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Author Topic: Tibial tubercle transfer surgery...so many questions!  (Read 25956 times)

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Offline Strawberrry12

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Tibial tubercle transfer surgery...so many questions!
« on: April 25, 2010, 11:03:08 PM »
Hello everyone!

I'm 16 and a tibial tubercle transfer and lateral release has been recommended to me after seeing a orthopedic surgeon for 20 months while trying physical therapy, taping and bracing, and icing like crazy. I've had 6 dislocations, 5 have been in the last two years. I have pain every day and can't squat, run, or jump. I feel like I'm way to young to have problems like this!! :-[

Anyway, I would like to know if you have had this surgery before and if you would recommend it/do it again. Also, how long was your hospital stay and recovery time?I know it will take about 8-12 months to be totally healed but how long until you could get back to regular life?

I know it will  be painful and long, but I really want my knee to stop dislocating!

Thank you so much for your input! :)

-Bree
-18 years old-
2002- 7 years old, first subluxation
4 more subluxations
9/'10- MRI: microfracture, damage and stretched ligaments
PT, all was going well, got into sports again
03/20/10- 6th subluxation: worse yet!
8/2/10 MPFL repair and lateral release

Offline oohheykate

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Re: Tibial tubercle transfer surgery...so many questions!
« Reply #1 on: April 26, 2010, 02:39:19 AM »
Hey Bree,

I'm kinda in the same boat as you, although I've only dislocated once (that was enough), I can sympathize with you. I'm also sixteen and I've had three knee surgeries on my left knee and I'm going to have a fourth surgery to fix my right knee probably this summer.

I didn't have this specific surgery, but Andi/Doublemom has a great post-op diary called "Andi/Doublemom's TTT/LR Apr. 6, 2010." You can also search TTT in the search bar or look in the post-op diary section. You just have to keep in mind that everyone is different and doctors have different protocals. Some people stay overnight to two days, while others go home the same day. Same thing with weight bearing, some people are WBAT from the start and others are NWB for 6 weeks.

Good Luck with everything,
Kate
-18 years old-
Left knee;
11.07.08- Scope
07.02.09- Lateral Release/Meniscus Repair
11.11.09- diagnosis of Patellar Instability/Patellar Tracking Disorder
12.10.09- Medial Reefing/Lateral Release
01.11- Synvisc
04.14.11- MPFL Reconstruction
06.21.11- LOA & MUA

Offline adevlop

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Re: Tibial tubercle transfer surgery...so many questions!
« Reply #2 on: April 26, 2010, 04:03:50 PM »
Hi there Bree,

I can definitely sympathize with you. I am 20 years old and have had multiple major knee surgeries to correct numerous problems and injuries. I had my first TTT done on my right knee in April of 2008, and this coming friday 4/30, i will be having that same TTT done again to revise the one that I had 2 years ago. Yes, it is a very long and painful recovery, but in the end I have found it to be worth it. I will be starting a post-op diary that you can look at, and if you have any questions I would be happy to answer them through email ([email protected]) I would definitely recommend this surgery, as long as you have an experienced surgeon- that is the key!! As long as you work hard at the rehab, the outcome should be very beneficial to you. If i didn't think so, I wouldn't be going through this procedure all over again! Good luck with everything, and let me know if there is anything I can do to help!

Alyssa
knee pain for 13yrs-20yrs old

'06-scope of R knee/cartilage repair
'08-TTT/LR/MI
'08-supartz injections-no relief
'09-open MPFL reconstruction with allograft/hardware removal/arthroscopic debridement
'09-synvisc injections and prp treatment-no relief
'10-TTT revision/cartilage debridement

Offline crankerchick

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Re: Tibial tubercle transfer surgery...so many questions!
« Reply #3 on: April 26, 2010, 04:50:14 PM »
Hi Bree, I had a TTT (but no lateral release) 6 months ago. My surgery also included 2 other osteotomies to correct my twisted bones. It's a lot of surgery to go through, but so far it has been worth it for me. The rehab has been tough, but my knee feels good and doesn't feel like it wants to dislocate any more. I am already having a much higher activity level than I did prior to surgery and without the associated knee pain.

There are quite a few satisfied TTT customers out there, but like Alyssa said, it is important to have an experienced surgeon and also equally important to have a thorough evaluation from said skilled surgeon. There are a multitude of reasons for why a kneecap may want to dislocate and it is important to address the root cause before choosing surgery. In my case, it was twisted bones and a TTT alone would have likely been an incomplete approach.

How long it takes to get back to regular life really depends on the doctor. You should discuss this with your doctor (and parents). My doctor gets his patients up and moving soon after a TTT but others are in a brace for 6 weeks and still others are nwb for the entire 6 weeks. Once the bone healing is sufficient usually around 6 weeks, then real rehab can begin. A lot of the people I've talked to have said that at 3 months out, they felt pretty good.

At 6 months out my TTT area feels pretty darn good. If it weren't for the other osteotomies and associated muscle loss, I think I would be back to full function by now.
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 Strawberrry12

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Re: Tibial tubercle transfer surgery...so many questions!
« Reply #4 on: April 27, 2010, 04:37:53 AM »
Thank you to everyone who has responded!

Another thing, What was the deciding factor for you to go through with the procedure?

And some more background on me: My first significant dislocation (actually, it was a subluxation) was 2 years ago. The other one in between was from playing basketball. After the basketball one, the next 3 were when I was just walking. I did rehab. and I was feeling great! So I started up tumbling to try out for cheerleading.

And my most recent one happened when landing a back hand spring. Do you think that my knee never would have subluxed again if I had not done something as high impact as a back hand spring?

Thanks for all the help!

