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Author Topic: PCL/LCL/PLC Reconstruction and now HTO???  (Read 1448 times)

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Offline Mookie11

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PCL/LCL/PLC Reconstruction and now HTO???
« on: September 28, 2009, 06:03:55 AM »
Hi,
I  have an odd situation, it seems. I am wondering if there is anyone on this site with some thoughts on my predicament. I was injured while  playing in a ball tournament in the summer of 2007. My diagnosis and treatment were initially badly mismanaged. It was not until the summer of 2008 that I underwent a 6 1/2 hour surgery to reconstuct the LCL, PCL and PLC with autgrafts. The recovery seemed to be progressing somewhat well, though I was continuing to experience instability. The surgeon initially chalked the instability up to muscle weakness, which seemed reasonable. I continued to wear a brace, to attend physio and to do as much strengthening as I could manage. Just at the point when it seemed my knee was beginning to feel better and behave better, I started to experiece pain on the medial side and the issues of instability began to increase, rather than to improve.

On Friday, I saw a bone and joint specialist at the university sports medicine department - the same group of doctors who treat the major sporting teams in our area. After review of some standing, long leg xrays, he concluded that my legs are shaped like bananas and that the leg that was operated on is significantly worse than the "good" leg. He suggested I would be a good candidate for a high tibial osteotomy. He said that it might have been preferable to have had this surgery prior to the ligament reconstruction but that it would likely address the issues I am currently having.

I have been reading up on this HTO procedure and all I am seeing is articles in reference to arthritis, which I don't have. Has anyone else experienced this kind of procedure for issues other than arthritis? Did it have any benefit for you? 

Any information you might be able to provide is greatly appreciated!

Candace
Who knew knees were so complicated!

Offline crankerchick

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Re: PCL/LCL/PLC Reconstruction and now HTO???
« Reply #1 on: September 28, 2009, 02:34:11 PM »
Candace, it sounds like the doctors are saying you are either bow-legged or knock-kneed. Did they use either term? I can picture a banana, but just not sure if your "banana knees" go out (bowed-legs) or in (knock-kneed) at the knees. I have knock-knees (techie medical term is genu valgus or something like that) so when I put my knees together, my ankles don't touch. I also have "twisted" bones (medical terms femoral anteversion and tibial torsion) so my femur twists inward and my tibia twists outward. I guess the bowed-legs way would be, putting your ankles together and your knees don't touch!

I can't "see" the anteversion and torsion, but I can "see" the knock-knees when I look at my knees and definitely when I look at my xrays. In any event, I've read that osteotomy is indeed a surgical approach for these conditions. I'm having osteotomies of my femur and tibia to 'derotate' my bones, but when I looked it up, I mostly found a lot of references to HTO and arthritis, which I also don't have. The concept is all the same though: changing the forces through the joint.

I would ask my OS to clarify for you what is wrong with your legs and how the HTO will fix your problem, so the physics make more sense to you.
« Last Edit: September 28, 2009, 02:36:42 PM by crankerchick »
Mar '07 - plica excision
Oct '09 - femoral + tibial derotational osteotomy & TTT
Aug '10 - hardware removal
"You control your leg. Don't let it control you." -Smart trainer
"Get your a$$ in gear and go for it! Nothing will happen until you make it!" -Smart doctor

Offline Mookie11

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Re: PCL/LCL/PLC Reconstruction and now HTO???
« Reply #2 on: September 29, 2009, 04:39:18 AM »
Hey, thanks for the great reply!!!

I am bow-legged, apparently. It is true that my knees don't touch! Anyways, the surgeon did say that an HTO would redirect the forces through my legs which would in turn help my issues of stability. The Xrays did show that on the injured knee the medial side is getting squashed down while the lateral side is opening up. He has advised me to get a customer made unloader brace to replace the customer made ligament brace I have been using. He said if the unloader brace helps, then I will have my answer and we will then move towards surgery. I have to wear the brace for 4 months.

I want to wish you well, by the way, in your upcoming surgery. I hope it will be a great success for you!

Candace
Who knew knees were so complicated!

Offline crankerchick

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Re: PCL/LCL/PLC Reconstruction and now HTO???
« Reply #3 on: September 29, 2009, 01:09:38 PM »
Candace,

It sounds like you are on the right path. I think that is the standard course, to try out the unloader brace and if it relieves the symptoms then an HTO is the way to go so it sounds like you are on the right track, or at least the common track.

Best of luck to you and thanks for the well wishes for me. Only 3 weeks left for me, just trying to keep the nerves at bay.
Mar '07 - plica excision
Oct '09 - femoral + tibial derotational osteotomy & TTT
Aug '10 - hardware removal
"You control your leg. Don't let it control you." -Smart trainer
"Get your a$$ in gear and go for it! Nothing will happen until you make it!" -Smart doctor