KNEEtalk

DIARIES => Post-op diaries (50-100 posts) => Topic started by: greyliston on November 21, 2011, 01:50:53 AM

Title: Grey's LPFLr, MPFLr, TTT
Post by: greyliston on November 21, 2011, 01:50:53 AM
Hello.

I am having surgery in the morning in Texas and wanted to get this kicked off. I am a 27 YO male from Portland, OR. I received so much great info on this website so I want to give back by providing my personal experience.

After 2 lateral releases on the same knee (totally unecessary), I am having my lateral retinaculum reconstructed using a graft of my IT band. Also, due to patella alta, I am having my patella moved down 1.5 CM and my medial patella ligament tightened.

Stay tuned for updates.

Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: Dave258 on November 21, 2011, 01:54:15 AM
Good luck tomorrow!
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: Fathead D on November 21, 2011, 02:15:00 PM
Good luck.  I am likely going to have something simialr done.  Are you having Dr Mark do your surgery? 
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: meemers on November 21, 2011, 05:34:17 PM
Best Wishes!!!                 Best Wishes!!!         Best Wishes!!!
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It sounds quite involved! Looking forward to your diary.
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: TOMMAX on November 21, 2011, 09:03:00 PM
Hi Grey, hope the surgery went well and you are now on the road to recovery. Keep us posted, good luck!
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: greyliston on November 21, 2011, 10:43:52 PM
Hello all. Thanks for the thoughts.

The surgery went very well. Yes, I had Dr. Mark perform this operation.

Everything went as planned but the Doc did mention that it was a challenging case due to the fact that my lateral retinaculum was non-existent because the previous surgeons had released it so much.

So I had my lateral retinaculum reconstructed with a graft from my IT band, my tibial tubercle moved distally 11 mm and medially 5 mm, and my medial retinaculum reconstructed with a donor graft.

I am just recovering in the hospital - pain free due to the nice drugs. I am supposed to start cannonballs in a few hours.
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: Driden on November 22, 2011, 01:39:52 AM
Way to go, G. Time to dust off the bike shorts.
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: TOMMAX on November 22, 2011, 03:11:03 AM
Really glad to hear that the surgery went very well and you are getting the proper pain control in the hospital. Let us know how the cannonballs are working out for you! :p
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: greyliston on November 22, 2011, 03:25:39 PM
So 1st day after surgery. Pain is definitely present. Doc has already had me walking this morning, fully weight bearing on my operated leg with the safety of crutches (but not really using them). Doc also has me doing cannonballs and straight leg raises of which both are painful but tolerable. I get discharged tomorrow.
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: lisa424 on November 22, 2011, 09:19:52 PM
I'm going to be having the same surgeries done (with both allografts). I'm so excited.
Good luck to you!
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: greyliston on November 23, 2011, 08:28:18 AM
So I am very excited. This is my last night in the hospital. I get discharged tomorrow. Also very excited to take a shower.

I am not gonna lie, the cannonballs suck. They are painful and I do not enjoy them. They definitely do not give you anytime to stiffen up around here. I am still just laying in the bed with my leg propped up and the cryo-cuff machine running 24/7. I dont think I have a lot of swelling but then again, my knee is so wrapped up that I cannot tell.

The treatment I have received by Dr. Sanders and the North Texas Medical Center has been everything I expected it to be - high quality and lots of personal attention by the Doc and staff. No dissapointments whatsoever. All I can do now is hit the recovery hard and hope for the best possible outcome.
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: Fathead D on November 23, 2011, 01:21:17 PM
Glad things are going well.  I have a feeling you are going to make a very quick recovery.
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: greyliston on November 24, 2011, 03:37:53 PM
Ok so things are not going so well today. I left the hospital yesterday and my mom drove me to Vicksburg, MS which is where my family goes every year for Thanksgiving. It was an 8 hour drive. I'm not sure if it was the drive or just leaving the care of the hospital but last night and this morning have been very painful and the swelling is bad.