-Bree ;)
-18 years old-
2002- 7 years old, first subluxation
4 more subluxations
9/'10- MRI: microfracture, damage and stretched ligaments
PT, all was going well, got into sports again
03/20/10- 6th subluxation: worse yet!
8/2/10 MPFL repair and lateral release

Offline dawn999hall

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Re: Tibial tubercle transfer surgery...so many questions!
« Reply #5 on: April 27, 2010, 05:47:32 AM »
Bree - I had a Lateral Release and TTT in Jan 2006 when I was 35 years old.  I was a soccer player and had my first dislocation when I was about 27 years old.  Subluxed regularly after that - I totally hear you when you say no squats, etc.  it was always so painful!  The surgery was not treat...I was totally No Weight Bearing for 6 weeks and then still on crutches for a few more weeks and then in a brace.  The surgery was a little painful but the rehab was the real pain!  I had some complications and had to have 2 surgeries - be sure NOT to use your quads to lift your leg after the surgery you could pull your screws out!  Use a scarf or towel under your heal - you will easily get the hang of it - but my surgeon was VERY conservative after I had to have the surgery re-done and so the getting flexion and extension back was hard work and very painful - extension mores so than flexion which really surprised me.  Your being 16 is on your side - young'uns heal so fast!!  Your incision will probably be 3-5" from your knee down your shin, try to keep the swelling down after surgery so the scar won't be so bad - swelling will make for more scar tissue.  Your main problem in the first 6-8 weeks will be bathing and boredom and the incision will start to itch when it is healing.  It took me a long time but I can do squats, walking lunges and hiking.  Depsite my complications I do not regret the surgery at all...but I remember being VERY anxious about it...I would do it again in a heart beat - I do not have the pain everyday.  I had problems with the screws especially when there were rain storms and so I had the screws removed.  I have had a LOT of surgeries and the advice I have for you is have a positive attitude before you go under the anesthesia - I really believe that helps when you come out the other side!  Good luck and use ice and your pain meds and you will be fine!

Offline crankerchick

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Re: Tibial tubercle transfer surgery...so many questions!
« Reply #6 on: April 27, 2010, 12:24:55 PM »
My deciding factor to find a solution to my knee problems was simple recognition that things couldn't get much worse. I lived with the instability and pain for years, but it was only intermittent. The pain was worse when I was younger and active. But last year, the instability got really bad for me. I was subluxing daily just walking around to do simple things like cross the street or go to the bathroom. I wasn't doing any of my activities at that point, like bowling, mountain biking, or photography nature walks (and these were the things I took up when I stopped playing sports because of my knee).

I decided to have my particular surgery after doing tons of research and getting multiple opinions, eventually good opinions from patella specialists. In the end, the procedure I chose "just made sense."

Regarding lifting your leg after surgery. Whether or not you will be allowed to lift it really depends on your doctor. It is very important to get moving as quickly but as safely as possible. The longer you don't use your muscles, the more they will atrophy and stiffen. Your doctors protocol will reflect the confidence he has in the hardware he selects for you. I selected my doctor for many reasons, but one was because of his aggressive approach to rehab. I had 3 osteotomies at once but my rehab still started in the recovery room with stretching and quadriceps exercises. I was on the bike 6 days after my surgery and everyday for an hour after that.

This is something you should discuss with your doctor rather than follow advice on the internet. Every doctor is different in their approach and guidelines.
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: Tibial tubercle transfer surgery...so many questions!
« Reply #7 on: April 27, 2010, 02:58:34 PM »
I have had four TTT's, two on each leg.  I have been an unsatisified customer and now I am probably the most satisfied customer on this entire board. lol

My biggest advice is similar to what others have posted on this thread already.  Make sure you get opinions from well qualified patella specialists.  I made the mistake with my first two TTT's in trusting my surgeon too much.  My first surgeon is a brillant surgeon and very good at what he does, but he is not a patella specialist.  Although he did everything the way it should have been done, my first TTT's left me in horrible shape with far more pain than before surgery.  After my first TTT's I could never even walk around the block without horrible pain.

It was at that point that I went to a patella specialist.  The patella specialist made all the difference in the world.  He revised my TTT's and did MPFL recons.  The result was a complete 180 degree turn around.  I went from unable to walk around the block to now a little over two years since my surgerys I am training for a half marathon.  There is literally no activity I cannot do these days.  Now I do get occassional soreness and my knees are cranky from time to time, but nothing like what it used to be and nothing that does not go away after a day of taking it easy.

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 Strawberrry12

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Re: Tibial tubercle transfer surgery...so many questions!
« Reply #8 on: May 02, 2010, 11:47:14 PM »
thanks for all the responses everyone!
I'm now waiting until May 18 to see the doctor again so he can let me start physical therapy. But now I've developed another weird thing...there's now pain right below my kneecap!  :-[ Does that mean that something could be torn? Like an ACL? I really hope not! This just keeps getting more and more fun.  ::)

Thanks for all the help
-Bree
-18 years old-
2002- 7 years old, first subluxation
4 more subluxations
9/'10- MRI: microfracture, damage and stretched ligaments
PT, all was going well, got into sports again
03/20/10- 6th subluxation: worse yet!
8/2/10 MPFL repair and lateral release

Offline Strawberrry12

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Re: Tibial tubercle transfer surgery...so many questions!
« Reply #9 on: May 15, 2010, 02:52:26 AM »
Hey everyone,
I'm getting really discouraged over here  :-[ It's been 2 months and I'm still in a lot of pain and I'm losing hope on avoiding a TTT/LR! I'm supposed to do leg raises and when I was doing them yesterday, my knee partially slipped out on the 5th one!! And I'm supposed to contract my quads and hold it but that hurts a lot. I'm so frustrated :( There's been a lot of pain and it's affecting my life. I go to a big high school with lots of walking around and I just can't handle it anymore. I'm a 16 year old having trouble walking like i'm 80  :-[
Sorry that I'm rambling, I'm just frustrated and really want a new solution.

