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Author Topic: Visit to the new OS!!!!! Help please!  (Read 2288 times)

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Offline ~*Heather*~

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Visit to the new OS!!!!! Help please!
« on: August 05, 2003, 12:39:26 AM »
Hello all!

I had told many on this board about my excitement in seeing this new OS for patella baja.  For those who don't know me, I had a quad tendon rupture repair (8/02) done 4 months after it happened and the patella baja (low riding kneecap) was caused by the long wait with the repair. It was orignally thought to be a partial tear so it went undiagnosed.  There aren't many OS that can deal with this problem since the entire extensor mechanism is thrown off by it.

I would like to seek advise from everyone and especially those who have patella baja.

Here is what I was told:

He feels the kneecap is pretty much as far down as it can get.  He says that a patella lengthening procedure can be done and I may regain use of the knee again. Like stairs, walking, ect. Things like running and stuff like that most likely a bad idea to try to get back to that again.  There are many procedures that he could do they will be discussed more in detail when I decide if surgery is worth it. He mentioned depending on how things looked in there, a cadaver tendon could be used (that turned my stomach). That would be worse case scenario though.

My question to everyone is the odds he gave me were roughly 60% that things will improve.  I will be able to enjoy everyday life, walk without the knee locking and alleviate a great deal of pain.  However, he was stressing that with any surgery there are risks such as infection and the 40% that things may not improve or may be worse. Any time you have a surgery things can worsen.  

This would be my 3rd major surgery on the knee, he could use the same incision though.  He also mentioned possible that I may have damage to the cartilige behind the knee and also the in the groove. He said scoping it would be silly since this is a such a deformation that any surgery I should have would be one to fix the deformity instead of exploratory ones. I agree with that. The less surgery the better. I was also told about the long and extensive rehab program.  I don't work and can dedicate all my time to my knee right now. Given those odds what would you guys do?  Just some opinions would be helpful.  

I know it is hard to comment without knowing every detail, but I am just not sure to even risk it getting worse.  Just the thought of going up and down stairs again or walking without pain would be so worth it though. Thank you all for reading this.

Also, for those of you who knew that I recently conceived and knew that was a big issue here, I recently lost my pregnancy at about 6 weeks gestation.  :'(

Heather
« Last Edit: August 05, 2003, 12:40:24 AM by Heather »
R knee-2 LR's, 1 ITB Release. L knee-LR/medial plication (2/02).Fell postop 3/02 & ruptured quad tendon.Quad tendon repair (8/02).Led to Patella Baja.TTT w/ Quad tendon reefing 9/03.Screw removal 8/04

Offline missmyknee

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Re: Visit to the new OS!!!!! Help please!
« Reply #1 on: August 05, 2003, 01:35:41 AM »
Dear Heather

First of all let me express my deepest sympathy for your misscarriage.  My heart goes out to you and hope you can find some comfort in knowing that we all share in your sorrow.


  I was diagnosed with patella baja caused by severe patella tendon contractures from the surgical procedure used to fix my broken leg.. I could not go down stairs,go down any incline , bend past 90 degrees and I had constant subluxations not to mention the constant bad pain. My OS performed a DeLee osteotomy on me. It involves cutting the bone where tendon is attached and moving it up and srewing it in place . He didnt give me a percentage as to improvement but anything was an improvement. He also did a Z release of the lat ret and used cadaver bone to replace the bone from where the osteome cut was made in the tibia. I too had damage under my patella and to the cartilage from the patella "scooping out" the groove. My os smoothed out as much as possible but can only do so much. I was in locking brace to keep my leg straight and non weight bearing for 4 wks. Started light PT after 2wks. Got off crutches after 7wks and during next 4-5 wks was allowed increases in flexion. This was done to make sure screw was in place and holding without stressing it. Since this was done I now can go down stairs, bend to 130,and do most rehab exercises, and dont have the intense pain I used to have. But I still have some probs after rehabing 17mos 3xs/wk. I have regained about 70% of my quad when I started out I had 15%. I stiil have pain and cant walk for any period of time. It has a rubbing and pulling when I walk. I diffinately cant run, jump, kneel. I am starting synvisc injections on Wednesday to see if that helps before he does another scope and possibly has to add more bone graft to elevate the tendon to raise the kneecap higher. I'm glad I did the osteotomy as in my situation my knee was very bad before it but I have a way to go. When I first had this done the OS said it would take about 6mos to recover and the changed it to over a year.

Hope this helps

Pam
4Fx Clsd red
IMrod fib plate
derotate osteotmy tibfib
AF
IPCS patbaja
DeLeeOsteotmy,LOA,LR Zplasty,bongrf,chondrplty
chondrplty,LOA,fatpad remvd
TKR
openLOA,neurectmy,ITB Zplasty,fabela
PLC recon,revison,LOA,synovec
MCL,revison LOA
openLOA,prox Zplasty
openLOA, 6 neuromas excised,synov
3 Fusions

Offline ~*Heather*~

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Re: Visit to the new OS!!!!! Help please!
« Reply #2 on: August 05, 2003, 01:43:47 AM »
Thanks a lot!  Success stories are always great! Well, not necessary success, but improvement stories.  Thank you for your sympathy as well.  I believe things happen for a reason. It would have been very difficult for me to carry a baby in my condition as much as that hurts to admit.

