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Author Topic: Tons of Questions About Tibial Tuberosity Transfer  (Read 2951 times)

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Offline missmaddie27

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Tons of Questions About Tibial Tuberosity Transfer
« on: November 06, 2008, 06:11:17 PM »
So, I'm having a Tibial Tuberosity Transfer (Elmslie-Trillat Procedure) in December and I have a lot of questions.

-- What size is the scar?  I have read a lot of different people saying that their scars were all different sizes, but I don't know if anyone has had the procedure that I have and what their scar size is from that.

-- How long are you in an immobilizer?

-- Will I really not be able to drive a car for weeks after my surgery?

-- Does the Cryo Cuff really make that much of a difference?

-- What is the recovery time for this?  Meaning -- when will I be able to walk easily?  Or when will I be able to go back to work?

-- Is the pain that high?  I've read that people are really in an immense amount of pain after surgery and that it lasts for a while and I was hoping to get a general feel for it.

-- Does this method of TTT require an overnight stay at the hospital or is it an outpatient surgery?

I'll probably end up coming up with many more questions than this, but these are the ones that I am going to start out with.  Thanks to anyone that is able to give me more information about my upcoming surgery!  Hopefully some answers will be able to relieve some of the stress that I am having about it!
Oct 2008 - OS says TTT way to go
Nov 2008 - Second opinion scheduled


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Re: Tons of Questions About Tibial Tuberosity Transfer
« Reply #1 on: November 06, 2008, 08:48:21 PM »
First I would like to encourage you to make sure that you have seen a Patella Femoral Specialist for your knee.  If your OS is not a PF Specialist I STRONGLY recommend you get an opinion from one.  The TTT is a major surgery and if done by the wrong OS, the results can be disatrous.

With that said, if you see the proper OS then the results can be quite positive. 

To answer your questions:
1.) My scar is 3.5 inches long on the front of my shin.  I have had four TTT's.  Some OS's make bigger scars and some smaller.  My scars really do not bother me at all.

2.) I was in a ROM Brace anywhere from four weeks to seven weeks with my various TTT's.

3.) For my left TTT's I was unable to drive for about 2 weeks.  For my right TTT's it was 6 weeks.  This can be a pain, but please do not try to drive sooner than your OS allows you to.  Its a matter of safety not only for you, but for the other cars out on the road.  Your reaction times will be slower and it is nearly impossible to move your leg with a large brace on.

4.) Its hard to define "recovery time" from a major surgery.  For me it took about 6-8 weeks to be able to walk well.  It was at about 5-6 months that I felt like I could really do most of what I wanted to do.  However, I still feel that at 11 and 9 months Post Op I am still recovering.  It takes a long time to rebuild muscle and strength after a TTT.  I was told to expect a 12-18 month recovery time for "full" recovery.  I have a mostly desk job and I was out of work for 2 weeks for my TTT's.  Part of my job involves being on construction sites and for that part of my job I remained off the construction sites for about 8 weeks.

5.) Its also hard to classify pain.  Yes, this surgery is very painful.  The first few days will be bad and the first few weeks are pretty rough as well.  Just remember that the pain will not last forever and it does get better.

6.) Overnight stays are really the preference of your particular OS.  All of my TTT's were overnight stays and one was a two night stay.  Personally I think the overnight stay is important and really helps.


Offline texasKate

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Re: Tons of Questions About Tibial Tuberosity Transfer
« Reply #2 on: November 06, 2008, 10:43:57 PM »
Hi- and welcome to the club, almost.  I don't remember exact details, but if you read through my diary of my TTT, you should be able to answer many of your questions!  It has been a year now, and I am having a few problems again- I am going to start a new thread about that.  Good luck, and remember the first 3 weeks are the worst. 
1997- debridement/patella shaving/plica excision LK
2001- osteochondroma removal RK
2007- 9/17/07 debridement/medial reefing/Modified Fulkerson TTT
2008- screw removal RK