I dread the cannonballs now. I've been told the 3rd day after surgery is the worst so hopefully this is the climax. I consider myself a pretty tough guy so this says a lot for me to be suffering so much.
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: Dave258 on November 24, 2011, 03:58:25 PM
Sorry to hear about the pain!  I know it is Thanksgiving, but try to get some rest.  I know it is hard around the holidays.  My surgery is 2 weeks before Christmas, I am already worried about all the moving around!
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: drmark on November 24, 2011, 05:32:32 PM
As we said an 8 hour bumpy car ride is way too long.  Unfortuantely, knee surgery doens't occur in a vacuum.  There is a person's life attached to the knee. 

The best solution for this is to be off the feet, using the ice 24/7 with the limb straight, and the foot elevated 8 inches above the heart. The cannonballs are an absolute necessity, lest you find youself in the unfortunate group of people who wil need manipulation under anesthesia, something I have never had to do in a PF case.
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: smartdriver on November 24, 2011, 10:18:26 PM
Sorry to hear about the pain and swelling.  Unfortunately, there's really nothing good about travelling after a surgery. Even if you had to fly somewhere, your leg wouldn't be happy.  The only thing you can do is keep your leg up, and try to do the cannonballs the best that you can.  At least you have family around to help... :)   I was on my own once I returned home, and trying to do the cooking, cleaning, laundry, etc. on crutches is the absolute pits, so "take advantage" of any assistance you can!

One thing that I learned after the second surgery (and in hindsight wish I would have done it after the first one too) is to get acupuncture.  After flying home, my leg was really swollen (as yours is from riding).  Prior to leaving for surgery, I made an acupuncture appointment with my TCM practitioner for when I arrived home.  For me, acupuncture made a HUGE difference in terms of swelling/pain/bruising.  I went twice a week for about 4 weeks.  The wonderful "blood rush" feeling that I had after the first surgery was almost non-existent for the next 3 surgeries.  The swelling and bruising  wasn't nearly as bad either.  After she would put in the acupuncture needles in my leg, she would also put a heat lamp over my knee as well.  Then she would put some needles in my head as well, for relaxation (aka NAP!).   It was the best hour I could have asked for! She also gave me a liquid pain reliever to put on my leg (but NOT on the incision).  After the TCM appointment, I could do the cannonballs better than I could prior....(and there's NOTHING good to say about the cannonballs). And, after the second surgery, I ditched the pain pills once I got home too since they didn't provide any relief whereas acupuncture did.  Hmmm....

In the end, you have to follow what doctor's instructions you have been given.  What worked for me, may or may not work for someone else. 

Good luck with your recovery - it does get better!  Just wait until you can get on the bike-then things will progress pretty quickly..
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: greyliston on November 25, 2011, 01:47:50 AM
smart driver: thanks for the encouragement. You are right. I am very lucky to have assistance from my family. My traveling is not done though. I have to fly back to Portland on Sunday. I may have to try the acupuncture thing.

My cryo-cuff machine broke! Has anyone else had this happen to them?
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: lisa424 on November 25, 2011, 08:15:17 AM
Mine broke a day after my last surgery. A donjoy one. Luckily the company I ordered from was awesome and overnighted me one. Usually they're guaranteed for a year. Those things do tend to break easily.
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: greyliston on November 26, 2011, 04:25:23 PM
Ok so today is post op day 5. Pain has calmed down, probably due to the meds I continue to take - tramadol, hydrocodone (spelling?), Tylenol, mobic. Cannonballs are getting easier but everything feels so tight in my knee. I start to worry that my knee has been over-tightened by the lateral and medial reconstruction but I think it is probably still just swollen and that is what is causing the stiffness. I am supposed to start biking in 2 days but that seems unrealistic at this time due to stiffness.

Also it is hard to mentally accept the new position that my knee cap is in. Your whole life you are used to it looking like X and now it's in position Y. It is freaky but I keep reminding myself that when everything feels great I wont even think about it. I need to get a new cryocuff machine since it broke at the worst time and I have to fly back to PDX tomorrow.
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: drmark on November 26, 2011, 04:53:37 PM
A few things that I am sure of:

1. Your knees hasn't been "overtightened".  Fixing the tension at 30 degrees flexion makes that impossible. After a few years of pathological laxity, it normal for it too feel tight.

2. Pain medications are given for a good reason. Use them

3. If you couldn't ride the bike at one week, then you would be the first  PF or ACLR patient I have had that couldn't. And that includes more than a few wierdos.