My OS mentioned something about X Y procedure. I am unfamiliar with that procedure but he didn't want to go into all the detials until I knew for sure that surgery was my way to go.  I am thinking that it is I am just scared to death of it getting any worse. I don't think it could be worse or any more dibilitating, but the OS does. They have seen everything haven't they? lol!  I need to listen to everything I hear and take it all in then make my decision so I thank you so much for you story. It really helps!

I wish you well in your recovery.  What are your current limitations this far postop?  

Heather
R knee-2 LR's, 1 ITB Release. L knee-LR/medial plication (2/02).Fell postop 3/02 & ruptured quad tendon.Quad tendon repair (8/02).Led to Patella Baja.TTT w/ Quad tendon reefing 9/03.Screw removal 8/04

Offline missmyknee

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Re: Visit to the new OS!!!!! Help please!
« Reply #3 on: August 05, 2003, 03:35:58 AM »
Hi Heather

Trying to decide on surgery can be nerve racking. You want to be as well informed as possible. Everyone is different in how much pain and rehab they want  to go thru. Will it improve the quality of life you have? My OS never said I could get worse from the surgery, he pretty much said I was causing continued damage to the patella and cartilage if I did not have the surgery. In my situation it was just getting unbearable to continue without it. I am better than I was but not the way I was before  my first OS did surgery to fix broken leg. My knee functioned perfectly then. I am not having the constant subluxating, only have it now when I come to a stand still when walking such as waiting in line,waiting at stop lights etc. My pain level has improved to where I dont have to take narcotics as much but do take Ibuprophen 3xs/day. I can go down stairs which was impossible before surgery. I can rehab better now than before. I was very limited as to the exercises . I couldn't tolerate much. I'll have to be honest and say I still cant do the sports I did before. Im still working on trying to walk with out pain and this rubbing. I doubt there is such a thing as "pain free" just less pain. I have been told I will probably need  the knee cap removed way down the road or a TKR. I wouldn't do the kneecap removal after reading all the posts. It's been hard to adjust from having a knee that functioned perfectly and literally waking up to find it ruined which is what my first OS did when he split the patella tendon to put a rod down my tibia to fix broken leg only to set my leg crooked too.  I'm still hopeful I will eventually get back to functioning normal.

Pam
4Fx Clsd red
IMrod fib plate
derotate osteotmy tibfib
AF
IPCS patbaja
DeLeeOsteotmy,LOA,LR Zplasty,bongrf,chondrplty
chondrplty,LOA,fatpad remvd
TKR
openLOA,neurectmy,ITB Zplasty,fabela
PLC recon,revison,LOA,synovec
MCL,revison LOA
openLOA,prox Zplasty
openLOA, 6 neuromas excised,synov
3 Fusions

Offline ~*Heather*~

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Re: Visit to the new OS!!!!! Help please!
« Reply #4 on: August 05, 2003, 03:50:17 AM »
Wow Pam! You have been through a time it seems.  My OS was only saying I could end up worse because anytime with surgery there is a chance for things not to go right. He also does not know what to expect when he goes in.  He wants me to think it through totally and see if I am willing to commit then give him a call in a few days, he just wants me to be sure....which I DO like.  It seems like you had it much worse than I do before your surgery. As far as my quality of life goes, I feel I have none.  My poor husband has to do so many things for me, he doesn't mind though, but I DO!  I can't do the walking thing or the standing in line right now. I have made it without needs narcotic pain meds too, but sometimes I take them and boy does it help.   I have lost so much in my life through this knee. I'll be 27 this month so I'm still so young to have these problems. But we all are too young for this no matter what our ages, right?  I will know more about the possible procedures when I call him back if I do indeed want to commit. I will be posting back to list those as well to get some more advice. This forum has helped me so much it's unreal!   Thank you again for all the information.  I appreciate you taking the time to tell me your story and help me out.  I wish you the best!

Heather
R knee-2 LR's, 1 ITB Release. L knee-LR/medial plication (2/02).Fell postop 3/02 & ruptured quad tendon.Quad tendon repair (8/02).Led to Patella Baja.TTT w/ Quad tendon reefing 9/03.Screw removal 8/04

Offline enuff81020

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Re: Visit to the new OS!!!!! Help please!
« Reply #5 on: August 05, 2003, 04:55:51 AM »
{{{{{{Heather}}}}}}

All I can do is pray that some Divine Intervention will take hold nad help you with all of this.  You are dealing with a lot of things right now--and it is time for one of them to go well--and the decision about knee surgery could be it.  I wouldn't hope to know what to tell you, but I'm sure you will weight the pros and cons and get where it is best for you.

I am so sorry to hear of your loss.  I experienced that once and know how difficult and gut-wrenching that can be.  My prayers are here for you.

