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Author Topic: Rotational Osteotomy of Tibia not healing  (Read 18396 times)

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PoppaPatella

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Re: Rotational Osteotomy of Tibia not healing
« Reply #30 on: August 18, 2009, 06:06:11 PM »
Hi Aree,

I'm sorry to hear about all of the trouble you have been having.  Your post caught my eye because you say you will beg for the bone stimulator, and coincidentally I just read about them yesterday at a different message board where an orthopaedic surgeon answers questions from anyone writing in. Someone who has been having trouble with delayed union wrote in to ask about the stimulators.  The OS's response there was:

"In my opinion, plate screws, and bone graft work a whole lot better than the stimulation thing, which works just a tad better than nothing."

So I just thought I'd mention that to you, not meaning to discourage you, but to get you ready for what your doctor might say.

Hope you start to improve soon.

Offline aturpin

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Re: Rotational Osteotomy of Tibia not healing
« Reply #31 on: August 18, 2009, 07:37:31 PM »
I am curious to you Aree and the chereb if she is following this thread and to anyone who has had trouble getting their bone to heal (although I suppose chereb's issue was with the medial compartment so perhaps that doesnt apply here).  But, I am wondering what kind of wedge and bone fill you had.  There are opening and closing wedge osteotomies.  For those of you who had an opening wedge osteotomy, they have to fill the gap with something.  That something is typically some kind of bone paste and they derive the bone from the "bone bank" or from you.  When my doctor told me he was going to take a bone graft from my iliac crest (hip), I was really bummed because I didnt want another scar or pain anywhere else.  He told me, however, that the healing rate of osteotomies with a bone graft from the patient vs. a donor, has a better success rate. For those of you troubled by slow or incomplete bone healing, did your bone fill come from you or from a donor?

Offline ArielF

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Re: Rotational Osteotomy of Tibia not healing
« Reply #32 on: August 18, 2009, 08:07:13 PM »
Hi Aturpin.

I had an open wedge HTO with donor bone.  Healing very slowly.  No infection.  I wouldn't have donor bone again.  My doc told me that harvesting from the hip can be very painful for a long time.  I didn't know that donor bone had a decreased healing time and don't know if that is why it is taking so long to heal.  I had no indication that I would be a slow healer.  I am healthy and have always healed (soft tissue) remarkably quickly.  Had I known then what I know now I would obviously choose my own bone but at the time there was no reason to suspect that donor bone would be an  issue.

Ariel

Offline aturpin

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Re: Rotational Osteotomy of Tibia not healing
« Reply #33 on: August 18, 2009, 08:59:27 PM »
Thats really interesting, thanks for your response.  I certianly have no idea if having donor bone is responsible for your healing time but I think it is an interesting idea to explore for people reading these boards and deciding on their own procedure. As for the pain in my hip, it was pretty tender right after surgery.  In fact, many people including myself, will report that the hip is actually more sore for the first week or so after surgery than the knee is.  It was painful to sit up and my hip flexor felt funny for a while as well.  after a couple of months it stopped bothering me and now its mostly back to normal.  Sometimes my hip flexor is tight and there is a strange feeling when I push hard on the bone.  Anyway, it is certainly a tradeoff.

Offline Alyce

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Re: Rotational Osteotomy of Tibia not healing
« Reply #34 on: August 18, 2009, 11:41:32 PM »
Hey aturpin,

I had a rotational tibial osteotomy.  Dr. Teitge sawed through the tibia and fibula, and rotated it inward about 25 degrees.  I have no idea what he used to fill in the gap, but I was never given a choice.  Frankly, I am grateful for that!  Before the surgery, when my patella was straight my foot was at a 45 degree angle.  When I would lie flat on my back, it would go to a full 90 degrees easily.

I just found out from my psychopharmacologist that I have a serious Vitamin D deficiency!  She realyed the information to my internist, whom I suspect will call tomorrow.  That explains a lot.  I've been eating everything under the sun with calcium, and just recently taking Viactiv with Vitamin D.  I am shocked because in Atlanta, I walked just about every day.  I'm also an avid gardener.  Of course, I haven't done either for over 3 months.  Although, I did sit outside in 15 minute intervals without sunscreen.  I am extemely fair, and will burn in no time.  I use a 55 Neutrogena as foundation!

I think it speaks to what an excellent physician she is to even think of it.  Neither my surgeon or internist did.  Guess it makes me glad to know my shrink is looking out for me!

aturpin and Ariel, thanks so much for your interest in getting to the bottom of the non healing problem.  I have always been the healthiest person I know.  My only nutritional vice is one cup of coffee in the morning.

Aree
Patella shaving & Lateral Release 6/2002
Reattachment of Lateral Retinaculum & Microfracture 6/2003.
Both procedures failed.  Reattachment was successful.
Lesion remains 15mm x 9mm x 6mm
Tibial rotational osteotomy May 2009
LPFL rebuild May 2009
Surgery for Baja Patella February 2010

Offline jumpi5d

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Re: Rotational Osteotomy of Tibia not healing
« Reply #35 on: August 19, 2009, 05:27:18 AM »
Hey Aree! I hope you had a better day today. I sent Dr. T an email today too,  I hope we both hear back from him soon.  Hopefully the Vitamin D will change things around for you.  I think the one thing that a lot of people don't know is that Dr. T has a pretty good idea what we go though. He's had HTO and from what I understand still has a plate in his leg as well.