Does anyone know any other simpler leg exercises I can do?
Thanks for all the help
-Bree
-18 years old-
2002- 7 years old, first subluxation
4 more subluxations
9/'10- MRI: microfracture, damage and stretched ligaments
PT, all was going well, got into sports again
03/20/10- 6th subluxation: worse yet!
8/2/10 MPFL repair and lateral release

Offline lynneM

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Re: Tibial tubercle transfer surgery...so many questions!
« Reply #10 on: May 16, 2010, 08:18:36 PM »
Hi - I have a thread on here being 7 weeks post TTT & LR. Everyone is different however from my own experience of many many repeat patella dislocations from the age of 11 to 34 .......... if you are young and get sound advice ..... I would not hesitate in taking that advice and opting for a surgical solution. I have had nearly 30 years of pain, being laid off sport and being reduced to almost nothing other than walking on the flat - all becasue I was told surgery would NOT help - for literally years. I had given up on doctors until aged 37 even standing still became an adrenalin sport and I reluctantly consulted the 9th orthapedic surgeon I have seen since being a child. I am already - although there is a long way to go ..... very very pleased with the results of this procedure. I know if I had had this as a young and much fitter person it would have been easier to recover from than it has been and in all honesty ....... it really has not been that bad. Its down to determination and doing all of the work you are instructed to do in rehab. My surgeon has told me that this procedure should have been done when I was about 14 for the best results. So dont be afraid as long as you check the doctor out ......... the long term effects for me of continually being in pain, imobile and fed up are far worse than having this operation done ....... 1000 times !!!!! Good luck.
October 2006 Arthroscopy & Patella Scrape
May 2007 MPFR & Gracilis
March 2010 TTT & LR

Offline Strawberrry12

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Re: Tibial tubercle transfer surgery...so many questions!
« Reply #11 on: May 17, 2010, 12:12:02 AM »
lynneM,

thank you for the advice. I go back to the OS on Tuesday of this week, so I really hope I am given another option of what to do! If I am offically given the opportunity to have a TTT then I'll do it. I know it'll be hard but from what i've read on here, PT is key to having a good recovery. Unfortunately the decision to do the TTT is not just between me and my OS, but also my parents. So now there's 4 people who all have opinions and things they want out of all this. I think you're right about getting it done as young as possible.   ;)

-Bree
-18 years old-
2002- 7 years old, first subluxation
4 more subluxations
9/'10- MRI: microfracture, damage and stretched ligaments
PT, all was going well, got into sports again
03/20/10- 6th subluxation: worse yet!
8/2/10 MPFL repair and lateral release

Offline lynneM

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Re: Tibial tubercle transfer surgery...so many questions!
« Reply #12 on: May 18, 2010, 07:13:37 PM »
Hi Bree ....... was just catching up with posts and am thinking you have seen your doc today. Hope it has gone ok and all the adults have given you a chance to have your say. To give you an idea of what u can expect but of course based only on my experience  ..... I have walked a mile today - 8 weeks post op ... no pain, no maltracking of the patella what so ever. Feels great. 4 weeks ago I could only bend my knee to 20 degrees ...... today I hit 110 degrees. I have not been taking pain killers for 5 weeks. I needed pain killers the first 7 days and then I only took them another week as they were anti inflamatories and helped with the swelling. I know there are many people on here who have a terrible time ..... however I have had 3 knee ops and honestly immediately afterwards it is managable ........  after the first couple of weeks it is annoying but ok    ..... I think sometimes some of the posts on this site are overly negative - I will probably be shot down in flames for saying that but I really believe it  ....... no pain no gain honey but the gain sure is worth it ...... hope you get sorted.
October 2006 Arthroscopy & Patella Scrape
May 2007 MPFR & Gracilis
March 2010 TTT & LR

Offline Strawberrry12

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Re: Tibial tubercle transfer surgery...so many questions!
« Reply #13 on: May 19, 2010, 06:55:10 AM »
I saw my doctor today, and we have finally settled on a decision. I am going to have a TTT/LR this summer! My OS says he has done it on several girls my age and they all love the results and come back asking to have it on the second knee. This is good that he is very confident in it! He told me that there wasnt a chance of it getting much better on its own and there is absolutely no reason why I shouldn't heal well and have fabulous results. Yes, I did finally get a say in all this! i said that I'm tired of living with a knee that gives out on me and they heard me out, for once! I still have to set a date after I talk wiith my parents and figure out the summer. The only thing is that I may miss out on flute camp that I already did an audition for and was accepted :( I think it'll be worth it though. I feel very educated on the surgery by reading a lot online and on this board. I was told to do the surgery "when I'm ready" and I think I am! thank you to all the knee geeks who have posted so many helpful things on kneegeeks!  ;)

-Bree
-18 years old-
2002- 7 years old, first subluxation
4 more subluxations
9/'10- MRI: microfracture, damage and stretched ligaments
PT, all was going well, got into sports again
03/20/10- 6th subluxation: worse yet!
8/2/10 MPFL repair and lateral release

Offline Strawberrry12

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TTT & LR- I got my date..
« Reply #14 on: June 03, 2010, 03:15:19 AM »
Alright, latest news is that I'm having my surgery on August 2nd which is quite a ways away. This date will allow me to go to camp and then have the surgery literally the day after I get back! Crazy, but worth it :) So for the meantime, what are some things that I should buy or make sure I have around the house to ensure that I'm comfortable during recovery? If you guys have a link to a post that has my answers I would love that. I'm not very good at navigating this site haha.
One last question, my knee brace is irritating my skin because I have really sensitive skin. what should I do about that? Would pre-wrap work?
Thank you for all the input!

-Bree
-18 years old-
2002- 7 years old, first subluxation
4 more subluxations
9/'10- MRI: microfracture, damage and stretched ligaments
PT, all was going well, got into sports again
03/20/10- 6th subluxation: worse yet!
8/2/10 MPFL repair and lateral release

Offline naturegirl

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Re: Tibial tubercle transfer surgery...so many questions!
« Reply #15 on: June 04, 2010, 12:44:03 PM »
Hello!

I had a Fulkerson Osteotomy, type of TTT, on April 30th.  I can suggest a few things for you that helped me be more comfortable.  Most likely you'll be stuck NWB for at least awhile (for me 5 weeks) so anything to keep you from being bored is extremely helpful.  So have books, movies, laptop, TV, etc on hand. 

