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Author Topic: Post-op patella baja....  (Read 7836 times)

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Offline ohiostatemel

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Re: Post-op patella baja....
« Reply #15 on: September 08, 2003, 06:54:47 AM »
Heather,
I got blisters after my Lateral release.  My OS said people get them when their bandages (usually immediately after surgery) become wet from fluid or blood- and the skin gets irritated.  He had me put antibiotic ointment on mine and keep the bandages off an the area super clean while at home.  Mine eventually popped/drained themselves.

Offline Heather M.

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Re: Post-op patella baja....
« Reply #16 on: September 08, 2003, 07:39:53 AM »
Heather,

Isn't it funny how you had a massive incision and a surgical fracture of your leg...and the blisters are driving you nuts??  I had the same with serious blisters due to the bandages, and I would have sworn they were gaping wounds!  

Anyway, the best thing to do with blisters is keep them clean, dry, and irritation free (no rubbing) but I've found that they hurt less if they are kept moist with antibiotic ointment.  It's really your doctor's call about what you should be doing with them--if you expose them to the air, they'll heal faster.  Just a few more days and they should go away.

As for infection, I wouldn't worry about getting an infection inside your knee from a blister, just keep the one that bled really clean.  Usually, the wound has to go deeper than that--I got infections through open arthroscopy ports, so we're talking deep.  I'm sorry to say that I've had infections flare as late as 3 weeks post op, but they were probably festering inside all along.  Are you on antibiotics?  I didn't take any last time (except the IV in the hospital) and I did just fine.  The two previous times I was on oral antibiotics and got infections, so go figure!

I'm guessing that your leg swells more during the night because you're not moving around much and not elevating it?  That's just a guess.  As for the pain meds making you sick, are you making sure that you eat a lot of easy to digest food with the meds?  Otherwise, you will get queasy.  I found cheese and crackers, nilla wafers, toast, bananas, and ice cream to go down very well with the pain meds, but it's a fairly individual thing.  If they continue to make you ill, ask for another prescription (maybe the sustained release, like Oxy-contin, which doesn't let the body absorb all the meds at once would help) or for anti-nausea drugs.  I did well taking my pills with ginger ale, sprite/7-up, or peppermint tea--yummy.

I hope you feel better soon.  Wish me luck--I see a new doctor who does open procedures on Tuesday morning.  I've got to get all my records together tomorrow.....

Heather
Scope #1: LR, part. menisectomy w/cyst, chondroplasty
#2-#5: Lysis of adhesions/scar tissue, AIR, patellar tendon debridement, infections, MUA, insufflation
#6: IT band release / Z-Plasty, synovectomy, LOA/AIR, chondroplasty
2006 Arthrofibrosis, patella baja
http://www.flickr.com/photos/hmaxwell

Offline ~*Heather*~

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Re: Post-op patella baja....
« Reply #17 on: September 08, 2003, 08:36:28 PM »
Oh Heather! That's wonderful about your appointment on Tuesday.  I'm happy to hear you are going to look into it.  We are all here for you to bounce ideas and concerns off of when you return.  How far is the trip?  It's scary isn't it?  You have been through this numerous times but each visit is still enough to get to you and make you nuts.  

As far as the antibiotic ointment...One of the blisters popped at 3 am last night so my husband ran to Wal-Mart and got me some. I have kept them covered with it and exposed to the air as much as possible.  They are to the sides of the lowest part of the incision, like on the sides of the shin bone. He reused my old incision and just added to it to move the tibia.  I think the brace rubbing the leg started this whole ordeal.

I like to open the brace and let the air get to them as I stated earlier, but they are right where the straps cross so I can only do that when not moving or sleeping. I don't trust sleeping with the brace open! Not with my luck anyway.  I had covered them with a light bandage and sure enough it dried to the blister and irriated it when I removed it this morning.

I am elevating at night while sleeping, but I think you are right as to the part where it worsens because it is not being moved. Last night was a good night as far as swelling went.  

It is funny how my concern and worries are with the blisters and not the insicion!  They just look so huge and round compared to the nice neat line down the leg.  lol!  Also the oozing reddish liquid brings me fear.  I have never had drainage from any surgery so naturally I'm freaking. I called my OS this morning and scheduled my post op (Sept 15) and left a msg about the blisters. I removed the steri-strips that were over the blisters since they were getting bigger and bigger with the strips on them.

I also remember when I worked for a foot and ankle clinic that when our patients would come in with blisters that the first thing the doctor would have us do was would be to remove them.  I checked for drainage and any open parts on the incision before i did this though.  They feel better already.  

