTES - Surgical Procedures :
fulkerson osteotomy - - Posted by jamielynn_135 (jamielynn_135), 21 June 2004
hi my name is jamie and i am 16 years old and i going to have fulkerson done to hopefuly reduce the pain in my knees. i have a few questions that maybe someone could answer for me. i am a very active teen and i play soccer and i am a synchronized swimmer and i want to know if i will be able to get back to sports and if so how soon. Also what is the bracing like and how long did you have to wear it. thank you for your time and support.
Posted by cat (cat), 21 June 2004
Hey Jamie,
I had a similar surgery done this past March. Prior to surgery I was in a Breg PTO knee brace. After surgery I was to be in a post op brace for about 6 weeks and then back to a neoprene knee sleeve type brace for another 6-7 weeks. (I was in the post op brace longer as I couldnt' get a regular brace to fit.) Some people report not having to wear the post op brace as long nor a sleeve type brace after the post op brace. Guess different docs have different protocols. Also, I had some soft tissue work done.
Let's see.... I was on crutches about 2 weeks and then started weaning off them by using just one crutch when shopping. I'm over 3 mos post op now and still not cleared for running or jumping. I'm not even cleared for walking on the treadmill but do swim- no breastroke or flip turns. It may be different for you as you are much younger than me. I'm your mommy's age. 
Anyway, here's a link to my photo album. It has a pic of my post op brace as well as the one I wore before surgery.
http://photos.yahoo.com/blairbears8
Good luck to you and feel free to ask more questions,
cat
Posted by Joe123 (Joe123), 25 June 2004
Jamie-
In dec 03 I had a laterall release and Fulkerson Osteotomy performed on my rt knee. I am an active 33yr old. My surgeon did not allow me to put any weight on my knee for 8 weeks! My bone did not heal as well as it was hoped for and so I remained on crutches for a full 2 months. After the first month I was allowed t o begin light therapy. However, I discontinued the use a a brace of any type after the fist month as well. I have since developed a stress fracture but using a sonic bone stimulator it is healing nicely. I would think if I hadn't developed the stress fracture I would have been up and running without any problems after 4-5 months. I hope this is helpful.
Posted by Helena (Helena KTF), 25 June 2004
I had a Fulkerson nearly 2 years ago and was on crutches partially WB for 3 weeks (with a full leg cast). Started PT week 4 (3 weeks of PT), off work 11 weeks (nurse) and ack jogging 5 months post-op. I am also active and one of the reasons I had the Fulkerson was to stay active! I play badminton 4 hrs a week, in winter I run 4km every other day, I cycle, swim, jump... whatever!
The most difficult part for me was to learn to walk again 
. I had a quick recovery so note that everyone will note different things here! I am very lucky! Can do anything I want, it hasn't been easy but i am oh so happy that at age 27 I can finally live without daily pain and subluxations (L knee) again!
The surgery is major open knee surgery but I do not regret I had it 
!
Good luck!
~H
Posted by jamielynn_135 (jamielynn_135), 15 July 2004
hi,
as my surgery is fastly approching i have a few more questions. i was wondering how long i will be off from school. this is a major consern because i will be having my surgery a week after i go back to school from summer vacation. also how easy was it to deal with daily life soon after the surgery. i am worried that being an active 16 yr old i will be stuck at home for a long time 
. also my surgery is goin to be out patient i was wondering if that is common. thanx again for all your help and support!
~*~Jamie~*~
Posted by Susanne (Susanne), 18 July 2004
It has been recommended by 2 O.S. that I have a Fulkerson (they have all said I need a TKR, but am too young) and lateral release. I have had knee issues since I was very young and have had previous surgeries on both knees due to chronic subluxations. I only hesitate to have this surgery because I am able to ambulate well and I have no knee pain (which is in part, why my knees are as bad as they are). I do feel disconcerting locking, popping, tightness and sense that one day soon I will step down a stair or pivot and my knee will just blow. My x-rays show bone on bone. My patellar has a significant tilt and is riding over 50% off the track. I struggle with the balance between preserving my own joint (which necessitates surgery) and just carrying on as I am (in which I potentially will have a knee accident, but I am able to live life and feel fine now). I am wanting input from those of you who have had this procedure. If you had no pain pre-surg but knew your knee needed the surgery from a mechanical standpoint, would you have had the surgery?
