Post Op Diary - Excision of Osgood Schlatter bone fragments/ossicles.

[Horz]

Hello,

I thought I might kick off a post-op diary for the knee op I am under going on Monday the 5 Feb 2007.

As I have found it very difficult to find information on the net about the procedure and recovery of the op I thought I might document my experience.

A little history:

As a teenager I played a lot of basketball and developed Osgood Schlatter – this basically resolved itself over time and left me with the large lumps under my patella tendons on both sides.  (I also have very tight quads which I find are difficult to stretch)

These days I am an avid runner and last year I developed tendonitis type symptoms in my distal patella tendon on the right side.  I tried conservative treatment and rest for months; however I continued to experience irritation after activity.

After an MRI and X-ray the OS has found I have fragmented bone/ossicles under the tendon which he is going to remove.  This will be done by a small incision over the tibial tuberosity, splitting the tendon and shelling out the bone fragments. (Not the actual Osgood Schlatter lump.)

My recovery will apparently depend on how much tendon is affected in the bone removal – I could be on crutches for a few days or 3 weeks.  If it turns out my op is  very invasive he may need to repair the tendon and stich it to the bone in which case I wont be back to 100% till after around three months.

The below link is the only information I could find on the procedure if you are interested.

http://www.rbo.org.br/pdf/2003_ago_20.pdf


My Goal is to hit the 10k Canberra Fun Run in late September.

I’m not particularly concerned about the operation itself but a little stressed about the rehab and rebuilding the quad and leg after the operation.  I plan to take the recovery very safely and not rush it as patella tendon rupture is a risk early on.


To be continued…..


Cheers

David

[Horz]

I also wanted to add that my procedure is very minor compared to what many on these forums have experianced - thank you for sharing your often very difficult experiances.  It helps those of us who have not had knee operations feel less concerned about the unknown.

Cheers

David

[fawn2388]

You'll be okay by septemeber I had it done twice within a 6 month time, I had in the Novemeber, and was skiing 'with caution' in Feb. I would take a removal of a bone over a TTT any day... lol. I was back to normal in 4 weeks, and this around it's 4 weeks, and I'm still on crutches, man does it stink...

[Clarinet'09]

Hey david,
I had this surgery in may and was doing marching band by late july. The only reason it took me so long was because the bone spur was so big and the tendon was shredded. So if you need any advide or have questions, please dont hesitate to ask me....id be glad to help!!!
               ~Chelsea~

[Horz]

Day 3 Post-Op Wed 7/2/07

Well had my surgery on Monday - which went well - the OS removed two bones one large and one small.  A repair of the patella tendon was not required (yay).

I spent the night in hospital and was released yesterday with exercises and being able to partially weight bear on crutches.

I am still in a fair bit of pain and cannot consistently get knee to full extension nor get much bend at all (the stiches/dressing feel very tight.)

Seeing my OS again on Thu 15/2/07.

Will add more detail in the coming days.

Cheers
David

[Horz]

Day 4 Post-Op Thu 8/2/07

Slept in my bed for the first time last night - quite an uncomfortable night as I placed my leg in a position were it had to straighten.  The good thing though is by this morning I pretty much have full extension in my knee.  My flexion still only remains at about 45-50 deg. 

Walking with the crutches is improving I can now roll heel to toe on both feet when walking.

My hip flexors are quite sore from constantly lifting my leg and not really using the quad which still seems fairly inhibited.

The main thing seems to be I am seeing daily improvement now – though by the end of each day I am quite sore after the exercise and moving around.
 

Cheers
David

[Horz]

By the way - thanks Fawn and Chelsea for your responses.

A quick question for either of you - how long did it take to see improvement in the angle of your knee bend.

As I said above at 4 days I am at about 45-50 deg.  Is this okay?

[fawn2388]

Yes it is... your doing better than I did, and I was told I made a fast recovery... also it is a bit hard to respond what is normal for just a ossicle removal, I also had a mensicus removal and plica removal at the same time.

[Horz]

Yes it is... your doing better than I did, and I was told I made a fast recovery... also it is a bit hard to respond what is normal for just a ossicle removal, I also had a mensicus removal and plica removal at the same time.

Ahh okay thanks - I had two bones removed - one slightly larger than a molar tooth and one about half that size.

[Bulldog]

Horz,
How is your recovery?  Can you or anyone else please give me a little more information on your symptoms?  I've been suffering with constant tendonistis like sypmtoms for the last 4 months, and I'm not fully convinced that is my only problem.  I've been telling the doctor that it is in the bone, and he did x-rays in Novemeber and in January wtih nothing visibile.  In January I had a cortisone to get ride of scar tissue in the bursa area below my knee.  It helped the scar tissue, but it has'nt reduced the pain.  I'm not in horrible pain, but it is constant.  I feel like it is in an exact spot around the bursa and tibial tubercle area.  My hamstrings, quads, patella tendon, and tendons running down my shin are a little tight, but I've been working for months to loosen these up.  Nothing seems to have changed the problem.
My history - tore ACL and medial meniscus Sept. 25 and had hamstring reconstruction surgery, difficult recovery, scar tissue buildup due to the sutures in the repair having broken, had another meniscus repair, continued pain, mensical transplant in September.  I have had continous shin pain since I started walking after 5 1/2 weeks of non-weighting bearing.
I would love any insight. 
Thanks,
christy

[Horz]

 Day 6 Post-Op Sat 10/2/07

I finished my course of panadine forte pain killers on Thursday night.  I am now just occasionally taking over the counter paracetamol.