To help you feel more comfortable, be sure to have a steady supply of ice.  I purchased a CyroCuff cooler, which was a blessing.  But I still have to fill it with ice about once a day.  And it takes a lot.  If you won't be having a CryoCuff or similar product, then have frozen peas (recommended by people on this site).  It conforms to your knee and keeps it cold.  Icing is extremely important and helps sooo much with pain and swelling.

Be sure to have a comfy chair that you can nap in too.  :)  I have an nice comfy armchair and a little ottoman.  You'll need a set up which allows you to keep your knee perfectly straight.  Even if you're allowed to bend it, keeping it in extension while resting is good because you don't want to lose the ability to straighten it. 

Have tons of pillows.  For under you heel/calf, arms, other leg, back, hip-who knows?  ;)  You'll have achy parts all over most likely, from sitting in odd positions and/or walking with crutches.  I stuck pillows under random body parts for awhile to relieve random muscle aches.  Be sure to have a few small pillows too, not just big ones.

A shower chair or something to sit on in the shower is also really good to have, regardless of weight bearing status.  Showers are hard, and you don't want to fall. Also, having a handheld shower head is helpful, though probably not necessary.  It makes it a lot easier to shower though.  And showers feel amazing, even though they are hard to do after surgery.   :)

That's what I can think of for now.  Let me know if you have questions about anything.  I do have a post-op diary too that you can check out if you want. Here's the link if you want. http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=51439.0  I also had another procedure done, but it might help you prepare.  Or just check for other diaries from people with TTTs.  There's a lot of info in the post-op diary section. :)

Also-for the darn irritating brace.  I've been in that situation!  My PT gave me a compression sleeve to stick under the brace to keep from rubbing.  Before that I took a knee sock and cut the foot off and used that under the brace.  During summer that was kind of hot, but I was desperate!  You could probably do that with tights or pantyhose as well.  Who knows, pre-wrap could work as well.  I just never used that.  Anything to keep the brace off your skin with help.  Braces suck...

-Jen
1999-ish: L knee hyperextension on trampoline
4/30/2010 Fulkerson Osteotomy and MPFL/LPFL reconstruction
Serving with Peace Corps July 2011-September 2013 in South Africa-knee is happy :)

Offline Strawberrry12

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Re: Tibial tubercle transfer surgery...so many questions!
« Reply #16 on: June 08, 2010, 06:09:05 AM »
Jen,
thank you for all the helpful information! The idea of cutting the foot off the tights is a winner for me :) I'm going to start a "collection" of pillows and fun stuff to have around. It's great to hear from people like you who have actually gone through what I will be doing. And thank you for the link to your thread.
Also, I'm going to look into getting the CyroCuff or talk to my OS about getting one. It sure sounds like ice will be my best friend for a few weeks!
I was told that I would be NWB for 4-6 weeks, but probably 4 since I'm so young. I got a chair to use in the shower and my friends said they would bring me games and stuff for a whole month while I'm sitting around bored out of my mind.
You said that I would have to sit with my knee totally straight so I don't lose the ability to straighten it...does that mean if I bend it, it could heal wrong?

Thank you again for all the helpful information! :)
-Bree
-18 years old-
2002- 7 years old, first subluxation
4 more subluxations
9/'10- MRI: microfracture, damage and stretched ligaments
PT, all was going well, got into sports again
03/20/10- 6th subluxation: worse yet!
8/2/10 MPFL repair and lateral release

Offline naturegirl

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Re: Tibial tubercle transfer surgery...so many questions!
« Reply #17 on: June 08, 2010, 11:32:58 AM »
Bending it is ok, but you don't want to sit for hours with it slightly bent because #1 it'll probably hurt and #2 you could risk losing the ability to extend.  But I started bending it in the hospital bed in a continuous passive movement (CPM) machine, which bent my knee 0-90 right after surgery.  And one of my exercises was to bend it by doing heel slides, or sliding my foot towards my butt.  Your protocol may be different, but it seems to be common that you'll do some bending exercises soon after surgery to gain back ROM.  But when you're sitting and elevating, you'll want to have it straight most of the time. 

The CyroCuff is amazing.  I still use mine everyday, and it often means I don't have to take tylenol.  And it really helps with the swelling too.  A coworker of my Mom said she had one and sold if after surgery, and has regretted that decision!  I plan to keep mine, especially since I'll probably have more knee surgery in the future.

Sounds like you have some good plans for recovery!

-Jen
1999-ish: L knee hyperextension on trampoline
4/30/2010 Fulkerson Osteotomy and MPFL/LPFL reconstruction
Serving with Peace Corps July 2011-September 2013 in South Africa-knee is happy :)

Offline Strawberrry12

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Re: Tibial tubercle transfer surgery...so many questions!
« Reply #18 on: June 10, 2010, 11:24:53 PM »
Alright, latest update is I know exactly what surgery it is now. It's a Fulkerson's Procedure and a MPFL reconstruction. Thats the only update :)
-18 years old-
2002- 7 years old, first subluxation
4 more subluxations
9/'10- MRI: microfracture, damage and stretched ligaments
PT, all was going well, got into sports again
03/20/10- 6th subluxation: worse yet!
8/2/10 MPFL repair and lateral release

Offline naturegirl

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Re: Tibial tubercle transfer surgery...so many questions!
« Reply #19 on: June 11, 2010, 02:11:18 PM »
Hey!  Now at least you know exactly which operation you have, and can research it as much as you want. :)  Have fun at camp! 