I'll let every know what the OS says when he calls back.  Good luck with your appointment. I know you know how to handle it as you are the one who gave me advice on how to handle my appointment. Please post back and let us know all you can and especially your thoughts/fears/doubts on the whole procedure(s). I'm hoping for a wonderful outcome for you.

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 cat

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Re: Post-op patella baja....
« Reply #18 on: September 08, 2003, 09:12:54 PM »
 :) Heather M,
You have always been a wealth of info for me and I appreciate that. Good luck with your OS appointment. I hope you get the answers you need.
cat
"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

Offline ~*Heather*~

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Re: Post-op patella baja....
« Reply #19 on: September 09, 2003, 01:07:29 AM »

The OS just called and explained another reason why the blisters may have formed.  He says sometimes the steri-strips can stick "too well" and when you have severe swelling (as I did) then it goes down the steri-strips still hold so tightly to the skin in the "swollen" stage that it can form blisters.  It is kind of confusing but when you think about it it does make perfect sense. I am not supposed to pop them but let them pop on their own then put neosporin (or something similar) on them.  Cover with gauze and just keep them clean.  Just thought I would share that with everyone.

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 Heather M.

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Re: Post-op patella baja....
« Reply #20 on: September 09, 2003, 03:30:04 AM »
Thanks Heather and Cat for your encouraging words.  I know I'm always giving everyone advice, but to be honest I feel like a basket case when I think about tomorrow's appointment.  I'm literally making myself sick, and I'm just praying I don't start bawling when the doctor asks me why I'm there to see him!  I'm feeling incredibly emotional--both hopeful and scared sick.  I don't want to get my hopes up, because so many previous doctors have said a variation of 'leave it alone, you could make it worse' to 'I wouldn't touch that knee for a million bucks' to 'I don't know what to do with it.'  I hate that hopeful buildup, the feeling that THIS may be THE DOCTOR who's going to turn your life around...only to have it all fall apart.

But let's not borrow trouble.  This doctor is wonderful--trained at the Mayo Clinic in Rochester, trained with Dr. Fulkerson, and spent over a decade at Cincinnati Sports Med, home of another arthrofibrosis specialist (Dr. Noyes).  He's been teaching orthopedics for years, and all the PT's I've talked to have said he's just solid, one of the best, knows what he's doing, has been doing knees for decades.  Of course, the same thing is true of my current surgeon, and even he's getting frustrated and talking open procedures.....

Anyway, I now have all my records together and will see this new doctor at 9:30 tomorrow.  I'll let you know how it goes.  Sorry to hijack your thread, Heather!  And thanks so much again for your kind words.  I figure there has to be SOMETHING positive to come out of this whole knee experience==if I can help someone else avoid the pitfalls I've stumbled into, then that's my silver lining.  Let's just hope that no one else has to deal with PFS, lateral releases, and the ugly ITBS from hell...

Heather
« Last Edit: September 09, 2003, 03:30:45 AM by hmaxwell »
Scope #1: LR, part. menisectomy w/cyst, chondroplasty
#2-#5: Lysis of adhesions/scar tissue, AIR, patellar tendon debridement, infections, MUA, insufflation
#6: IT band release / Z-Plasty, synovectomy, LOA/AIR, chondroplasty
2006 Arthrofibrosis, patella baja
http://www.flickr.com/photos/hmaxwell

Offline ~*Heather*~

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Re: Post-op patella baja....
« Reply #21 on: September 09, 2003, 04:45:07 AM »
Heather,

Feel absolutely free to hijack this thread if you want!  It's easier for me to keep track of the updates on you...lol!

I wanted to also say that I too heard the stories of how I could make it worse and how several OS's didn't want to mess with it.  I totally understand where you are coming from with that.  I also didn't want to get my hopes up.  When I found this OS he stressed the LOW percentage of total improvement and was painfully optimistic. (Semi-pessimistic if you ask me!!)  I just realized he was trying to keep my focus real and not give me anymore false hope.  

I know I took a chance with this procedure, just as you will if you decide to go ahead with it, if they are qualified to help you that is.  You have to go back and reread your posts here as I did and get back in touch with your misery and pain.  Several times I thought, 'Noway I'm not going to go through with it.  I'm safe where I am and at least here I can manage what I have'.  Then I would rethink that strategy and say "what if I could only take a stair easier? or walk a few more feet at one time?"  Simple things like that gave me the strength I needed to go through with it.  Like I said if you wanted to wait and see how mine turns out I would be happy to personally keep you updated on each stage of the recovery. I am however, only 1 case and our situations are so different but still so simliar.  It's horrible when there are no guarantees and all we have left is chance.    