4.  Tomorrow will be a bad day if you are traveling. You will just have to accept that. Wear the TED hose.

5.  Work that knee!  It has evolved to bend, but that won't happen unless you make it.   

 That's it.
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: greyliston on November 26, 2011, 05:32:56 PM
Thanks for the info Dr. Mark. Thats what I needed to hear.
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: Driden on November 26, 2011, 06:43:05 PM
Have you figured out how to deal with the cyro cuff?  If not, email Michelle, and her DJ rep will send a new one immediately. It has a 90 day warranty. Mine broke at week 6 or so, and Michelle took care of it. Unless you got a used one, in which case you may need to get a new one.

I found assisted cannonballs to be helpful.  In fact, I could not sleep worth a flip the first 2 weeks, so had my loving wife cannonball me many times through the night during that period. She has to be mean and bend it beyond your comfort level. And yell profanities at you when you start to wimp out.  I got an extra torque as punishment for taking her to gainesville,Texas, for our 10th anniversary.

Mine still feels a bit tight at 13 weeks post op. Until the swelling is gone entirely, a sensation of pressure and tightness will remain. Mine gets a tad better every week.

I hope you can rest when you get home. I was mostly pain free, but was on my back for 3 weeks with cryo cuff running 24/7.  Only exceptions were breaks for cannonballs, bike, SLRs, meals, and showers.
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: smartdriver on November 26, 2011, 11:52:03 PM
I am supposed to start biking in 2 days but that seems unrealistic at this time due to stiffness.

I have to fly back to PDX tomorrow.

Even though I "only" had an HTO, getting on the bike actually felt good.  Yes, your leg will be swollen like a sausage (esp. after flying), but just the movement from pedaling will actually feel good - in a weird way, but it does.  Just don't say "I'll get on the bike tomorrow" - with you flying home on Sunday, even if it is Monday night, you've got to make yourself sit on the bike and pedal!  Over the course of 4 surgeries, I've managed to break 3 of the stationary bikes at the gym.  The last one "caught fire" - the transformer on the circuit board blew up and there was smoke coming out of the pedals in addition to the "electrical fire" smell :o  So, I've now been "accused" by the guys at the gym that I'm riding the bikes into the dirt....I'm thinking that they mean that in the nicest way of course!!  By the time I got off crutches, I was biking well over 100 miles a week.

As far as flying, were you able to book first class going home?  Obviously that will give you alot more leg room.  At the least, hope you have an aisle seat?  If you aren't flying first class, were you able to book the bulkhead row?  That row is reserved for people who need "extra assistance" and that's why it is normally blocked out - you generally have to call the airline to book the bulkhead row.  Are you getting any assistance at the airport (wheelchair)  If so, those individuals are really good about getting ice.  Even the flight attendants on Delta made me bags of ice to put on my leg in addition to keeping ice in my cryocuff.  Just don't be afraid to ask.  If you have a connection, and depending on how long between flights, try to get your leg up as much as possible during that time as well - it will really help.

Good luck!
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: greyliston on November 27, 2011, 12:45:13 AM
I am going to get Michelle to get me a new cryo-cuff machine on Monday even though I can just use ice packs. It will just be nice to have that thing around for future use (as long as this one lasts longer than the other). The cuff fits all sorts of body parts.

As of this evening the cannonballs are getting better and I will definitely make myself get on the bike Monday. Ive also been feeling better all around today. I got a flu shot right as I was leaving the hospital and I think that made me feel ill for a bit as well.

As for flying, I will definitely milk the system and get an aisle seat and wheel chair assitance in Houston for the connection.

Thanks for the replies and caring!
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: greyliston on November 30, 2011, 12:04:19 AM
Post-op day 8.

I had a horrible time travelling back to Oregon. Continental airlines is truly a terrible airline. Going to surgery - flight IAH-DFW was delayed 2 hours due to the pilot being over his flight hours and being sent home. Flight home was delayed 6 hours due to mechanical - missed my connection and had to stay in a hotel in Houston - flight in the morning was delayed another 1.5 hours due mechanical. I arrived home 18 hours late. My leg HATED me. I was away from ICE and pain meds the whole time.