Best of luck in this trying and important time--Hugs, Sylvia
Both kneesOA.
Scope on rt knee,9/00;2/01
scope w/ LR and debridement rt knee 2/02
left knee same5/02
Patellar problems
LeftTKR12/16/02
Right TKR7/14/03
Complications MUA 8/14/03
R TKR revisio

Offline Jennie

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Re: Visit to the new OS!!!!! Help please!
« Reply #6 on: August 05, 2003, 05:14:32 AM »
Hey, Heather

Let me offer you my deepest sympathy for your loss, I am very sorry and please know that you are in my prayers right now.

As for the surgery desicion, I am with the others on the fact that there is no way that I can tell you or try to persuade you in one direction or another, although I do have this bit of a story that i hope you can take something out of it and maybe it will help make your desicion a little easier.

Back in April of this year, 5 months I had had a TTT done, I took a trip and done some not so smart things with my leg and it started having problems again, I was alot like yourself in the fact that I could not climb stairs, stand for long periods or run, even walking at a fast pace was out of the question, I was at my wits end!
I returned to my os and he said he was going to take my kneecap out, any other time I would have said no way!! but at that moment I had had it with my knee and consented to having it taken out, but when he got in there realized that he could save it and performed a reconstruction, now I am so glad that I had the surgery because even though I have many horrible knee days the good out weighs the bad and I am so happy with my desicion to do whatever it took to solve my knee problem, although now I realized it was a very drastic desicion to consent to a patellectomy, and thank God everydasy that he didn't do it!

What I am trying to say in the midst of all of this jabber is, sometimes we are in so much pain and fed up with everything and want our lives back that we are willing to try anything, and most the time like wso many have said our pain speaks for itself, so listen to your body, and pain, and please if you need anything I am hear for you and if you think surgery is your answer than I will fully support you however I can, b/c I got critized by many of my friends and family for going through another surgery but sometimes its our only option :-/

Good luck with your desicion, and let us  know which one you make

Love,Jennie
21 yrs. old..Right knee injury. Ligament Recon 6-21-01, 2 LR's 3/02 & 9/02
TTT 11/08/02, patella and ligament recon 5/03
Recently dx with OA, Having hardware removed and knee scoped on 6/24/04

Offline Janet

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Re: Visit to the new OS!!!!! Help please!
« Reply #7 on: August 06, 2003, 02:53:36 AM »
Heather:

I'm so sorry you lost your pregnancy. That's a lot of emotion on top of the pain and confusion you are having about your knee. I'll keep you in my prayers.

As for having the surgery, only you can decide. I know that's not much help. When I had my third surgery, my OS said she was hoping for a 50% improvement. I thought 50% sounded like a huge number, and jumped at the chance. It took about a year, but I guess I did eventually get that 50% improvement in that my patella no longer jumped out of the groove and I had better ROM. But I was still having so many problems, I eventually went to a different OS for another opinion. He offered a fourth surgery.....nothing so big as you are thinking of, but still a FOURTH surgery. There was no guarantee it would work. I really had to struggle with the thought of going through it all again. But my pain and limitations made the decision easy in the end. Then I second-guessed myself during the waiting period before the surgery, almost convincing myself I was crazy to go through it again. It will be 6-8 months before we know if the surgery is successful, but I am glad I had it (although I don't think I'll ever be pain-free). Without the surgery, I know what my life would have been like and I wouldn't have given myself the chance to improve it. Good luck on making the decision! Let us know what you decide.

Janet
Torn quad tendon repair & VMO advancement 4/99, MUA with LOA 10/99, Patella baja and arthrofibrosis, LR & medial release & LOA 5/01, LOA & chondroplasty 6/03,TKR on 11/06, MUA 12/06. From perfect knees to a TKR in 7 years, all from a fall on a wet floor...and early undiagnosed scar tissue.

Offline ~*Heather*~

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Re: Visit to the new OS!!!!! Help please!
« Reply #8 on: August 06, 2003, 03:30:17 AM »
I'm anxious awaiting Heather M. to respond.  She is my education manual when it comes to the procedures...lol!

Honestly, I think I am going to try it. Like you Janet, the rest of my life will be in pain if i don't try and worse case scenario...I will remain in pain.  No different then now I guess. I went out shopping today to help me and my depression and my knee locked the whole day almost every step. it is now locking on stairs which is very dangerous!  If he thinks he can fix that then I will most likely go for it.  I can't stand the pain and the stiffness/swelling when I come home from an hour and a half shopping spree...Do you all remember the days when we could spend ALL day at the mall without needing to sit down........AHHHH, the memories!    

I thank you all for your support and prayers. I will call my OS in tomorrow and leave a message that I am willing to go forward.  I will then learn more about the procedures and will post back to see if anyone has done them or knows about them.  I will still have time to change my mind. I just think I need all the facts. But again, like your situation Janet, OS says it will be months to see if it is a success.  Thanks again to all you wonderful people!

Much love to all,
Heather
R knee-2 LR's, 1 ITB Release. L knee-LR/medial plication (2/02).Fell postop 3/02 & ruptured quad tendon.Quad tendon repair (8/02).Led to Patella Baja.TTT w/ Quad tendon reefing 9/03.Screw removal 8/04