Don't worry about walking in there and bawling.  I did. They understand your pain and frustration by looking at the thickness of you medical record! LOL!  Just hearing that someone can, will, and has hope for your knee is a real comfort. The real battle begins when you know you can go ahead and have the surgery but have to make the choice of whether you want to risk it.

Just know that we all will be here to help you sort it out and listen to you vent.  You are an asset to this board and it's the least we can do to help you out in your time of need.  You will be in my thoughts tomorrow. I wish you the best of luck.  Get some rest now and try and relax. Let us know what happens just as soon as you can.

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 Jammy

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Re: Post-op patella baja....
« Reply #22 on: September 10, 2003, 12:55:31 PM »
Heather - glad everything is clearing up. I have also been getting swollen calf and unable to move toes. I also had a lot of fluid and bruising after the LR haemarthrosis repair op that I had a few days ago. I was told that basically it's gravity trying to move the fluid down, and that I should keep my leg raised (knee higher than hip, foot higher than knee) because it's better to get the fluid to drain to the groin area apparenty. My PT also massaged my calf a lot to push the fluid back up, and is making me loop a belt around the ball of my foot and pull, to keep the calf stretching, which also apparently pushes the fluid back the way it should be going.

Anyway, I hope that this problem disappears soon !


James
Left knee cartilage removal 1992, right knee cartilage removal 1997, right knee lateral release 26/08/03 with 3 haemarthroses in the first 3 days post-op. 4th procedure to clean up right knee 30/08/03

Offline ~*Heather*~

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Re: Post-op patella baja....
« Reply #23 on: September 11, 2003, 11:04:55 PM »
Thanks to everyone for all the responses. It means a lot to be able to get advice here.  (Also vent which is what I am about to do)  ;)

Here's an update:

The blisters have popped and are in the process of drying up. I still cannot sleep at night even with the pain killers.  I loosened the brace one night to the point that it may as well have been completely off and I slept almost 12 hours...go figure. I can't keep doing that because I know I am not supposed to. I just needed sleep so badly.  

Even elevated, it swells to fit the brace. So if it's loose, it swells more. If it's tight, the ankle swells more. My ankle on the medial side has lost a lot of its swelling but it's been replaced by severe bruising...lol. The outside of the ankle is still deformed and swollen and is starting to bruise. I know all this is normal so I'm not worried.

I posted about pain around the tourniquet area in my quad and all the responses I received said that was normal as well.  One more thing not to worry about.  

Everything seems to be going as good as can be expected. I think I'm just down in the dumps right now.  No matter how long I have waited between surgeries as soon as this brace is back it feels like it never came off.  I'm also stuck at home on the 3rd floor which doesn't help. I feel like I've gained 6 million pounds (or stones depending on where you are from...lol).  I'm just ready to rehab it now.  

My husband is also frustruating me.  He is back to work now and sometimes I need to wake him in the middle of the night to help me and he gets grumpy.  Well, if I could sleep I wouldn't need anything in the night!!! Ha ha!  I know it's not intentional and when I tell him about it, it breaks his heart that he did it. But still it's so frustrating. I'm probably just being a brat since I never sleep. He means well, Bless his heart.

Oh well, I'm just venting. I'm sure you all understand the "trapped" feeling I am experiencing.  I'm just tempted to drop the crutches and get moving!!!!!  Maybe Monday my OS will tell me I can fully weight bear. That would be a wonderful help! I feel helpless. I can't even carry a glass of soda myself.  URRGG! It's funny because I knew what to expect as this is not my first go around and I still go through with it and then turn around and complain.  Yeah I am a brat!  ::)

Thanks so much for listening!  

Love to you all,

Heather ;D      
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 Jillian24

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Re: Post-op patella baja....
« Reply #24 on: September 12, 2003, 01:05:15 AM »
Oh my gosh Heather you are so not a brat,
     We have all felt that way. It's just a part of surgery and unfortunately it is the pits. But you will get there, I am so sorry though that you are having a hard time sleeping. Thats so hard! Hopefully you can get some releif soon. Maybe ambien? Just to get you through the next week or so. Hang in there! I can't believe that I am having surgery and it's my choice? What the *&^@ am I thinking? Oh man, well hang in there....Jillian
ONE TTT LAST OCT
10 LR'S    ONE MEDIAL RELEASE
STAPH INFECTION.....MANY MONTHS IN HOSPITAL

Offline ~*Heather*~

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Re: Post-op patella baja....
« Reply #25 on: September 12, 2003, 03:47:14 AM »
Jillian,

We decide to have these surgeries in hope of a better life. The benefits outweigh the risks hopefully.  It's just so hard when it's time to get better.  I just want to be better now!  How did your tests turn out?????? I'm dying to know!