So i think the travel was a set back in my recovery. I am still in pain and my leg is still swollen. I forced myself to get on the bike last night for 1/2 hour. It sucked but I did it anyways. Walking is sketchy and I have a severe limp but I am trying to walk as best as I can. I got back to working today from home (remote desktop) so that was nice.

I am gonna ride the bike again tonite for 40 minutes - trying to build up to 1 hour but it is difficult with all the swelling.

So for now its still RICE, pain meds, and as much PT as I can handle.
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: Dave258 on November 30, 2011, 03:49:42 AM
At least you are home now, and the worst is behind you!  Good luck with the rest of your recovery.
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: lisa424 on November 30, 2011, 08:14:52 AM
I'm not looking forward to traveling for surgery either. But it sounds like you're doing alright. At least you get to work from home!
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: meemers on November 30, 2011, 05:18:40 PM
just curious - I've heard canonball exercises mentioned in several postings. What are they?
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: greyliston on November 30, 2011, 05:46:46 PM
you pull your knee up to your chin as if you were doing a cannonball off the diving board. Its done to keep ROM immediately after surgery.
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: greyliston on December 03, 2011, 08:14:36 PM
Post-op Day 12:

I still have significant swelling and am still layed up on the couch (for the most part) with ice on and leg elevated. I am encouraged by the way my knee feels though. It feels very different than it did prior to surgery and in a good way. My knee cap, which was once completely lose and floating around is locked in solid now. I have been rigorous with my PT. Everyday I ride the bike for one hour (broken into 2*30 min sets). It feels great to get exercise. I do straight leg raises and cannonballs as well (at least every 2 hours). Even with all this, the atrophy is still noticeable (scary!). My incision is at least 10 inches long and is being held together by 35 staples.

I have been getting around ok though. I never use crutches now. Walking is sketchy. I just have to be very cautious and take it slow. I have to get out of the house every once in awhile so I walk to the grocery store around the corner and drive to meet with friends for dinner and whatnot. After a couple of hours I feel the need to get back on the couch, elevate and ice.

I go to sleep with the cryo-cuff machine running but wake up in the middle of the night because of pain. So I get up, pop some pain meds, re-fill the ice machine and go back to sleep. I feel kind of yuck all the time due to all the medications I am taking. I also live alone so I have to do everything myself which has been hard but manageable.

I am currently taking: Hydrocodone, Tramadol, Mobic, Tylenol, Aspirin, vit D, vit C, calcium, multi-vit, and glucosamine. They gave my Phenergan for nausea which I have yet to need and they gave me Ambien for sleep which I have taken several times hoping it would keep me asleep despite the pain but it doesn't seem to have much affect on me.

I also have increased my protein intake per Doc's orders. I use whey protein to get the extra boost.

Overall I would say things are going smoothly. It was a big surgery so it is going to take time to recover. I just need to be patient.

Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: drmark on December 03, 2011, 08:33:20 PM
The story sounds alot better than last week's.
Its too bad I don't get paid by the staple.
I'd be rich!
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: smillie on December 05, 2011, 08:05:14 AM
Travel after surgery is just lousy. It definitely sets you back a bit. I'm glad you're back on track and feeling better about things. That tight feeling will get better. I tried to just embrace it as a positive thing since I definitely didn't want the loosey goosey feeling ever again. It's just really weird to get used to a new alignment in there, but it will come. Congrats on getting your knee fixed!
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: Driden on December 06, 2011, 02:07:16 AM
For me,  Ambien was worthless--not because of pain (which was mostly nonexistant as long as cryogenic cuff was pumping) but rather some sort of bizarre post surgical adrenaline rush. That lasted 2 weeks. After that, Tylenol PM was more effective. If there is ever a next time (other limb), I will say no thanks to Ambien and narcotics. Got to find what works.
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: greyliston on December 09, 2011, 09:02:05 PM
2 weeks and 4 days post-op:

I cannot get the swelling to go down. I don't think there has even been any real decline in the swelling.

Does anyone have any suggestions for keeping swelling down besides rest, ice and elevation?

I have had to go back to work this week so when I am at my desk, all I can do is prop my leg up on some boxes but there is no way for me to get the knee above my heart.

