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Author Topic: Derotational Osteotomy + TTT - 10/20/2009  (Read 130280 times)

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Offline slmac

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Re: Derotational Osteotomy + TTT - 10/20/2009
« Reply #60 on: November 04, 2009, 11:54:29 PM »
fold up shower chairs and scooting definitely don't go together! lol. The hand held shower head makes all the difference doesn't it? I had my husband install one in our shower the day before surgery because I knew it would be one of those small luxuries that allow you to feel human after the complete and total loss of privacy that only childbirth and surgeries can bring to our lives. He went above and beyond though in picking out my shower chair. He even installed raised arm rests on our toilet...bless his heart. I didn't even know they sold those.
Knee pain and issues during HS...played tennis
7/30/09 dislocations began
9/18/09 TTT (Fulkerson Osteotomy), MPFL Repair, and arthroscopic debridement
12/29/10 hardware removal
8/12 dislocations started
9/11/12 MPFL recon with allograft

Offline crankerchick

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Re: Derotational Osteotomy + TTT - 10/20/2009
« Reply #61 on: November 07, 2009, 06:54:51 PM »
11/7/2009
18 days post-op

I layed off posting for a while, since posting daily felt like it was making the days drag. Not much has happened anyway, just slowly progressing a little at a time. I've noticed in these last few days that the lateral tightness across my tibia is getting a little better each day. Sleeping at night is also getting slightly easier. I've laid off the strict elevation only with air under the knee and that has helped for sleeping. I emailed my doctor to ask if if that was ok and he said yeah so that was sweet!

I also asked about straight leg raises, which I still can't do on my own and he reiterated that I'm doing fine in my rehab and that it just takes time. For the femoral osteotomy, the quad has to be moved out of the way completely, so it isn't surprising that my hip muscle strength is lacking. I guess because I don't "feel" so weak up there, i feel like I should be able to do the raise. But then in physical therapy, I am reminded of just how weak my hip muscles really are. Lifting my leg is pretty tough, but the extensions are coming along nicely. This week the therapist worked my hips and ankles a lot more and boy was I feeling it yesterday. But I can now in a sitting position lift my foot off of the floor, like marching. Before, I could only extend it off the floor, but not actually lift it.

So progress is slow but steady and uneventful. Still doign my at home exercises 3x a day and riding the bike for an hour a day. Today I tried some heel slides and found that I can bend just as much as the other leg and I can sit comfortable like that too. That's going to be huge for when I wake up in the middle of the night and want to bend.

So that's it. I can't believe I haven't walked in 18 days. I'm starting to wonder what it will be like when I can walk. Will I be afraid? How hard will it be? Time will tell.

3 more weeks until I will go home! I decided to stay with the in-laws through the thanksgiving. It's just easier for me and everyone else. My husband will come down for thanksgiving and then we will go home together. Right after that will be my 6 week xray and hopefully things will be great and I can start putting more weight on the leg.
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

drmark

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Re: Derotational Osteotomy + TTT - 10/20/2009
« Reply #62 on: November 07, 2009, 08:42:41 PM »
I don't regularly see my post op patients every week, so there are some milestones that a reached without my being there. 

A week before Crankerchick's surgery, I did a DFO and tibial tubericle advancement on another chick, whose insurance didnt cover outpatient PT.  So, that left Michelle and I as the therapists.

It took four weeks for her to be able to do a SLR without a quad lag.  Also at four weeks,  her ROM without a CPM or formal PT was 0-110 degrees and she decided to ditch her crutches (against my advice, but it hard to impose your will on a 16 year old).  The TOMOFIX plate is amazing.