-Jen
1999-ish: L knee hyperextension on trampoline
4/30/2010 Fulkerson Osteotomy and MPFL/LPFL reconstruction
Serving with Peace Corps July 2011-September 2013 in South Africa-knee is happy :)

Offline Strawberrry12

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Re: Tibial tubercle transfer surgery...so many questions!
« Reply #20 on: June 13, 2010, 07:05:42 AM »
I'm having second thoughts about this whole thing now. I'm really worried because I didn't get a second opinion. I'm not sure it's really necessary because my OS said that he has done plenty of these before and they have always had a good outcome and the people he has done it on have come back asking to have it on the other leg! Sounds pretty good to me. The only problem I have though is that he is not a patella specialist. He was highly recommended to me by another surgeon who operated on a family member. If a OS thinks he can't do a good job then he would refer me to a different surgeon, right? I mean, they can't mess someone up just to get money or whatever.  Am I making a mistake about this? I don't really want to get a second opinion and go through all that unless it is totally necessary. What do you guys think?
« Last Edit: June 13, 2010, 02:34:05 PM by Strawberrry12 »
-18 years old-
2002- 7 years old, first subluxation
4 more subluxations
9/'10- MRI: microfracture, damage and stretched ligaments
PT, all was going well, got into sports again
03/20/10- 6th subluxation: worse yet!
8/2/10 MPFL repair and lateral release

Offline crankerchick

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Re: Tibial tubercle transfer surgery...so many questions!
« Reply #21 on: June 13, 2010, 03:37:35 PM »
It is completely normal to get nervous and have second thoughts.

However, a second opinion (or third or fourth etc) is never a bad thing, especially from a patella specialist. Different doctors check people for different things, all aren't created equally. There are a few different approaches out there to addressing instability and all doctors don't look for all the different reasons nor do they take the same approach to the problem. For example, bone deformities (like knock knees, bowed legs, femoral anteversion, tibial torsion) are something a lot of doctors don't rule out, but a good patellofemoral specialist will.

I'm sorry to say but your optimism in a "highly recommended" surgeon and your "hope" that an OS would refer you to a different surgeon if he didn't think he could do a good job is, well, admirable, but in my opinion only optimism at best and not really reality. Plenty of people think they are good at something and really aren't. Plenty of people think they are right about something but aren't. Doctors are no exception, they are human just like everyone else. There are doctors out there would send you off to another doctor if they didn't know what to do, and there are others that are confident they can fix you with their approach, so why would they send you elsewhere?

I wouldn't say a doctor would "mess you up for money." I think most doctors have a patient's best interest at heart, but that doesn't mean they know what they are doing or that their approach is the best one. Just because they mean well doesn't mean they know what they are doing or that they have evaluated you for everything.

A second opinion isn't a lot of hassle in my opinion. In my case, a fourth opinion revealed somethings about my knees that no doctor in 20 years ever looked for.  Given what I've learned in my journey to better knee days, I would never have surgery without getting multiple opinions from specialists. But that's just me. It's your knee, the only one you will ever have. How could taking time to look at options ever be a hassle?

Just sayin.
« Last Edit: June 13, 2010, 03:47:05 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 Strawberrry12

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Re: Tibial tubercle transfer surgery...so many questions!
« Reply #22 on: June 13, 2010, 04:01:17 PM »
crankerchick,

thank you for your input about the situation. I'm really new to anything like this so I don't really know what I'm supposed to be doing! I think your advise to go ahead and get a second opinion is a good idea. The whole hassle thing was because I live in an area without many OS's so I'll have to really look to find another one. Thank you for giving me your opinion!

-Bree  ;)
-18 years old-
2002- 7 years old, first subluxation
4 more subluxations
9/'10- MRI: microfracture, damage and stretched ligaments
PT, all was going well, got into sports again
03/20/10- 6th subluxation: worse yet!
8/2/10 MPFL repair and lateral release

Offline crankerchick

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Re: Tibial tubercle transfer surgery...so many questions!
« Reply #23 on: June 13, 2010, 04:57:06 PM »
Bree, most of us don't know what we are doing, LOL! It's good that you are asking and willing to take advice. What state are you in? There is a list of knee surgeons on the right of this page that maybe help you find someone close to you. The list isn't meant to be some "magical, these are the best surgeons" kind of list, but it is a start.

I ended up traveling out of state to see who would eventually be my OS (after getting other opinions) and I don't regret it one bit. It's worth a thorough evaluation from patella specialist imo.
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 Strawberrry12

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Re: Tibial tubercle transfer surgery...so many questions!
« Reply #24 on: June 13, 2010, 10:56:10 PM »
I'm in California. The closest surgeon in that list on the right is 2.5 hours away haha. The thing is, my parents don't think I need a second opinion...I want one though! Ahh, so much confusion  ???
-18 years old-
2002- 7 years old, first subluxation
4 more subluxations
9/'10- MRI: microfracture, damage and stretched ligaments
PT, all was going well, got into sports again
03/20/10- 6th subluxation: worse yet!
8/2/10 MPFL repair and lateral release

Offline crankerchick

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Re: Tibial tubercle transfer surgery...so many questions!
« Reply #25 on: June 14, 2010, 12:08:25 AM »
Perhaps your parents should come read a few posts on this site. Patello-femoral problems are not cut and dry problems to solve. You only get one set of knees.

I only know one doctor in CA and he is in the sacramento area.
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 Strawberrry12

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Re: Tibial tubercle transfer surgery...so many questions!
« Reply #26 on: June 14, 2010, 05:50:30 AM »
Crankercihck,
That's a good idea, I'll tell them about this website and see if they'll read some stuff. And I'm from southern CA so Sacramento is quite a ways away! I actually found a knee specialist that is about 30 minutes away. Yay! So I'll see about going to him. Thanks for all the help!

-Bree
-18 years old-
2002- 7 years old, first subluxation
4 more subluxations
9/'10- MRI: microfracture, damage and stretched ligaments
PT, all was going well, got into sports again
03/20/10- 6th subluxation: worse yet!
8/2/10 MPFL repair and lateral release

Offline Strawberrry12

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Re: Tibial tubercle transfer surgery...so many questions!
« Reply #27 on: June 17, 2010, 12:04:46 AM »
Hey everyone,
Sorry to double post but I have a question! My dad wants me to try acupuncture before trying surgery because it worked for his tendonitis. I really don't want to though. I hate needles! Every time I've had a shot I've cried. He told me this last night and I already had a nightmare about it. I guess I really don't like needles at all! ::)

Does acupuncture heal torn ligaments? I tried looking it up online but every site seems to have a different answer for me. I know it won't do anything to help my misaligned knee which is the main source of my problems. What do you guys think? Is it worth a try??