Despite the swelling I have still been pressing on with the biking and PT.
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: aaa on December 09, 2011, 09:43:12 PM

I haven't had a surgery like yours, but I remember with my isolated lateral release there was a 'breaking point' where swelling started to go down ... it seemed like it wasn't for a while.  But, then again when I returned to work it came back a bit and the rest of the swelling to relatively longer to go down.

Sucks that you have to go back to work ... yeah icing, elevating, compression (if Doc allows) should help.

For me, I found good nutrition and getting plenty of sleep helped move things along. 

A friend of mine got me a book on injury healing ... I've linked to a page with list of foods from it, I found it helped:   http://books.google.ca/books?id=q7bjfwAbkCwC&lpg=PA1&dq=Healing%20Injuries%20the%20Natural%20Way%20%3A%20How%20to%20Mend%20Bones%2C%20Muscles%2C%20Tendons&pg=PT80#v=onepage&q&f=false

Of course, the healing process always takes time, no quick fixes i guess


Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: TOMMAX on December 10, 2011, 12:29:59 AM
Grey, I also remember after my lateral release my knee ballon up for 6 months and I thought the swelling would not go away, and that was just from a little 3 inch cut with and elctrocautrey probe to the lateral retinaculum. Youve had some serious, serious knee surgery here and your knee is likely gonna be pissed of and swollen for quite some time. It will go down for sure though. Even if it feels like its not getting u anywhere just keep resting, icing, and elevating. Maybe you are having set backs with your swelling by going back to work too soon since you cant elevate and ice your knee properly?
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: greyliston on December 10, 2011, 12:43:19 AM
I probably am not helping myself by going back to work so soon but I cannot take any more time off. I just started this job 4 months ago and haven't accrued that much time off.

This is also true that I have had a serious surgery. I am walking ok and biking a ton already so the swelling is the only thing that is holding me back. Yea I guess my knee is pretty pissed off with all the crap that I have done to it in the past 1.5 years.
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: Driden on December 10, 2011, 01:35:30 AM
You can jam a needle in the knee, and self-aspirate, but I would not advise it.  RICE  plus NSAIDs are it, and the latter may interfere with bone healing. If it makes you feel better, I am cryogenic cuffing my swollen knee right now, and I had a several week head start. This is part of healing. Time.
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: bassetlover on December 10, 2011, 01:42:09 AM
Hello friend, I hear you. I'm in the exact same boat.  I purchased compression socks, knee highs from Walgreen's (our local drug store) they help tremendously. My knee still balloons out but below that is much better with the compression socks. Stay hydrated, over hydrate, for reason I swell less when I drink more water. Hope that helps my friend. Sounds to me you are doing great!!
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: drmark on December 10, 2011, 01:47:22 AM
The thigh high TED hose can help with the swelling.

Eighteen days after a tibial tubericle osteotomy, LPFLr, and MPFLr, you have 130+ degrees of flexion, and walk pretty normally without crutches, and are making progress on the bike, by comparison with the other folks who have undergone a lesser procedure, you are ahead of the game. 

Someone can say that I am breaking my own arm patting myself on the back.  So I will say it first.
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: bassetlover on December 10, 2011, 01:57:13 AM
Dr Sanders, so cool to see you comment occasionally. I've read many of your patient's treads on here. You sound like a fantastic doctor. Thank you for all you do! I will look into thigh high compression socks. Lol thank you.
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: greyliston on December 10, 2011, 06:37:10 PM
Dr. Mark - you do deserve a pat on the back. Great work.

Thanks for the comments folks. Seems like I am just impatient. But its only because This is my 3rd knee surgery in 1.5 years so the waiting is not like just having 1 surgery and then recovering. This has been going on for awhile. Alas - I wait some more!
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: smartdriver on December 12, 2011, 05:28:32 PM
I cannot get the swelling to go down. I don't think there has even been any real decline in the swelling.

Acupuncture was really the thing that helped me the most.  A couple of times a week for 2-3 weeks (if you can afford it) is all that you really need.  After each session, my leg would feel SO much better.  It was definitely worth every penny.  And I am now going to acupuncture for some other health issues that I'm faced with.