Offline FormerlyActive

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Re: Derotational Osteotomy + TTT - 10/20/2009
« Reply #63 on: November 09, 2009, 01:08:01 AM »
Latise
Sorry I haven't posted I have been thinking of you and praying for your healing.
Sounds like you are one tough chick!
Really give you credit for all you have been through and your proactivity.
Best healing wishes FA
3/82 - Medial Synovial Plica removal both knees
9/89 - Lateral Release both knees
3/08 - Reinjury left knee hiking Asia Pac
5/08 - Miserable Malalignment diagnosis
4/08 - 9/08 Five doctors diff. opinions
7/08 - 02/09 - In PT, no chg.
4/09 - Dr. 6 opinion femur & tibia derotation together

Offline slmac

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Re: Derotational Osteotomy + TTT - 10/20/2009
« Reply #64 on: November 09, 2009, 10:26:29 PM »
Latise...It's the craziest feeling when you try walking again for the first time. The first few days I would have moments where my leg just wouldn't step. It was like my brain was saying no! It gets better quickly though and you'll be to that point before you know it. It's so great that you have your ROM. I'm still trying. Hopefully I'll be able to bike soon. I have about ten more degrees to go in ROM before I can go all the way around...fingers crossed. When do you go back home to Texas? I feel your pain when it comes to straight leg raises. I can do it, but my leg isn't completely straight. They've been using the TENS that has super shocking power on my VMO to pop it up and then I can do the raise no problem at PT. Slowly but surely, we'll both get there. We're getting our grooves back... (I'm doing my seated happy dance...can't wait to actually dance...doesn't work so well on crutches) Sandra
Knee pain and issues during HS...played tennis
7/30/09 dislocations began
9/18/09 TTT (Fulkerson Osteotomy), MPFL Repair, and arthroscopic debridement
12/29/10 hardware removal
8/12 dislocations started
9/11/12 MPFL recon with allograft

Offline CHILLYdogs

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Re: Derotational Osteotomy + TTT - 10/20/2009
« Reply #65 on: November 12, 2009, 04:13:10 PM »
It's been vewy, vewy quiet around here...

Latise, may your silence be an inspiration to all who prefer to go for a life free from knee drama: Great job!





(we do like updates, though, even if they are accounts of oh-hum booooring successes such as yours  ;) )
[email protected]

contralateral BPTB ACLr: Nov'08
back to sports, no restrictions: Feb'09
( yep!! that's @ 12 weeks post-op :-)

Thank you, thank you, thank you, Doc Sanders!!!!!!
(http://www.sandersclinic.net/)

Offline crankerchick

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Re: Derotational Osteotomy + TTT - 10/20/2009
« Reply #66 on: November 12, 2009, 08:25:29 PM »
11/12/2009
23 days post-op

LOL, back by popular demand is my post. I meant to post at 3 weeks, but I've been a little busy. And by busy I mean, you know, sitting around, exercising, sitting, sleeping, exercising, LOL.

I'm excited today because I have only one more Lovenox shot. Tuesday coming (4 weeks post-op) I get the staples out. Tuesday past at therapy I got a decent massage of my quad for once and it felt better for a few hours. No such love today though--just exercises. My strength is coming along, but still no SLR. I was really hoping I would be able to do it by the 4-week mark, but I'm not so sure if I'll reach that. Only 5 more days to hit that target and it feels like I'm not close, so I guess we'll see.

I'm a bit dismayed that I still have swelling around the tibia and its still pretty tight and numb along the lateral side. But given the numbness, I guess the swelling is to be expected. Its not THAT swollen, but its enough to feel some tightness.

I've also been getting muscle spams when riding the bike. OMG, its quite painful. It doesn't start right away, but at some point during the 30 minute session, it starts. I bend the operative leg and it feels like elastic that has reached the breaking point and is about to snap! If it is bad enough, I stop and massage the area and then start again. Otherwise I just apply pressure as I pedal and just wait for it to subside. Both my PT and doctor said its just something to work through and they don't think it's anything serious.