-Bree :)
-18 years old-
2002- 7 years old, first subluxation
4 more subluxations
9/'10- MRI: microfracture, damage and stretched ligaments
PT, all was going well, got into sports again
03/20/10- 6th subluxation: worse yet!
8/2/10 MPFL repair and lateral release

Offline naturegirl

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Re: Tibial tubercle transfer surgery...so many questions!
« Reply #28 on: June 17, 2010, 07:26:45 AM »
Hey Bree,

I have no clue whether acupuncture can heal ligaments, but I would hazard to guess not.  And even if it could, the misalignment would still be an issue, possibly resulting in more ligament problems later.  It seems like you would be treating the symptom, pain and such, and not the problem.  In the long run, it's not going to be beneficial. 

If you think it could help with the pain, then I suppose it wouldn't hurt.  But that doesn't mean you should cancel the surgery.  Pain is an indicator of a bigger problem.  Those issues in you knee have already been identified as serious and needing surgery.  To overcome your knee problems, you'll need more than a simple fix.  :( 

-Jen
1999-ish: L knee hyperextension on trampoline
4/30/2010 Fulkerson Osteotomy and MPFL/LPFL reconstruction
Serving with Peace Corps July 2011-September 2013 in South Africa-knee is happy :)

Offline crankerchick

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Re: Tibial tubercle transfer surgery...so many questions!
« Reply #29 on: June 17, 2010, 03:45:25 PM »
Hope it works out for you to be able to see the knee specialist. Ideally, the second opinion would come from a patella specialist, but a second opinion is at least better then not.

It's always a good idea to exhaust conservative treatments before doing surgery. The methods sometimes help get things under control and make them tolerable and liveable to deal with. But that's just it, they aren't fixes, only work arounds, but if they are successful work arounds then they are worth it. Accuncture wont heal ligaments, but it might help with your pain.

I've never had acupuncture before, but i have had people tell me that it's not the same as like getting a shot. they all say it doesn't hurt. i have no idea and i don't plan on finding out either.
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 Strawberrry12

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Re: Tibial tubercle transfer surgery...so many questions!
« Reply #30 on: June 30, 2010, 01:47:12 AM »
My entire situation has changed in the last 24 hours and I'm not happy. My parents decided to cancel my surgery and try other things until December. Honestly, this makes me mad. How many more times am I gonna have to go though painful knee problems before I can just be done with it?! I tried acupuncture today (not my idea) and it helped in the way that my knee has loosened up but the amount of pain is now more. I'm very unhappy right now. I though my battle with a stupid knee was soon to be resolved but it turns out that it's not. And won't be for a long time. This makes me so mad I don't even know what to do... >:(
-18 years old-
2002- 7 years old, first subluxation
4 more subluxations
9/'10- MRI: microfracture, damage and stretched ligaments
PT, all was going well, got into sports again
03/20/10- 6th subluxation: worse yet!
8/2/10 MPFL repair and lateral release

Offline naturegirl

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Re: Tibial tubercle transfer surgery...so many questions!
« Reply #31 on: June 30, 2010, 04:52:36 AM »
Hey sounds like you're having a crappy day!  And no wonder!  After I decided to have the surgery, I was super impatient because I was ready for something to be fixed finally!  It stinks that your parents are unwilling to do the surgery now.  Is there something that made them decide that? 

I'm sorry the acupuncture didn't help out like you/your parents hoped.  I hope you find some pain relief soon.   :-\

-Jen
1999-ish: L knee hyperextension on trampoline
4/30/2010 Fulkerson Osteotomy and MPFL/LPFL reconstruction
Serving with Peace Corps July 2011-September 2013 in South Africa-knee is happy :)

Offline Strawberrry12

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Re: Tibial tubercle transfer surgery...so many questions!
« Reply #32 on: June 30, 2010, 07:58:00 PM »
Jen-

I think the whole idea of me having surgery just really scares my parents, which I understand. One of them thinks that I'll "grow out of it" and the other one says, "in 20 years there will be better solutions". The growing out of it thing, we've already been told that's not going to happen. And who knows, maybe there will be better solutions in 20 years. But my problems are now, and can't wait 20 years. They also have the idea of waiting until winter break to see if it gets better by then and if not, doing the surgery then. But then I wouldn't be able to do swim team next year, and that was my original goal!

I'm going to talk to them again and ask them to keep the appointment just a little longer so we can really think about this. What happens happens, and there isn't much I can do about it.

p.s. sorry for being such a downer, i'll be happier soon!
 
-Bree
-18 years old-
2002- 7 years old, first subluxation
4 more subluxations
9/'10- MRI: microfracture, damage and stretched ligaments
PT, all was going well, got into sports again
03/20/10- 6th subluxation: worse yet!
8/2/10 MPFL repair and lateral release

Offline naturegirl

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Re: Tibial tubercle transfer surgery...so many questions!
« Reply #33 on: July 01, 2010, 05:49:23 AM »
I'm sure my Mom had some of the same reservations, as any parent would.  But she's disabled and has numerous knee/ankle/foot problems so she KNEW how I felt.  I'm not sure my Dad or sister ever really understood my pain and fears with my knee because they haven't been through anything like it.  I can imagine that someone who hasn't had problems since childhood like us would have a problem understanding why such extensive surgery at a young age IS good.  You don't need to apologize for being such a downer because I'm sure most of the people on this site understand how you feel.  Knowing there's a possibility of a solution but having it out of your reach is hard to deal with! 

I'm really sorry you are struggling with this now, and really hope your parents listen to YOU!  While you are still a minor (If I recall correctly) you do have a working mind and I hope they listen to you, or are just willing to have a good discussion about it. 