The TED hose helped, especially once I got back to work (I only took a week off before I had to go back to work due to the amount of time off I had). 

At night I kept my leg on a pillow more for "comfort" than anything (but, it also goes back to acupuncture for me)so I never really elevated it above my heart.  For sleep, I would use something like the Yogi Bedtime Tea or Gaia Herbs has some good products for sleeping as well.  Note:  I wasn't on any pain relievers when taking herbs either.  I tried the generic Ambien (since my insurance doesn't pay for the "real thing").  One night I took it (and I'm by myself), fell asleep, and when I woke up I was in a different room.  Not sure when/how I got there.  So, I won't go back to that again....

Unfortunately, it just takes time and for some it may take longer - everyone's different....

Just keep on biking!

Good luck!

Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: greyliston on December 15, 2011, 08:01:33 AM
Post-op 3 weeks and 2 days.

I would have to say that things are progressing along very well. Despite the lingering swelling, I am walking very well now (only a slight limp on occassion). I walk about 9 blocks to and from work everyday to get to the street car stop. Standing up for a awhile doesn't bother me to much either. I still prop my leg up on some boxes under my desk at work.

I feel like the swelling has peaked as well. It seems to be going down little by little bit everyday and is all on the lateral side (mainly where the LPFLr was done and up the side of my thigh where the IT band graft was taken).

Tonight when I was biking I noticed that I actually felt halfway decent. I powered on through the whole hour keeping my heartrate at about 160 bpm the whole time. I am able to keep a very high cadence as well.

SLRs bother me a little bit but full arc extensions are ok. I am also ascending steps very well. I walked up 2 sets of 7 flights today at work with not too much trouble.

I am still resting with my leg eleveated and ice on alot and its usually the first thing I want to do when I get home from work. I sleep with the cryo-cuff on for a about 3 hours and then remove it.

For somebody who had a massive knee surgery done 3 weeks ago I would say I am progressing along very quickly. Dont get me wrong though, I am still along way from being fully recovered.
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: Fathead D on December 15, 2011, 01:22:05 PM
Great news Grey.  Keep it up.
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: Dave258 on December 16, 2011, 04:44:57 AM
It sounds like things have went very well for you!  Great job.
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: drmark on December 16, 2011, 01:59:11 PM
Here I am breaking my arm patting myself on the back again.

Fat head showed pictures of his surgery.  The surgery I did on Grey, looks about the same.  While only the surgeon knows how tight the screws went in (you can't appreciate that from a two diminsional pic), the recovery, both in the near term (who long until you return to normal life) and the far term (how many arthrofibrotic knees are created) all amounts to the rehab philosophy of the guy or girl who holds the knife. 

For my patients and I, that leads to immediate weight bearing, immediate full ROM, and no brace to help the knee freeze in its locked position.  To do this requres good screw tightening, usually the use of a third, insurance, screw, for the TTT or tibial/femoral osteotomy  and sound fixation of the  LPFLr MPFLr, with multiple sutures, all tied in 30 degrees of flexion to avoid overtightening.  That idea, which has worked great for me goes back to the mind of Dr. Jack Andrish.
But in the end, the doctor needs to have the courage of his/her convictions, or these threads will certainly go into the +300 pages.
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: Fathead D on December 16, 2011, 02:24:59 PM
Fully agree with Dr Mark.  My surgeon wanted to use 3 screws to fixate my tubercle but he said that it was anatomically too small.  I guess I am a genetic freak.  Big guy on the outside with small tubercles. 
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: bassetlover on December 16, 2011, 10:05:21 PM
I think we are exactly the in our post-op recovery. It's so cool to read how well you are doing. Keep up the good work. My surgeon is very aggressive post-op also. Keep up the good work.
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: greyliston on December 21, 2011, 12:27:59 AM
Of course, I have the staples out now. This was at week 2.
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: Fathead D on December 21, 2011, 01:10:09 PM
Wow thats a huge scar.  I had a TTT and LPFLr as well and my scar is about half that size.
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: Dave258 on December 21, 2011, 03:08:49 PM
That is one nice scar!  Mine is much smaller also, I think I only have 15 staples in mine that should be coming out tomorrow if I am lucky!
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: drmark on December 21, 2011, 03:23:23 PM
The Saphaneous nerve runs on the medial side of the knee.  I frequently gets cut in the first part of the incision.  Its accidental section is a potent cause of Chronic Regional Pain Syndrome, a life changing doctor-caused disease.  For that reason, I make my knee incisions on the lateral side of the leg, and have complete confidence that the nerve is safe.  My view is that the skin heals in two weeks, CRPS from a saphaneous nerve injury last forever. Commonly it will lead to an unemployable, uninsured, divorced, drug addicted person who's life just isn't worth living.  If you doubt this, go the the forum on CRPS or Reflex Distrophy.  Here is the link:  http://www.kneeguru.co.uk/KNEEtalk/index.php?board=44.0
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: Dave258 on December 21, 2011, 03:46:33 PM
Dr. Mark, would you believe I was diagnosed with RSD/CRPS after my second knee scope before the real problem was found.  I am still pretty pissed of at the Doctor that just threw out that diagnosis willynilly!
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: greyliston on December 21, 2011, 04:12:09 PM
Yea I could care less about what kind of scar I have as long as the knee works properly and I don't have nerve damage.
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: drmark on December 21, 2011, 04:42:38 PM
Minimally invasive surgery?

