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Author Topic: New to Board - Questions about upcoming HTO & TTT Revision  (Read 1387 times)

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Offline rtwarren

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New to Board - Questions about upcoming HTO & TTT Revision
« on: March 11, 2008, 06:35:06 PM »
Hi, I am new to the board, and had some questions.  Has anybody ever had an HTO with a TTT revision done at the same time?  What is the recovery like.  I am not a stranger to knee surgery recoveries, but would like to know what I am in for.  My surgeon is Dr. Teitge in Detroit, and he is supposed to be very good at what he does.  My regular OS referred me to him when it got to the point he could not do anything more to help me. 

I have had ongoing knee problems for the last 23 years, and have been told everything from the pain is all in your head to just live with it - there's nothing we can do.  It took me almost 10 years to find an OS who took me seriously and realized that I had a problem.  He attempted to fix my right knee arthroscopically, as it was the least invasive and he wanted to try that first.  It lasted about a year, and then he had to do a TTT.  At that time, he also warned me that I could possibly have problems with my left knee and to keep an eye on it.  Maybe if it was caught earlier, the arthroscopy would work.  In 12/09 he did arthroscopy and Lat Rel on my left knee.  Things went really well for abouth 3 years, then I started having more pain in my left knee again, and a lot of subluxing.  He decided it was time to do a TTT on my left knee in 2/01, and he removed the screws in 6/02.  I did not have any major problems until 1/07 when I tore the meniscus in my right knee.  My OS removed the damaged meniscus, and I began having a lot of pain in the medial section of my knee.  I went back to my OS, and he gave me a cortisone injection to try and relieve the inflammation, but it didn't work.  He told me that the medial compartment of my knee was causing my problems, but there wasn't much he could do for me.  I didn't have enough damage to warrant a TKR (aside from the fact he didn't want to do one because I was too young), and he said that the prosthetics for PKR were not very good in his experience with them.  They ended up causing more problems.  He said that the only thing he could offer would be to scope the knee and clean it out, and that might alleviate the pain for awhile, but it would eventually come back.  I went to another OS for a 2nd opinion, and he agreed with my OS, so I went back to mine to see when he could scope it.  At that appointment, he decided it wasn't going to be worthwhile to scope it and suggested that I see Dr. Teitge who specialized in this type of problem.  I made my appointment with Dr. Teitge, and he said that I have a 6 degree bow in my right knee.  He wants to do a Valgus Osteotomy as well as re-do the TTT to relieve some of the pressure (he feels the first one may be pulling too far in), and once those are done he may have to tighten some of the ligaments around the knee.  I am scheduled for surgery at the beginning of June, but would like to know what to expect.
Any information would be great - Thanks
Rhonda
First started having problems with my knees in 1985.
7/93 - Arthroscopy & Lateral Release R Knee
9/95 - TTT R Knee
12/99- Arthroscopy & Lateral Release L Knee
2/01 - TTT L Knee
1/07 - Torn Meniscus Repair R Knee

Offline cat

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Re: New to Board - Questions about upcoming HTO & TTT Revision
« Reply #1 on: March 11, 2008, 11:13:15 PM »
Hey Rhonda!
It's nice to meet another patient of Dr T. He's a great guy as well as a wonderful surgeon. I just wish I had seen him from the start. Anyway, as for the HTO and TTT revision, I didn't have the HTO but did have a derotational osteotomy of the femur along with a TTT revision.  I wanted the two procedures done together. It saved on travel time and expenses (I'm from out of town) and then I just had the one recovery and rehab to go through instead of two.

Was there anything specific you wanted to know? My surgery was on a Thursday and I could have left the hospital Sat but opted to stay til Mon- the day I flew home. CPM was used in the hospital so I got my ROM back right away. I was on crutches for 7 weeks and then was able to wean off them. BTW, the hospital and staff were top notch.

Feel free to ask more Qs. You might also post in "Changing Forces Through the Joint" in the arthritis section.

Keep us posted,
 ;D cat  ;D


"Miserable malalignment"
 Lateral release, medial reefing, VMO advancement, and TTT-  3/2/04
Screw removal- 5/24/05
Cortisone injection to pes anserine- 7/27/05
Femoral derotation osteotomy, TTT revision- 10/18/07

brianne

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Re: New to Board - Questions about upcoming HTO & TTT Revision
« Reply #2 on: March 12, 2008, 01:44:48 PM »
Rhonda,

You are in good hands with Dr Teitge.  Cat and I are members of the Dr T fan club.  I had a TTT revision and MPFL reconstruction done by him on both my right and left knee.  I do not know too much about the HTO, but I do know that he is the best.