Good luck!!
-Jen
1999-ish: L knee hyperextension on trampoline
4/30/2010 Fulkerson Osteotomy and MPFL/LPFL reconstruction
Serving with Peace Corps July 2011-September 2013 in South Africa-knee is happy :)

Offline Strawberrry12

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Re: Tibial tubercle transfer surgery...so many questions!
« Reply #34 on: July 01, 2010, 08:15:04 PM »
Hey Jen thanks for the response.

I've done some talking and convincing and I now I have my mom on board! My dad's the tough one though, so I'll have to talk to him again. As I was reading your post, I got up and started walking away and I hit the inside of my knee on the arm rest and POP my knee subluxed again. Uggh it's so frustrating but I'm not giving up yet!
I hope you are doing well too by the way, I haven't had a chance to check your diary but I will sometime today! ;)

-Bree
-18 years old-
2002- 7 years old, first subluxation
4 more subluxations
9/'10- MRI: microfracture, damage and stretched ligaments
PT, all was going well, got into sports again
03/20/10- 6th subluxation: worse yet!
8/2/10 MPFL repair and lateral release

Offline naturegirl

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Re: Tibial tubercle transfer surgery...so many questions!
« Reply #35 on: July 02, 2010, 01:57:35 PM »
Hi Bree!

Good job with getting your Mom on board.  I hope you all get the right decision, and soon so you don't have the uncertainty to deal with!

Ick!  Pop noises are NOT fun! Hope you don't have that happen again!!

And I am doing good! I am pleased with how I'm doing and glad I had the surgery done.  That hasn't always been my attitude, but I'm feeling much more "normal" now.   :D

-Jen
1999-ish: L knee hyperextension on trampoline
4/30/2010 Fulkerson Osteotomy and MPFL/LPFL reconstruction
Serving with Peace Corps July 2011-September 2013 in South Africa-knee is happy :)

Offline Strawberrry12

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Re: Tibial tubercle transfer surgery...so many questions!
« Reply #36 on: July 03, 2010, 02:02:37 AM »
Jen,
It's so great to hear that you're doing well! It's great for me to see someone else who is young like me and has survived this surgery   ;) haha

I've put together a bunch of websites showing the pros and cons of this procedure and I will present it to my parents hopefully tonight. Being at the undecided point 1 month before my scheduled date is killing me. I really need to know if it's gonna happen! I'm gonna ask them to make their final decision by the end of this weekend because the suspense of not knowing needs to stop! After this weekend we're going on vacation until mid July anyway, so there's no time to talk then.

Thanks for all the support and for keeping such a great post op diary for me to look at! :D

-Bree
-18 years old-
2002- 7 years old, first subluxation
4 more subluxations
9/'10- MRI: microfracture, damage and stretched ligaments
PT, all was going well, got into sports again
03/20/10- 6th subluxation: worse yet!
8/2/10 MPFL repair and lateral release

Offline naturegirl

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Re: Tibial tubercle transfer surgery...so many questions!
« Reply #37 on: July 05, 2010, 10:16:28 PM »
Hey Bree!

Hope the discussion with your parents went/goes well!  Uncertainty sure is a pain in the rear!  And have a great vacation! 

-Jen
1999-ish: L knee hyperextension on trampoline
4/30/2010 Fulkerson Osteotomy and MPFL/LPFL reconstruction
Serving with Peace Corps July 2011-September 2013 in South Africa-knee is happy :)

Offline Strawberrry12

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Re: Tibial tubercle transfer surgery...so many questions!
« Reply #38 on: July 07, 2010, 05:22:27 AM »
Hey Jen!

I sure appreciate hearing from you :)
I am getting closer in the discussion with my parents! We are not totally finalized, but it's looking like a yes so far. Dad said "I will support whatever you and your mother choose to do." Mom says "I want all three of us to be in on the decision making process." Me and my mom are going to call my dad soon and have a "conference call" to make a decision. I know this is an important choice to make so I guess it's a good thing that we are taking so long and spending so much time thinking about it.  ;)

-Bree
-18 years old-
2002- 7 years old, first subluxation
4 more subluxations
9/'10- MRI: microfracture, damage and stretched ligaments
PT, all was going well, got into sports again
03/20/10- 6th subluxation: worse yet!
8/2/10 MPFL repair and lateral release

Offline Strawberrry12

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Re: Tibial tubercle transfer surgery...so many questions!
« Reply #39 on: July 16, 2010, 05:48:49 AM »
Another update! We are definitely going for the knee surgery now, and I am not letting my parents change their minds again! We finally got to sit down and have a good long talk about the benefits and risks and I think there's more going for me than against me  ;)
So now I have 9 days to prepare before I go to camp! The day after I get back is the big day so the clock is definitely ticking. It's 17 days away..wow.
Another interesting thing i found out...my great grandma had this same surgery done because her knee was twisted like mine! So now I can officially blame genetics for my issues.
So what are some other good things to have besides ice packs, pillows for elevation, shower seat, and crutches?
One last thing...I was stupid and googled imaged of "fulkersons osteotomy" and saw some reeeeally big scars. Anyone care to share how long your scar is? I've seen 3in-10in. That's a huge range!
Thanks for all the help!
 
-Bree  ;D
« Last Edit: July 16, 2010, 06:07:21 AM by Strawberrry12 »
-18 years old-
2002- 7 years old, first subluxation
4 more subluxations
9/'10- MRI: microfracture, damage and stretched ligaments
PT, all was going well, got into sports again
03/20/10- 6th subluxation: worse yet!
8/2/10 MPFL repair and lateral release

Offline naturegirl

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Re: Tibial tubercle transfer surgery...so many questions!
« Reply #40 on: July 16, 2010, 06:45:48 PM »
Hey Bree!

I'm glad you finally have a definite plan and can prepare for it!  You've got some time, but I'm sure it won't seem like enough.  Enjoy being able to walk and do everything normally!  :)

You ought to ask your doctor if you'll be prescribed a cryocuff (or similar) cooling device for post-op.  It is much better than using ice packs, and was my best friend after surgery.   ;)   Make sure you have stuff to do-books, movies, tv, computer.  You will be bored once you are not sleeping all the time.  I had a nice little nest made at home and at my dorm with everything I needed withing easy reach. 