Do we measure it by length of incision, or by time with crutches, braces, or casts, or time off work with no money coming in, or by incidence of serious complications requiring serious medicines or revison surgery?

For example, I alway make a longer incision over the tibia, so I can osteotomize at least 6 cms of tibial tubericle and attached anterior tibial cortex.  This way, I can always fix the osteotomy with three strong screws and a tension band.  This way the person can start immediate braceless, and shortly thereafter crutchless weightbearing.  The cost of this is at least another two inches of incision.

I know what I think about this stuff,  but opinions are like butt holes, everyone has one.
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: Driden on December 21, 2011, 06:16:30 PM
Dave, I can top your story. I traveled a long way from my home to the cleveland clinic, thinking that a team of doctors at a top institution could figure out why my post-LRR knee and quad were in such poor shape despite many months of physical therapy, oral drugs, injections, personal trainer, etc. The OS was worried about RSD due to osteopenic bone and sent me to a neurologist specializing in RSD. The neurologist concluded that i did not have RSD but, instead, had some unidentified sympathetic response to pain, causing muscle inhibition, that had "not yet been published" in the medical literature. He advised that I ride an exercise bike with my eyes closed every day, for only 5 minutes, and take an unspecified muscle relaxer. The OS, who attended this appointment with the neurologist, nodded in agreement--this was the course we should take and not surgery to reverse the lateral release. So, I flew back home, $1,000 poorer, wondering what the heck happened and if I am on planet Earth or someplace else. The neurologist never wrote down his clinic notes--so I have no proof of this incident--but he charged my insurance $700 for it. 
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: greyliston on December 21, 2011, 09:29:10 PM
Yes there are some serious idiots out there. Like the doctor here in Oregon that knew that I had already had 2 LRRs and yet he wanted to do another one.
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: Driden on December 21, 2011, 09:48:15 PM
One of the biggest idiots I have ever known recently got admitted to medical school at age 34. He tried 4 or 5 times over the years, and they finally took him. With that kind of brains and tenacity, if he goes into orthopedics, I anticipate that he will be the type of doc who does a repeat release for a failed release. Scary stuff.
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: Fathead D on December 21, 2011, 09:54:14 PM
My Fiance' is a Med Mal attorney.  You would be suprised at the stories I can tell you. 
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: greyliston on January 10, 2012, 06:20:42 PM
7 weeks post-op:

Things are going well. I am pretty much back to normal life with a few exceptions. Now the real test is when I can start hitting the athletics hard. Here is an example of my activities this past weekend:

Saturday: Went to the gym and lifted legs (hami machine, squat machine, extension machine), upper body and swam 2k yards. Then immediately went into the Columbia River Gorge with friends and did a 5 mile hike up to the top of Angel's Rest and back down (relying heavily on hiking poles). Saturday night: went out for beers (great beer in Portland) with friends, drank too much and probably did stupid stuff that made me hurt the next day. Sunday: Rode 20 miles with my friend up to North Portland and back into town. I cannot get up out of the saddle to climb a hill yet - must be sitting down to bike. Monday: needed to take a day off because of pain levels.

