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Author Topic: Tibial tubercle transfer surgery...so many questions!  (Read 25939 times)

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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