Here's a pic of my scar as of today.  Mine is about 7 inches long.  When I bend, it's over 9 inches long. ;)  I didn't expect it to be that long, but I'm ok with it now.  It was a shock post-op though!  It's starting to turn white now, which is nice.  Some people do have small scars.  When I posted a pic of mine on here, lots of people were surprised with how large it was.  So you might not have one quite so large.  You'll have to check with the doc.
  

-Jen
1999-ish: L knee hyperextension on trampoline
4/30/2010 Fulkerson Osteotomy and MPFL/LPFL reconstruction
Serving with Peace Corps July 2011-September 2013 in South Africa-knee is happy :)

Offline KW

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Re: Tibial tubercle transfer surgery...so many questions!
« Reply #41 on: July 16, 2010, 06:51:46 PM »
I've had 3 TTT's and none of my scars have been over 3.5".  My PFJR scar is only 6.5"
Right Knee
2000 - 2002 - Scope,LR,TTT,Unscrewed
01-10-12 - PFJR

Left Knee
04/07 TTT/LR
08/07 Bone Grth Stim
10/07 Loose/Bent Screw
1/08 Unscrewed/MRI~NON-UNION
02/19/08 Lt  TTT Revision W/Graft
12/09/08 Scope
05/15/09 Scope
09/04/09 PFJR/Unscrewed

Offline Strawberrry12

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Re: Tibial tubercle transfer surgery...so many questions!
« Reply #42 on: July 17, 2010, 12:10:20 AM »
Thank you to everyone who replied!

KW- I really hope mine will only be 3.5 like yours!

Jen- Was your MPFL an open surgery? Maybe that's why your scar is so long! I was told they could probably do mine arthoscopicly which would be awesome. For some reason the idea of having an incision that goes over my knee cap freaks me out...I don't know why! But if mine turns out as long as yours I guess it won't be too bad. I  mean, you survived it why can't I?  ;)

-Bree  :)
-18 years old-
2002- 7 years old, first subluxation
4 more subluxations
9/'10- MRI: microfracture, damage and stretched ligaments
PT, all was going well, got into sports again
03/20/10- 6th subluxation: worse yet!
8/2/10 MPFL repair and lateral release

Offline naturegirl

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Re: Tibial tubercle transfer surgery...so many questions!
« Reply #43 on: July 17, 2010, 03:45:41 AM »
Yeah, my MPFL was done open, which obviously made for a longer scar.  It was a little scary to bend it right after surgery because I was afraid of the incision bursting open. :)  That didn't happen, but it did make me nervous!  I think most people do it arthroscopically though, so it might very well be smaller.  Either way, it's just a scar.  Better on my leg then on my nose or something.  ;)

-Jen
1999-ish: L knee hyperextension on trampoline
4/30/2010 Fulkerson Osteotomy and MPFL/LPFL reconstruction
Serving with Peace Corps July 2011-September 2013 in South Africa-knee is happy :)

Offline Strawberrry12

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Re: Tibial tubercle transfer surgery...so many questions!
« Reply #44 on: July 17, 2010, 06:48:31 AM »
Jen,
your scar does look really good though! it's light colored which is what I'm hoping for :) I guess I don't really care about the scar that I end up with, i'm more scared of the incision itself and I have the same fear of it bursting open spontaneously.

-Bree  :)
-18 years old-
2002- 7 years old, first subluxation
4 more subluxations
9/'10- MRI: microfracture, damage and stretched ligaments
PT, all was going well, got into sports again
03/20/10- 6th subluxation: worse yet!
8/2/10 MPFL repair and lateral release

Offline Strawberrry12

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Re: Tibial tubercle transfer surgery...so many questions!
« Reply #45 on: July 19, 2010, 06:01:48 AM »
Hey everyone,

I've had a change in attitude about all this now. I'm happy that I'm having it done and I feel confident that we have made the right decision and I am now looking forward to having a normal life style that is not stopped by a bum knee! And thank you to everyone who has helped me with gathering information and helping me to understand what I'm in for. As of the end of this week, I won't be in contact until after my surgery. Hope everyone is feeling well today!

Bree  ;)
-18 years old-
2002- 7 years old, first subluxation
4 more subluxations
9/'10- MRI: microfracture, damage and stretched ligaments
PT, all was going well, got into sports again
03/20/10- 6th subluxation: worse yet!
8/2/10 MPFL repair and lateral release

Offline naturegirl

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Re: Tibial tubercle transfer surgery...so many questions!
« Reply #46 on: July 20, 2010, 01:44:31 PM »
Hey Bree,

I hope you have a great time at camp, and I'll be think about you!  I hope that all goes well!  I'm glad you're feeling comfortable about this now, and that you can envision the big picture.  I look forward to hearing from you post-op!

-Jen
1999-ish: L knee hyperextension on trampoline
4/30/2010 Fulkerson Osteotomy and MPFL/LPFL reconstruction
Serving with Peace Corps July 2011-September 2013 in South Africa-knee is happy :)

Offline Strawberrry12

  • MINIgeek (20-50 posts)
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Re: Tibial tubercle transfer surgery...so many questions!
« Reply #47 on: July 21, 2010, 09:20:52 PM »
Hey everyone!

I'm closing down this thread now, I won't be posting on here anymore. I'll be gone now until surgery day so this will be the last post until then! Thank you so much to everyone who helped my through this and helped me in the decision making process.   :)

I will open up a post-op diary in the post op section probably titled "Bree's Fulkerson's Osteotomy and MPFL Repair". Surgery day is August 2nd, but I'm not sure when I'll get home and be able to post, but I will ASAP!

Bree  :)
-18 years old-
2002- 7 years old, first subluxation
4 more subluxations
9/'10- MRI: microfracture, damage and stretched ligaments
PT, all was going well, got into sports again
03/20/10- 6th subluxation: worse yet!
8/2/10 MPFL repair and lateral release















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