Susanne
Posted by Leta_MT (Leta_MT), 27 July 2004
Hi Susanne!
You are dealing with what I dealt with for many years. As you fear will happen to you, I realized the injury that sent me to surgery. I functioned very well for 14 years with horrid knees until I slipped on the ice and had a wicked dislocation. My situation has brought me to a patello-femoral replacement with a modified Elmslie TTT. (I think it was an Elmslie, not sure but I know it wasn't a Fulkerson.)
Your decision to have surgery will depend on what you can live with. Since you are bone on bone, you will probably need something in the future. If you are active and are limited by your knees, you might want to consider it. It sounds like you have little everyday pain?
Surgery is a personal decision when it is elective. What can you live with? Don't go into it if you have reservations. If you are not hampered by your situation now, think long and hard before you lay down for this. It is major surgery and has a long recovery. If your motivation is not coming from within, you will be wondering why you did this post-op. On this board, you will find people who are very happy with their surgeries and people who are not so happy. I venture to say that most, if not all, were in dire straits before they had their first surgery. Surgery should always be your last resort. If you can live with it, do so. If not, your choice is clear.
Good luck!
Leta
Posted by maxfactor (maxfactor), 5 August 2004
Suzanne,
I was reading your post about needing a TKR eventually. Did you know that after having an osteotomy it makes TKR more difficult? Read up on this before you do it. Also, osteotomy is MAJOR surgery. Why not do the TKR? It really isn't so much about age anymore. On the other hand, if I didn't have any pain, I would opt to not have surgery at all. They are very tough recoveries requiring a lot of hard work.
Jane
Posted by cinderamy (cinderamy), 10 August 2004
I had a Fuklerson, LR and scope on my right knee on June 10, 2004. My husband and I opted to go for it because I have been having a lot of trouble following my 5 kids around. It was a big decission because I too had full ROM, just a lot of pain and I thought if I just have the surgery I would feel better, rather then waiting for my knees to give out. I chose to do the Rt knee frist because then I could drive by the time school started even after the Lt knee was done (expected in September).
However, it has not gone well for me at all. On June 21st I was back in the hospital with a staph infection and had emergancy surgery to remove it, I stayed in the hospital for 6 days and left with a central line in my chest so that IV antibiotics could be administered at home. It has been 8+ weeks now and I can not move the leg with out severe pain, I can bend it 24 degrees on a good day. I am unable to up any pressure on my Rt leg and I am using a walker to get around. I can not do the stairs, so I have to stay in my house ( we have 6 steps to go outside). A nurse and PT come to my house. It has been the most frustrating thing I have ever done. My DR is completly stumped by my problems and that scares me. I go back tomorrow with the hopes that my infection ratet has gone down enough to remove the central line and use strictly oral antibiotics. I also hope he will have something to say about the pain, I assume it is from the damage done by my infection, but I can't get any answers about that. I hate the thought that more surgery could be the answer. If I could roll back time, I would not have the surgery in the first place. I did think I was well informed and prepared prior and very comfortable with my Dr and hospital. I seem to be the 1 in a million that has something go so horribally wrong, but it doesn't make it any easier.
I would love any help or info, I have just started my quest to be a person again and I get lost surching the internet.
Amy
Posted by hmaxwell (Heather M.), 11 August 2004
Amy,
A severe infection like the one you had can unfortunately lead to massive production of scar tissue. The most important thing is to get the infection under control (sometimes this requires repeated surgeries to clean the knee out) and then worry about salvaging what was left.
There is a section on this board above that is for people who have soft tissue healing problems--infection, scar tissue, and nerve damage. You may want to read there. The condition that most commonly comes after infection like yours is arthrofibrosis--an excessive amount of scar tissue forming in the knee joint. The remedy for this is a special surgery and intensive rehab regimen to keep the scar tissue from growing back.