As Cat said, the hospital is top notch as well.  They were all very skilled and very friendly.  You will be very happy with the care given at the hospital.  The hospital is very sensitive to travel issues as I think many of Dr T's paitents come from out of town, so they will make sure you are ready to travel before sending you home.  Also, if you are there on a weekday, the food is amazing.  Cat says the weekend food is not so good. :)

As for my results, its still too early to tell on my left knee, but my right knee feels amazing.  Like you, I had too much pressure from my TT being moved over too far medially in my original surgery.  I also had patella alta and so my TT was moved distally in my revision. 

Brianne

Offline rtwarren

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Re: New to Board - Questions about upcoming HTO & TTT Revision
« Reply #3 on: March 19, 2008, 07:26:28 PM »
Cat & Brianne,
Thank you for replying.  I guess some of the main questions I have ar 1) How long were you on crutches, and during that time was it NWB or partial?  On my previous TTT I was off crutches by 3-4 days after surgery, and this time Dr. T is saying it will be 6 weeks NWB.  Is this because it is a revision, or because he is also doing the other procedures at the same time?  2) Does Dr. T prescribe PT, or is that something that you decide to do on your own?  Again with my previous surgeries, I was given specific exercises to work on at home by my OS, and did not need to go to PT.  3) Pain wise is the revision worse than the original TTT?  I still remember that one quite well, and I'm not looking forward to it again, but if it fixes the knee it will be well worth it. 

That's it for those, unless you have any suggestions for getting to sleep at night.  I have a really difficult time getting to sleep because of the pain.  I am still trying to stay as active as I can in the activities that I enjoy, but it is getting harder and harder to do that.  I keep pushing myself, because I know that as long as I keep working out, my quads are staying strong which I am hoping will help with recovery.

Well, I gotta go...
Thanks,
Rhonda 

First started having problems with my knees in 1985.
7/93 - Arthroscopy & Lateral Release R Knee
9/95 - TTT R Knee
12/99- Arthroscopy & Lateral Release L Knee
2/01 - TTT L Knee
1/07 - Torn Meniscus Repair R Knee

Offline cat

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Re: New to Board - Questions about upcoming HTO & TTT Revision
« Reply #4 on: March 19, 2008, 10:10:30 PM »
Hey Rhonda,
1) How long were you on crutches, and during that time was it NWB or partial?
I was to be on crutches for 6 weeks but couldn't get in to see Dr T til 7 weeks post op. So for 7 weeks I was partial weight bearing- allowed 30 lbs. The restricted weight bearing was for the osteotomy I had- not the TTT revision. At 7 weeks I pretty much used just one crutch when out and about, none at home. I imagine that your period of NWB will be for the HTO you're having.
2) Does Dr. T prescribe PT, or is that something that you decide to do on your own?
I felt like he gave me hte choice of whether or not to go through formal therapy. I am really glad I chose to see a PT as I had no idea what exercises to do to recover from a femoral osteotomy.
3) Pain wise is the revision worse than the original TTT? 
My TTT revision was a nonevent in comparison to the femoral osteotomy but then, I didn't have any soft tissue work done on my knee w/ the revision, only the bone work. I think the soft tissue work adds alot of 'unpleasantness'.

As for not sleeping at night-
Quote
I am still trying to stay as active as I can
Are you doing too much? LOL, I'm one to talk. I usually like to keep busy until I drop. I do find yoga to be helpful- great whole body workout (except for the cardio) and very calming. I made sure I got a session in the night before surgery.

Keep in touch,
 ;D cat  ;D[/color][/b]


"Miserable malalignment"
 Lateral release, medial reefing, VMO advancement, and TTT-  3/2/04
Screw removal- 5/24/05
Cortisone injection to pes anserine- 7/27/05
Femoral derotation osteotomy, TTT revision- 10/18/07

brianne

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Re: New to Board - Questions about upcoming HTO & TTT Revision
« Reply #5 on: March 20, 2008, 02:56:03 PM »
1) How long were you on crutches, and during that time was it NWB or partial?
I was WBAT from the first day of surgery.  I used the crutches for about 3.5 weeks with each surgery.  My guess is that your NWB will be from the HTO part of the surgery.

2) Does Dr. T prescribe PT, or is that something that you decide to do on your own?
I got a script for PT from Dr T and then I took it to my local OS.  My guess is that you are coming from out of town.  I would recommend finding a good local OS that you can work with as well if you do not already have one.  My local OS did my first surgeries and has been very helpful through my revisions.

3) Pain wise is the revision worse than the original TTT?

I had more pain from my MPFL recon then the TTT.  However, I do not think it has caused any trouble from the revision...things have progressed the same as the first time.

4.) Sleeping at night?

I have never had a problem with this, but I have also found that for the first week or two it can be more comfortable to sleep on the couch.  I used the couch as a good way to rest my surgery leg and get good support.  A comfortable brace helps.  I made special arrangements to get one I knew I would 'like' from my local OS.  This can make a world of difference with sleeping.

5.) Staying active is a good thing.  I did as much as I could before my first surgery and it really helps make the recovery go smoother.

Good luck with everything.  You are in really good hands with Dr T, he is the best!