To hopefully answer Aturpin's question, the rotational ostoetomy doesn't have a gap. It's a straight cut and just rotated.

-Paige
-Paige

3/5/09 Right Distal Femoral Osteotomy for Patella Alignment 
11/19/09 Left DFO for Patella Alignment.

Offline Alyce

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Re: Rotational Osteotomy of Tibia not healing
« Reply #36 on: August 19, 2009, 03:55:55 PM »
 Hi Paige,

When Dr. T. told me about his osteotomy, he said that he could walk without crutches at 6 weeks, his tibia was healed at 3 months, and he had PAIN for 11 months.  I agree with you that he does understand.  I'm not counting on him approving the bone stimulator.  He's really "old school," and beleives it will heal when it's ready.  I just can't wait a year without driving!  I am able to bear more weight on it while using both crutches, so that's  good.

How is your pain and/or sleeping?  Better I hope.  It's weird that you would develop this 5 months post op.

Aree
Patella shaving & Lateral Release 6/2002
Reattachment of Lateral Retinaculum & Microfracture 6/2003.
Both procedures failed.  Reattachment was successful.
Lesion remains 15mm x 9mm x 6mm
Tibial rotational osteotomy May 2009
LPFL rebuild May 2009
Surgery for Baja Patella February 2010

Offline jumpi5d

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Re: Rotational Osteotomy of Tibia not healing
« Reply #37 on: August 19, 2009, 08:05:00 PM »
Hey! He is still old school on somethings, but on other things I think he's ahead of a lot of doctors. I wouldn't know about not driving, lol I still don't have my license. I could get it now, but I'm having surgery again in Nov. and then March. So I've just waited a little longer no point in paying insurance that I won't use. The doctors down here had told me not to drive out of fear of my knee locking up or dislocating   ::)

I slept a little better last night, well, this morning. I fell asleep around 4  and got up at noon. Pain is still there, but not near as bad as what it was a few days ago.  It's there but I can deal with it. Dr. T seemed to think it was just some minor tendonitis (I want him to define minor...) from the plate. He said it could develop at any point.

How are you doing today?

xoxo
Paige
-Paige

3/5/09 Right Distal Femoral Osteotomy for Patella Alignment 
11/19/09 Left DFO for Patella Alignment.

Offline Alyce

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Re: Rotational Osteotomy of Tibia not healing
« Reply #38 on: August 26, 2009, 02:58:56 PM »
Hello to All,

Well, I finally got the Exogen bone stimulator yesterday!  I am thrilled to have something that might potentially help.  I have three distinct fractures that show up on X-ray.  One is on the front of the tibia, the medial side, and on the back.  I have been instructed to use it for 20 minutes on the first two fractures, but 12 hours apart.


Of course, I'm totally obsessive about it.  Am I using too much gel?  Did I get all the gel off?  is the cuff tight enough?  As I've told others, if I can learn an insulin pump, and manage my daughter's diabetes for 10 years when she was still on shots, this should be a breeze!

My pain is not where the fractures are.  It's a little higher than where the lesion used to be.  That devil is probably there, but I'm not going to go there now.  I need to concentrate on walking again, when the bone is healed.

How are others?

A HUGE thank you to Ariel for all your support.  I need someone who has stuggled and overcome to say "it will get better."

Aree
Patella shaving & Lateral Release 6/2002
Reattachment of Lateral Retinaculum & Microfracture 6/2003.
Both procedures failed.  Reattachment was successful.
Lesion remains 15mm x 9mm x 6mm
Tibial rotational osteotomy May 2009
LPFL rebuild May 2009
Surgery for Baja Patella February 2010

Offline jumpi5d

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Re: Rotational Osteotomy of Tibia not healing
« Reply #39 on: August 26, 2009, 07:19:14 PM »
Yayyyyyyyy!!!! Aree thats so exciting. I hope this changes things around for you. Just make sure you don't do it to much and I'm sure everything else will work out fine. 

I'm doing okay. I'm getting a little bit more sleep I still don't think it's enough. I'm trying some different things before I even think about taking meds to sleep.  Pain wise I'm doing okay.

How are you besides the leg?

-Paige
-Paige

3/5/09 Right Distal Femoral Osteotomy for Patella Alignment 
11/19/09 Left DFO for Patella Alignment.

Offline Alyce

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Re: Rotational Osteotomy of Tibia not healing
« Reply #40 on: August 26, 2009, 08:06:35 PM »
Hi Paige,

Thanks for asking how I'm doing.  I feel really exhausted today.  I think that I was so emotionally tied into this b.s., that now that it's over, I'm spent.  The doc that is following me here is smart, but typical O.S. attitude.  I asked him if I was 50% healed or what exactly.  He replied "the osteotomy was so perfectly done that I could barely see the fractures."  I wanted to scold him for speaking the name of one so great!!!  Apparently, after my begging email, Teitge called this doc and said ok.  He's such a doll.  I see him in two weeks.