Offline Davori

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Re: Tons of Questions About Tibial Tuberosity Transfer
« Reply #3 on: November 10, 2008, 09:07:53 PM »
My son has had 2 fulkerson ttt's done in the past 7 weeks.. they were 5.5 weeks apart... Both of them were out patient.. he came out same day.
Driving depends on you and your recovery.... My son could not bend or lift his post op leg . He has just begun to do leg raises on the 1st knee....
Cryocuff... I opted not to have it . The 1st one it was not offered... the 2nd one it was... but we used ice a food saver instead.... its alot of rotating ice... but no more hassel than the cryocuff... Ice will be your BEST FRIEND the first 2 weeks...
If you are only doing one knee then 2-3 weeks should be enough time for you... each person is different.
Pain.... tough one to answer.... just remember STAY AHEAD OF THE PAIN>>>> DONT LET IT GET YOU... It snuck up on us, as he was feeling pretty good with the nerve block for about 24 hours.... then it HIT! YEOWWW... But it passes... then on the road to rehab.  yay... Good luck

Offline Laura_Jane

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Re: Tons of Questions About Tibial Tuberosity Transfer
« Reply #4 on: November 15, 2008, 05:15:30 PM »

I had a TTT on the 6th November,  when i came round from the op i had a 1/2 leg cast on (just around the back)  and was told i wold have a full leg cast put on the following day.   On the 7th i was taken to have my leg cast,  this was the first time i was able to see my leg, i had a large dressing covering the stitches.  my leg was cast and i was discharged and told i would need to come in on the 19th of november for the DR to check the wound, xray and have my leg re-cast.  How ever this morning I recived a letter informing me that my appointment is on the 3rd of December.

My question is should i be worried that i will have had my stitches and dressing on for 4 weeks, its not like i can see how the wounds healing or can see any signs on infection because of the cas, and its starting to worry me quite a bit.



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Re: Tons of Questions About Tibial Tuberosity Transfer
« Reply #5 on: November 16, 2008, 02:14:45 AM »
There are many ways to skin a cat. By example I allow my TTT patients full weight bearing and full motion from the day of surgery and don't issue them crutches..  Some docs use casts and prolonged nonweight bearing. .  So there is a tremendous spectrum of post op plans.  Folks should find out from their doctors what the deal is going to be in their particular case, and better yet, speak with patients who had the same procedure from the same doc.

Two things I can say is that wound heal just fine in a cast, and a doc really doesnt' need to look at the wound to know if its healing or if its infected.   Infected wounds have increasing pain and the patient usually has a fever.

For those folks lucky enough not to have a cast, the Cryocuff is a lifesaver.

Offline Laura_Jane

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Re: Tons of Questions About Tibial Tuberosity Transfer
« Reply #6 on: January 14, 2009, 04:24:54 PM »
Thanks for the advice on the wound, when the cast finally came off i had a nice pink scar.  I was places into a leg brace with a ROM of 30 degrees, and told to partial weight bare,  that was 4 weeks ago, got an appt in a week to have the ROM changed.  i cant wait to start PT, not having moved my leg properly for 10 weeks has caused alot of muscle wastage and at the moment its like dragging around a dead weight!!

Offline deddard

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Re: Tons of Questions About Tibial Tuberosity Transfer
« Reply #7 on: March 10, 2009, 04:22:44 PM »
I had TTT done on my right leg three weeks ago.
I'm in a limited ROM brace at the minute, set to 60 degrees flexion.
Bearing in mind how bad the thing was before the op, I'm pretty hopeful that it will prove reasonably successful - it isn't a straightforward job, and is likely to be just a precursor to a Total Knee Replacement; the total replacement was on the cards, but as my femur is knackered (a highly complex medical term!) it was thought that the total replacement would be useless at present. (congenital problems - leg shortening, r femur internally rotated by god only knows how much (currently about 45-60 degrees I think, and that's after corrective surgery!))

The one thing I can say for anyone who hasn't had the op is that it certainly does help with the tracking issues - my patella doesn't seem to hate the medial side of my femur any more and is quite happy sitting a bit closer to it.

As for the scarring, my scar runs about 15cm (that's about 6 inches in old money) and is extremely neat.  As my right lower limb has been chopped up along virtually it's whole length, this is no problem - I don't think I'd win any beautiful leg competitions.
« Last Edit: March 10, 2009, 04:26:12 PM by deddard »