I guess my only funny thing to share is yesterday I went to get my hair done at my mother-in-law's salon. I should have known it was some hoity-toity spot. A day spa and salon with all the fancy chairs and soothing decorum and high prices. It was supposed to be a fast appointment, but the stylist was behind and it took 3.5 HOURS! Fortunately I wasn't too uncomfortable in that time. But the (not so) funny part was sitting in the styling chair, I could only keep my foot on the ledge for so long and then I would have to put it down on the floor. I told the lady to warn me before spinning the chair so I could lift my leg, and she said she would just wlak around me and not spin it. Well, whenever someone would come and talk to her, she would forget and spin the chair. The first time I was like WHOA WHOA WHOA! She was this close to getting a crutch to the ribs! She apologized for like 5 minutes. Then she did it again (while distracted as someone was talking to her) but this time I knew it was coming so I lifted my leg off the floor. Right after she started to spin it, she caught herself and started apologizing, which I let her do. I didn't tell her I knew the spin was coming and had lifted my foot off the floor.
« Last Edit: November 12, 2009, 08:33:00 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 crankerchick

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Re: Derotational Osteotomy + TTT - 10/20/2009
« Reply #67 on: November 13, 2009, 04:46:33 PM »
So, on the SLR front I have some progress!

Last night I had my mother-in-law stand at the foot of the bed and just help me lift my heel off the bed to start the SLR. I've been doing the SLR assisted anyway, where I contract the quad and all, but my helper lifts the leg. After a few assisted, I would try one on my own but couldn't get the foot off the bed. So last night, instead of helping with the whole raise, I just had her start my heel off the bed like 1 inch. She did this twice and I would just try to hold it there. On the 3rd, I tried raising it myself and I actually got the heel off the bed! I did like 5 of these and was pooped.

This morning my father-in-law helped me the same way and I did 2 sets of 10 of just getting my heel off the bed. I can't raise my whole leg yet, but hey, its a start. Perhaps I will be raising the whole leg by Tuesday after all.

Also, doing the leg extensions today I am *this* close to getting my leg completely straight. I feel some resistance that I feel like is more because of the tightness and swelling than actual lack of strength.
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 fraud_ninja

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Re: Derotational Osteotomy + TTT - 10/20/2009
« Reply #68 on: November 13, 2009, 06:37:38 PM »
Its amazing how such seemingly simple movements such as a straight leg raise become such a challenge after surgery.  I mean, how would have thought that something so seemingly insignificant could become so difficult to do.  And then, there is the excitment that goes with getting closer to accomplishing one.  LOL...you're doing great.  And having someone assist is a good way to start.  My PT always showed me a way to use a strap or a belt to help assist with that intital 'lift-off' from a SLR.  You'll be doing them on your own in no time at all!

Brianne
12/26/02 LR R
10/26/06 TTT R
1/25/07 TTT L
12/17/07 TTT revision, MPFL recon R
2/7/08 TTT revision, MPFL recon L
3/24/08 screw removal R
4/30/08 screw removal L

Knees are fixed, training for a triathalon.

9/21/09- Right ankle reconstruction

Offline doublemom

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Re: Derotational Osteotomy + TTT - 10/20/2009
« Reply #69 on: November 13, 2009, 07:45:34 PM »
Cranker - you are doing so well!  I tell Sharon (Snorunner) the same thing with her PFJR rehab.  Those tiny little milestones all add up in the long run, and one day you'll take a step or do something without expecting it, and all that hard work will be worth it.  I haven't been posting much, but have been following your progress.  Keep up the good work, and hopefully when this is all behind you you'll be able to climb mountains or do whatever your heart desires without having to think "those darn knees!"

andi
2000 R patella dislocation
2004 - Soccer injury - LK medial and lateral meniscectomies
2007 - Dx patellar tilt, lateral subluxation, grade III chondromalacia
5/13/08 - RK medial/lateral meniscectomies & patellar chondroplasty
4/6/2010 - RK TTT/LR scheduled

Offline crankerchick

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Re: Derotational Osteotomy + TTT - 10/20/2009
« Reply #70 on: November 17, 2009, 06:11:41 PM »
11/17/2009
4 weeks post op

Thanks for the encouragement every one. Yes, the excitement of getting closer to accomplishing something so simple as a straight leg raise is just too funny. I was so happy when I got the leg off the bed. Of course I was also exhausted and sweating, but so proud. I'm still not completely doing the full SLR, which I had hoped to be at this point, but I can still see improvement, as I seem to get it a little higher each session, or I have a few more that are "good" each session, versus barely leaving the bed.