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 Janet

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Re: Post-op patella baja....
« Reply #26 on: September 12, 2003, 04:31:26 AM »
Heather:

No matter how much we think we are prepared for surgery, and no matter how much we can't wait to have it done and get on the road to recovery, I don't think we are ever fully prepared for the first few weeks. No wonder you feel trapped. I wrote in an earlier post about my time at home. I realize I said that I couldn't drive for 3 weeks. I meant 3 months! So I know exactly how you feel. I think as the pain and swelling subsides, you will come to a certain peace about the situation and find a routine to fill the days. That's what I found with me. Also, I slept so much....healing is hard work (lol)!

When do you see the doctor again? After this last surgery, they had me starting PT the next day. Couldn't do much because I was non-weightbearing. But it was good because my knee was being checked 3 times a week and I could always ask questions and know if there was anything to worry about. Once you see the doctor again and when you can start PT, I think a lot of your anxiety will end.

Anyway, hang in there. Come here to vent. We really do understand. Things will get better.

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: Post-op patella baja....
« Reply #27 on: September 12, 2003, 05:17:42 AM »
Thank you Janet for your reassuring words.  They mean a lot.  Yeah I won't be driving for a long time either. Still trying to figure out how getting to PT will be possible!  
Last surgery (quad tendon repair) I started out in a hinged brace so after a few weeks I could unlock it some to sit properly in the driver's seat. I have a stick shift so my husband and I switched cars. I was able to at least get to work and PT. This time I'm in the immobilizer for 6 straight weeks so I don't know what I'll do yet. I'm sure I'll figure it out. I see the OS Monday so I can also tell him that bit about the driving and maybe I can start exercises at home or switch braces sooner.  How are things with you?  Any more progress?

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 Laura_S

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Re: Post-op patella baja....
« Reply #28 on: September 13, 2003, 10:05:52 AM »
Heather:

Hang in there girl....you're gettin there!  It takes time but it sounds like this one will pay off for you.  

As a side note for you because I meant to update you before, I went to Duke Univ...to see Dr. Alison Toth this past Monday.  You were right, as soon as I got in there, they took 3 different types of Xrays of my knees.  She said she's very worried about the amount of weakness and atrophy in my leg/quad/hip.  The xrays show my kneecap being in the right position, hence, no patella baja/alta from what she could read.  She thinks that my muscles are so weak they can't stablize my patella AT ALL.  She said she really thinks that's the case, and at a far chance it could be cartilage damage...but she doesn't know seeing that my other OS LOST my most recent MRI...that's always nice.  So, she says no to patella baja or surgery, and yes to hardcore, intense physical therapy where she will be sent graphs/charts/numbers weekly of how I'm responding to the computer rehab.  Have to see a completely different PT.  Surgery isn't even an option to her because she says there's nothing to really operate on since I'm so weak, she can't tell.  But she said intense PT should do it she thinks, and if not, she'll discuss surgery later...but that's not even something to talk about now.  Reason being, I have never built up any strength post LRR...and I went into the LRR w/ hardly any muscle = bad mixture as you know.  I go back to Duke in 8 weeks, Nov 3.

That about sums up that story, as short as I could get it.

Keep us updated with your recovery...
Laura
"Never give up, for that is just the place and time that the tide will turn." - Harriet Beecher Stowe

Offline ~*Heather*~

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Re: Post-op patella baja....
« Reply #29 on: September 13, 2003, 07:23:26 PM »
Laura,

That's great news that surgery is not in your immediate future. I did want to let you know that patella baja is a very hard thing to diagnose.  Sometimes when you get in the position for the x-ray the knee cap slips back to where it is supposed to be and therefore looks "normal".  It can also do this in the MRI scans.
I think that happened to someone on this board but I can't remember who.  I just hope your knee didn't play a trick on her.

They are good there at Duke so your OS was probably looking for that to happen. My baja was so bad you didn't need an x-ray to diagnose it and when my 2nd OS (the one who referred me to Duke) took bi-lateral views it was just horrible.  Almost scary.

Thanks for the update. Let me know where you are going for PT and what they have you doing.  I had this surgery on top on severe atrophy and now it's even worse.  My leg lies flat, i mean totally flat!  It's going to be the hardest road I travelled yet getting this muscle back. Having the kneecap in the right place should help a bit  ;)  

Keep working at it and don't give up, you'll get there.  It very well could be the weakness. That is what originally started all my tracking problems and pain.  I wish you luck and please share your PT exercises. I'm taking notes so I can be sure to have tried EVERYTHING during my rehab.  Good to hear from you again  ;D

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