Another complication of severe infection is septic arthritis--this is where the articular cartilage is severely damaged by the infection, so it seems like the knee belongs to an 80 year old. The solution for this is usually a partial or total knee replacement.
I ended up with both severe arthrofibrosis and moderate septic arthritis (the damage is quite severe, but limited to two relatively isolated areas). I've had several clean up surgeries...but my scar tissue went undiagnosed and then incorrectly treated for so long that it left me with permanent damage.
If your own doctor has no idea what he/she is doing and what to do next, then I URGE you to see someone who does! Your knee is still salvageable at your age, so please go see someone who can salvage it...who does that kind of thing all the time! Where do you live? Maybe someone here can point you toward a knee specialist...
And in the meantime, remember that the priority is to get the infection taken care of, then to deal with any problems it might have left behind. Some people have a frozen knee like you are describing and are able to rehab it through intensive work in PT. Others (myself included) had to have the scar tissue cut out and then work very hard to not have it grow back. Either way, there IS hope, as long as you see a doctor who treats these difficult 'salvage' cases on a daily basis. I can't tell you enough how much difference it makes to see someone who says "Ah, one of those cases, I've seen lots of them,' vs a doctor who says "I've never seen anything like this before, I have no idea what is going on."
Take care and visit the Soft Tissue healing problems section for more information on infection and arthrofibrosis. And don't lose hope. It may take a while, but you can get through this and come out walking on the other side!
Heather
Posted by cinderamy (cinderamy), 12 August 2004
Heather
Thank you so much for your reply. I was at the Dr today and he confirmed what you had said about scar tissue. He said that the scar tissue is the reason for the pain and lack of motion. My Fulkerson fracture has healed and everything on my x-ray looks fine, my MRI is a waste because the screws blured the picture too much to see the important areas. We have schedualed surgery on Monday to remove the scar tissue arthroscopicly and manipulate it if he needs to. He said I'll stay a day in the hospital and put on the CMP. I think it sounds horribale, but in a way I feel relieved, this might be what I need to get back to some part of normal.
I really am wondering what to expect. I realize that surgery hurts, I just wish I knew that there is a time line. Should I expect to be more mobil in 2 weeks or 2 months? I want a Miracle, but I know there is not going to be one. I am aware that there is no easy way out of this and that I can't turn back time and skip this all together. I would like to put it in my head that I could be taking care of my kids and Mom duties by myself in a month, am I just setting myself up for dissapointment?
On a good note, my blood counts turned out great and my infection is all but gone. I need to stay on oral antibiotics for a while,but I was able to have the central line taken out today. It feels nice to have a normal chest again, no more "boob tube!"
I know my journey has just begun, I have found comfort from reading what others are going through. It is lonely when it seems no one understands, my mother has me constantly on my death bed and my mother-in-law thinks I just need to suck it up and walk. I have a wonderful husband, but it is easy to see the stress this has put on him, and I hate that.
Hope this is all over soon- Amy
Posted by beaurose14 (beaurose14), 7 September 2004
HI my name is Rose,
I am 38 and the mother of 4 and I just found out that I need my 4th knee (left) surgery. I have had 2 scopes with a lateral release and as my OS informed me that the knee aligment that I had 10 months ago was done incorrectly 
!!! It is the type that is not done anymore
So now I can't go from sitting to standing or up/down the stairs without dislocating and loud popping and cracking. The pain is constant. I have seen 15 OSs and not one wanted to touch me. Finally found a OS that is great. He belives he can help with the Fulkerson Osteotomy. My last surgery was done to the wrong side and my OS says that is why I have so much pain. I am so not looking forward to having this all over again but I know I can't go on like this. Has anyone else had to have this kind of procedure twice?? Big worry is having my second set of screws put in and hoping for the bone to heal correctly. Thanks, hope to chat soon. Rose
Updated Sat Nov 21 2009
