Derotational Osteotomy + TTT - 10/20/2009

[Clarkey]

Hi Crankerchick,

I am so pleased to see that 7 years after your Derotational Osteotomy that it is still a successful outcome and are benefiting greatly by going ahead with the surgery. Dr Mark Sanders sounds like a fantastic OS that not afraid to try and get his patients back to competitive sporting activities rather than saying you stuck with it for life! Learn to accept and live with it was what my PT said to me last week which is not something I can do so easily.

18/09/15 14 Months Day 427 Post Op

14 months post-op after AIR surgery and hope I am 3rd time lucky in 5 days when I finally get to see Prof Snow. Lucha, you are right that it a good that the hospital are making sure I am seeing the best! My right knee problems has not been a straight forward fix as originally planned.

Here a CT scan report done on my right knee with talk about a 'rotational osteotomy' by the registrar that my OS soon ruled out as an option not to go ahead with. Maybe the registrar is right after all as he the only one so far that pinpointed the intense knee pain while assessing my knee. 


Dear Dr ****

I have reviewed this gentleman in clinic today, with the results of the CT scan. His TT-TG on both sides is 13mm and there is approximately 37 degrees of external rotation of the distal tibia with respect to the proximal tibia on the right, and 42 degrees on the left.

I discussed possible treatments with rotational osteotomy, I explained all the pros and cons of the surgery, however I would like Professor Snow to consult the patient before listing him for further surgeries. I asked him to come back in four weeks’ time and we can decide about his further treatment.

Yours sincerely

Mr *** **** 

I do know that 13mm is within normal range and nothing to worry about. What I am not so sure about is the 37 degrees of external rotation of the distal tibia with respect to the proximal tibia on the right, and 42 degrees on the left is something to look at as it matches with the term ‘rotational osteotomy’

Could the wrong angles cause excessive maltracking problems to such an extent that the a knee realignment surgery of rotational osteotomy is required! PT has not helped my PFS is at a chronic level that it now having a daily impact in my daily activities.

I am not a expert as I am only guessing what could be wrong! I would think an exploratory scope or a lateral release surgery would be a less drastic form of surgery that often not a successful surgery! I will not say anything or suggest to something else. I will leave it to the capable hands of experts to decide what happens next. Why did he say surgeries in his report that could well be a grammar error! It could be for hardware removal if the procedure in the report was to go ahead.

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No idea if I would benefit going ahead with such a big surgery or not?

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[neptronix]

Thanks so much for this update. I've been looking for some hope for a while. I have my kneecaps tilted outward significantly and a foot that's about 10-12 degrees out. Tibial torsion surgery is probably for me.

What surprises me is that your kneecaps went back into alignment after such major issues with them. Were your kneecaps hanging off to the side like mine too?

[Clarkey]

Crankerchick does not post or visit very often on KG Bulletin Board, might get a delayed response back from her. I do not know what was going on when I saw my OS's registrar suggestion to me such a major surgery when I am only slightly out of alignment that is a common occurrence for many of the general public being bow legged. It is nice to hear a success story, good luck with what every surgery your OS decides to do that will take significant time to recover from! At least 18 months to 2 years for any type of knee realignment surgery.

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[crankerchick]

My kneecaps pointed in ever so slightly while my feet pointed out ever so slightly. When viewing my legs from a distance they looked slightly knock-kneed but once I bent them, it was apparent they were wonky. I saw myself in the mirror riding a bike after the surgery and my still twisted leg looked quite gross once bent and the rotation was more apparent.

My kneecaps do have a bit of tilt to the outside but the joint itself clearly points inward. I have femoral anteversion also so I think this makes sense. Femur rotates inward, tibia compensates back outward and the result is my feet look pretty normal but the joint is poorly aligned.

My left (corrected) knee is pain free and issue free. I still have some nagging discomforts from various aspects of the surgery itself, but they are the casualties from such an elaborate procedure in my opinion and don’t affect me more than the original problem ever did. The surgery was worth the collateral damage of surgery itself. I was very fortunate not to have had any previous realignment surgeries to have made things worse and also very lucky that my cartilage behind the kneecap wasn’t terribly damaged from the mal-alignment.

My right knee is still wonky and gives me pain and problems. It has started to be unstable as of late but life is not at a place right now where I can really do the surgery on that knee. When people ask about the knee and I show them how to look to see the wonkiness, they can’t believe I walk on a joint with bones going 2 different ways. Again, it’s quite subtle to see and is more apparent when looking from the right angle from above when the knee is bent or from a distance where you can see that my knee actually points in and isn’t in line with my ankle. When I look at my fixed leg now, my knee joint points a bit more straight and is in line with my ankle. My foot also doesn’t rest pointing outward.  My right knee the joint points in and is literally offset from my ankle to the inside (my knee joint isn’t inline with ankle), again I guess because the torsion on the tibia rotating outward approaching the ankle. It just creates a mis-aligned knee joint as well as legs that don’t carry the force of the body perpendicularly to the ground.

[neptronix]

Thank you for chiming in again. Hope we hear that your other leg gets corrected one day and how it goes.

[neptronix]

I just wanted to come in here and say thanks again. I had a derotational osteotomy done on my right tibia and went with an external fixator. The process was brutal and it took 8 months in the fixator for healing to be complete enough for it to be removed.

I still have both femurs to fix, but i am already seeing big improvements. The searing ankle pain is gone and the hip pain has gone from disabling to just a little nagging, which gives me a lot of hope for having that femur corrected and seeing it go byebye.

Your posts were a big inspiration to me and the reason why i am not in a wheelchair today.

I hope we hear how you are doing in the future.