Got the staples out today. Just a pinch feeling a few times, but no pain, and most of them didn't even feel the pinch. The day started a bit on the wrong foot, as the appointment was at 8:30, so we left at 7:30 (40 minute ride) and still got there at 8:40, only to learn we were at the wrong office! Thankfully traffic was clear going to the Decatur office, so it only took about 15 minutes to get to the right place.

They took xrays (even though I said I didn't need them), checked for blood clots, and asked about my pain and ROM. The PA-C for some reason was really amazed that I wasn't taking any pain meds any more.

The doctor said things looked good, definitely signs of the bones beginning to heal. I think the doctor was going to say it was ok to start putting a little more weight on the leg, but he got a phone call at the end and stepped out. It wouldn't have mattered, I'll be following my doctor's protocol which is no more than 25# until he sees my 6-week xray and gives me the ok.

This was the first time I noticed that my screws extend out the opposite side of the bone, so that kind of freaked me out. The doctor said its a tough decision whether to let the screws protrude out or not, but its better structurally to do it the way it was done. I asked if my body won't like that, and he said, it won't like it but everyone is different so it might be fine. The PA-C said she thought my hardware might need to come out at some point, which kind of alarmed me. But my doctor has repeatedly said he's confident I'll be fine, so we'll just have to wait and see.

So all in all good visit. I'm still progressing with the exercises. The spasms during the riding the bike are getting better. I have to make sure I stretch really good before riding and also start slow in the beginning. I'm trying to work up to going at a decent pace where I might actually get some kind of cardio workout out of it. Right now, my HR probably hits 105, which isn't much of an exercise at all.
« Last Edit: November 17, 2009, 06:19:03 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 crankerchick

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Re: Derotational Osteotomy + TTT - 10/20/2009
« Reply #71 on: November 19, 2009, 01:30:58 AM »
I kept meaning to post this yesterday but forgot. I think I did reach my hope/expectation of a real SLR at 4 weeks. Yesterday after posting, when I did my session of exercises, I did 10 legitimate SLRs! I raised my leg, held it, and lowered it back down like a real SLR, LOL! It was a decent amount off the bed too, like easily 6 inches, probably more.
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 Tailwind

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Re: Derotational Osteotomy + TTT - 10/20/2009
« Reply #72 on: November 19, 2009, 02:21:04 AM »
Keep up the hard work! You will so look back on this and laugh. I remember not being able to extend my leg 4 inches! One day at a time.
10/06 - Man v. Dog Collision
12/07 - Meniscus Trim
4/08, 12/08 - Synvisc
6/09 - Diagnostic Arthroscopy
8/09 - DFO

drmark

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Re: Derotational Osteotomy + TTT - 10/20/2009
« Reply #73 on: November 19, 2009, 04:50:26 AM »
It seems like the four week mark is a consistant time for a patient to be able to resume SLR after a femoral osteotomy and tibial tubericle advancement.

Our patients who just have a tibial tubericle advancement can SLR from the first day, so the delay must be due to the femoral osteotomy, either distal or proximal (as in this case).

Offline Tailwind

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Re: Derotational Osteotomy + TTT - 10/20/2009
« Reply #74 on: November 19, 2009, 11:56:35 AM »
Dr. Sanders

Thanks so much for your posts on this forum. They are always informative. I am impressed you have the time, desire and risk tolerence to post here. Thanks again.

TW
10/06 - Man v. Dog Collision
12/07 - Meniscus Trim
4/08, 12/08 - Synvisc
6/09 - Diagnostic Arthroscopy
8/09 - DFO