I've had to take sleeping meds, and it's not that bad.  I've even gone through withdrawl coming off of several. If I don't sleep, I'm a total wreck.  I understand you wanting to stick to benadryl.  That makes me too "hungover."

I wish I could post my xrays. Even I can see the fractures, but healing, too.  I'm going to toe touch NWB on my own, and see if things don't get better.  I keep trying to walk with one crutch, such a no pain, no gain gal!

Keep bugging Dr. T. for the PT.  Although, I would like to beat the PT who made me walk with one crutch at 9weeks with both crutches.  She actually took it away from me.  Anyway, that's in the past.  Just wish I could fast forward through this part of my life!!!  I keep looking for the meaning in this suffering, and it just a'int there.

Glad to hear you are some better.  Thanks for always being there.  We need a girl's weekend, once we all get better.

Aree
Patella shaving & Lateral Release 6/2002
Reattachment of Lateral Retinaculum & Microfracture 6/2003.
Both procedures failed.  Reattachment was successful.
Lesion remains 15mm x 9mm x 6mm
Tibial rotational osteotomy May 2009
LPFL rebuild May 2009
Surgery for Baja Patella February 2010

Offline jumpi5d

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Re: Rotational Osteotomy of Tibia not healing
« Reply #41 on: August 26, 2009, 08:43:24 PM »
Aree,

Dr. T is known for doing things so 'perfectly!' It's seriously awesome to see his work next to another doctors and you can visibly see the difference on xrays.  I bet you're glad to see  Dr. T again. He's such an awesome person.

The benadryl helps some, but last night was another late night but I slept in pretty good. 

Do you have your xrays? I can tell you how to post them! Be careful and take things slow. I don't think I ever went to one crutch. I went with full weight using both and then ditched them that way. I walked with them for balance and mostly the security have having them for about a week and a half after I was putting full weight on my leg.

I've been doing some PT on my own. I think it's helping some. I have a fear of going to PT and them pushing me to far. I want to go for the modivation of having someone there but then thats still stuck in my mind.  I've asked every time I've talked to him and he keeps telling me to wait it out a little longer.

I can't believe that your PT did that to you.  I wish sometimes I could fast forward through all of this and it be done, or that it would have never happened. But, it's made me a stronger person, and I've learned so much from it about myself and others. But, most important is that I've made some life long friends!!!!

-Paige
-Paige

3/5/09 Right Distal Femoral Osteotomy for Patella Alignment 
11/19/09 Left DFO for Patella Alignment.

Offline Alyce

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Re: Rotational Osteotomy of Tibia not healing
« Reply #42 on: August 26, 2009, 10:48:14 PM »

Paige,

You are so right about making REAL friends.  It seems like my knee buds tell me the truth about overdoing, expectations, family reactions.  When you experience the same things that are especially difficult, it bonds you.

When my daughter was diagnosed at 3 with Type 1 diabetes, a couple with a younger child came to assure us that things would get easier. To this day, whenever we run into them at diabetes fundraisers, we greet each other with big hugs.

Glad you got some sleep.  Critical!

Thanks for all your encouragement, sweet pea,
Aree
Patella shaving & Lateral Release 6/2002
Reattachment of Lateral Retinaculum & Microfracture 6/2003.
Both procedures failed.  Reattachment was successful.
Lesion remains 15mm x 9mm x 6mm
Tibial rotational osteotomy May 2009
LPFL rebuild May 2009
Surgery for Baja Patella February 2010

Offline jumpi5d

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Re: Rotational Osteotomy of Tibia not healing
« Reply #43 on: August 28, 2009, 06:45:29 PM »
Aree!! Sorry I went MIA the last few days. One of my neighbors past away and we've been trying to help them with everything and some of their family is staying with us.

Theres a bond with this that I don't think anyone could ever understand. All my 'twisted sisters' become my second family.  I don't know what I do with all of you.  You'd laugh at all of us when we got together in Michigan. There was 4 of us at once. I think it was hug city!

I have some ideas about all of us getting together one day. I'll have to share that with you in PM sometime. ;)

Ooo and 9 hours of sleep last night woot woot!

xoxoxoxox
Paige
-Paige

3/5/09 Right Distal Femoral Osteotomy for Patella Alignment 
11/19/09 Left DFO for Patella Alignment.

Offline ArielF

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Re: Rotational Osteotomy of Tibia not healing
« Reply #44 on: August 29, 2009, 03:27:34 PM »
Hi Everyone,

Paige there really is nothing like sleep.  I'm glad that you are finally getting some. 

Aree, How are you holding up?  I got away for the first time in 6 months! I can't tell you how good it felt to actually leave the sofa behind.  I took the crutch and used it for the Ben and Jerry's tour and for walking around the resort.  I didn't take the tour of the University, there is always a lot of walking, steps and stairs they offer a wheelchair but I know thay my son would be more worried about me than deciding if this was the school for him. I hung out with my youngest while the others went on the tour.  I hope that you are resting and healing. 

Have a good weekend
Ariel















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