My knee seems at the moment to be feeling pretty good in the morning and then after a day of exercises quite achy in the evening.

I have been doing isometric quads, heel slides and foot pumps (for DVT) since the operation – and have added in yesterday short arch extensions (towel under knee and straightening knee) and sitting on a table and forcing my bad leg to bend under me with the good one.

Hope I’m not pushing it to fast as I don’t see the OS and Physio till late next week.

I can occasionally walk with only one crutch on the good side but I think at this stage it irritates the knee.

When moving around and doing exercises it fascinates me that I have to consciously think of contracting the quad to get the leg to work – for example to lift the leg I don’t just think ‘lift your leg’ I have to think ‘contract quad – then lift leg’ LOL.
Hope that makes sense.

My flexion is still somewhere between 45 deg and 90 deg and my extension is good, however I still don’t have the strength to get it up straight in the ‘short arc extensions’.



BTW – I really recommend the rehab document on this site…..


http://www.kneeguru.co.uk/KNEEnotes/knee-rehabilitation


Cheers

David

[Horz]

Horz,
How is your recovery?  Can you or anyone else please give me a little more information on your symptoms?  I've been suffering with constant tendonistis like sypmtoms for the last 4 months, and I'm not fully convinced that is my only problem.  I've been telling the doctor that it is in the bone, and he did x-rays in Novemeber and in January wtih nothing visibile.  In January I had a cortisone to get ride of scar tissue in the bursa area below my knee.  It helped the scar tissue, but it has'nt reduced the pain.  I'm not in horrible pain, but it is constant.  I feel like it is in an exact spot around the bursa and tibial tubercle area.  My hamstrings, quads, patella tendon, and tendons running down my shin are a little tight, but I've been working for months to loosen these up.  Nothing seems to have changed the problem.
My history - tore ACL and medial meniscus Sept. 25 and had hamstring reconstruction surgery, difficult recovery, scar tissue buildup due to the sutures in the repair having broken, had another meniscus repair, continued pain, mensical transplant in September.  I have had continous shin pain since I started walking after 5 1/2 weeks of non-weighting bearing.
I would love any insight. 
Thanks,
christy

Hi Christy,

I had patella tendonitis symptoms at the distal (bottom part of the tendon) which is unusual as most tendinitis occurs at the tendon joining the knee cap.
I’m a runner and my knee would get sore after running and sitting and squatting.
At first a physio gave me eccentric exercises for the tendinitis which only irritated the tendon in my case – I assume because of the pressure the loose bones were putting on the tendon.

I had an x-ray and MRI on my knee and the bone fragments were very clear on both images.

I also have very large lumps from the Osgood Schlatter at both my tibial tubercles.

I’m sorry to hear about all your knee issues - where were the sutures in your repair that broke and how did they break?
Also I am concerned about scar tissue how did that become a problem for you?

Cheers

David

[Bulldog]

David,
My knee problems are not severe and are not anything like they have been in the past.  Scar tissue became a problem, to my understanding, because I did not have full range of motion when I had my ACL surgery.  The doctor never sent me to pt before surgery or encouraged me to get full range back, because of the way I had torn the meniscus.  I tore the posterior horn of the medial meniscus and this was preventing me from moving my knee.  About 4 weeks after surgery the scar tissue began to form and it became really difficult to move my knee.  I believe I tore the sutures working really hard at forcing my knee to bend.   My pt thinks I did it when I was limping, but I believe I was limping as a result of the retorn meniscus. 
From that point until the second surgery was done the pain kept getting worse.  At 3 months an MRI was done and the tear was found.  They cleaned out the scar tissue, and scar tissue has'nt been a problem.  I had a little form around the bursa after my lastest surgery, but it isn't a big deal.
As long as you keep your knee moving and work on your range of motion scar tissue should'nt be a problem.
I don't have any history like you do, but I was told that the tunnels from my ACL had enlarged.  My next appointment with the doctor is on March 5, and I keep telling myself to wait.  Because of the transplant that I had 5 months ago, I'm considered a high risk patient.  When I call the doctor to ask about pain, they require that I come in for a visit.  I made an extra appointment for Wednesday and then cancelled.  I decided to give the cortisone shot some time, but I'm having second thoughts about waiting a month.  It's a 2 1/2 drive one-way, and hours waiting in the doctors office.  It becomes an entire day ordeal.
What were symptoms like before the surgery?  How long did you have problems before the started to consider surgery?
Here is hoping for a good recovery.

christy

[Clarinet'09]

David...Sounds like youre ding really well!!! A lot better than i did!!!
         ~Chelsea~

[Horz]

What were symptoms like before the surgery?  How long did you have problems before the started to consider surgery?

As I said I would have an aching distal patella tendon after exercise or being seated for a long time - I would also feel it if I squatted deep or kneeled on the knee.

I decided on surgery after about 6 months of initial conservative treatment - my symptoms began after having a lay off running with a back injury and then hitting the road to hard to early.  My sports doctor basically said my knee may settle down over time without surgery, however due to having the loose bone there it may come back any time.  So I decided to get it over and done with.

Depending on how my recovery goes (eg my end result of ROM and/or scar tissue) I may decide to get my other knee done even though it is not symptomatic yet.

Cheers
David