This may sound like I am doing really well but there is definitely still pain and my knee is definitely still on my mind all the time. I am still icing but not every day. Swelling is down but still a little puffy. ROM is great, maybe 140?

Additionally, I have been receiving acupuncture regularly. I have had 6 sessions thus far and have 2 more this week.
One thing that concerns me is that my skin is still slightly numb around the knee.

In conclusion, I am doing well but still a long way to go before I am fully recovered.
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: smartdriver on January 13, 2012, 03:13:09 PM
Additionally, I have been receiving acupuncture regularly. I have had 6 sessions thus far and have 2 more this week.
One thing that concerns me is that my skin is still slightly numb around the knee.
Grey:

Glad to hear things are progessing well!  But, I'm REALLY glad that you're doing the acupuncture!  I assume that you have noticed a difference since starting the acupuncture (esp. since you keep going back!).  If I ever have to have surgery for anything else, I think I will bring my acupuncturist with me so I can get pre- and post-surgery sessions.  Does your acupuncturist use the electrodes?

On the numbness, I've never regained (full) feeling back -it's better than it was, but  probably won't ever be back 100%  :(
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: greyliston on January 13, 2012, 06:36:34 PM
Hey smartdriver,

The acupuncture has been great. No, my acupuncturist does not use electrodes.

The first time I went I had significant swelling and the day after, the swelling went down tremendously. Thats when I knew it did something.

The numbness is going away slowly because now I feel the needles in places where I had not felt them before but it is just going to take time.
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: greyliston on February 07, 2012, 04:57:28 PM
2 months and 3 weeks post-op.

I can relate to Driden now in that I have hit a plateau. I am still dealing with pain but only when I am pushing myself.

The pain is definitely patellar but there is also a sense of overall knee pain and tightness. My ROM is great but there is this resistance to bending the knee. Most likely it is because of all the new parts inside there (TTT screws, IT band graft stapled down, donor ligament stapled down).

I will go hard and then have to stay off of it for several days. I go hard because I think that that is the best way to build muscle and get my knee back in shape but it becomes more apparent that I need to be resting and doing light PT. Like this weekend, I rode 33 mi Sat and 40 mi Sun. By no means was this pain free and I forced myself to get up out of the saddle on the climbs. Monday I was hurting and today I am still hurting.

I understand it is still early in the process and I will not pass judgement on this surgery until 1 year post-op.

On a pleasant note, I was trying to catch a bus and had to run after it (total run time of 10 sec?). I didn't even realize I was running and it actually felt ok. Running was impossible prior to this surgery so that is huge for me! Also, the fact that I can no longer pick my knee cap up and almost flip it over is very relieving. It is lock solid in there!
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: TOMMAX on February 24, 2012, 07:10:05 AM
Hey, sounds like youre hitting the rehab hard and its good to hear that youre able to be so active so close from surgery. I hope the pain will go away completly for you in due time and this surgery has solved the problem for you. Look forward to your future updates, best of luck to you.
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: greyliston on March 01, 2012, 09:50:16 PM
Ok so I am 3.5 months out and I am really starting to feel good. I even called Dr. Mark up today because of how excited I am.

Definitely still need some healing but to actually see improvement after a knee surgery is very encouraging.

Still have some numbness around the incision area. Not sure if that will ever go away but thats not really what I care about.
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: greyliston on April 09, 2012, 11:04:04 PM
Dr. Mark is a miracle worker.

A year ago, I thought my athletic life was over. This past Saturday I climbed Mt. St. Helens and then on Sunday I rode my bike 55 miles, all pain-free.

Thank you Dr. Mark.
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: iwillwalkagain on April 11, 2016, 06:27:31 PM
Grey's recovery is an inspiration for me.  Rest in Peace. 
Title: Re: Grey's LPFLr, MPFLr, TTT
Post by: raliston on January 06, 2019, 06:29:45 PM
I am Grey Liston's father, Rick. To learn more about Grey go to StokedToGoOut.com . He has been gone well over five years as of this post. Having this record of his battle for his knee is inspirational for the Liston family. Thanks to those who reached out directly to us from this community.