Banner - Hide this banner





Author Topic: LPFL reconstruction, derotational tibial osteotomy  (Read 8259 times)

0 Members and 1 Guest are viewing this topic.

Offline acheek71

  • MINIgeek (20-50 posts)
  • **
  • Posts: 32
  • Liked: 0
LPFL reconstruction, derotational tibial osteotomy
« on: July 04, 2010, 01:06:08 AM »
Here goes!  I have had several requests for a post op diary regarding the LPFL reconstruction.  I am now 5 days post op but I will try to catch you up.

A little background about myself and what led to this surgery to begin with.  I have raced motocross since I was 13 years old, I am now 28.  Last July I was racing and stuck my left leg out to catch myself and it popped.  I never did crash, but I did finish the race.  The pain continued into the next week and I went to see a local orthopedist.  He gave me a cortizone shot that did not help. So On August 21 he did athroscopic and supposedly removed some plica.  The knee did not get any better, and me being the stubborn one I am, I kept racing.  In November I crashed and popped the knee again.  I was referred by a friend to a doctor in OKC. By then, the knee was dislocating medially.  So he did a lateral release on December 31.  Sure wish I had done my research before agreeing to either one.  Of course, I did not get any better.  So I did my own research and found an amazing doctor in Texas.  He did some x-rays, CT scan ,etc. and came to the conclusion that my tibia was rotated apporoximately 12 degrees to far and that it would need to be corrected before anything else would work.  My knee by this time was dislocating laterally several times a day.  We started PT and scheduled my surgery for June 29.

Surgery day:  I remember doc coming in and moving my patella in every direction possible.  He told us that he was doing a LPFL reconstruction, osteotomy, MPFL tightening and a possible bone graft.  I don't really remember anything until dinner time.  I think I ate jello.  My husband has been my god send during this whole process.  I know that doc didn't do the bone graft because my right tibia is still in tact!  That night I had a very pushy nurse named Mary.  I was instructed to do 5 cannonballs an hour, every hour.  Well, Mary was good about making me do my cannonballs....not so good about keeping up the pain meds.  So finally about 2am, she gave me a large shot of demeral!!!

Day two:  Didn't get much sleep due to the constant cannonball action.  The pain meds and I weren't really getting along too well.  The pain was there, all over the leg at that time.  Then the PT came in.  We did the cannonballs (bent to 120!!), tried some SLR's  and then he wanted me to get up and try to walk, with crutches, baring 20lbs. Did that twice.  Took alittle bit though....way too dizzy with the meds.  I am getting very acquainted with the cryo-cuff...and I love it!!

« Last Edit: July 04, 2010, 09:10:54 PM by acheek71 »

Offline acheek71

  • MINIgeek (20-50 posts)
  • **
  • Posts: 32
  • Liked: 0
Re: LPFL reconstruction, tibial osteotomy, and MPFL tightened
« Reply #1 on: July 04, 2010, 01:26:29 AM »
They also released me from the hospital on day two, to return to the hotel.  My dad showed up right before they let me go....which was a very welcomed surprise.  My appetite really wasn't up to par, so after we left and they got me back to the hotel and settled in.  My husband and father went to get me some dinner.  I chose....hushpuppies and a chocolate shake.  Please do not ever choose hushpuppies and a chocolate shake the day after surgery.

Day three:  woke up alittle shaky.  Husband went down and brought me back an assortment of goodies.  I chose half a bagel and OJ....forcing it down.  Had therapy at 10:30.  As 10:30 was approaching, so was last nights dinner and breakfast.....if you know what I mean.  It showed its ugly head.  Therefore making us late for therapy.  I had not taken any pain meds in hours, due to the shakes and not feeling well.  So there I was at therapy with no pain meds.  The PT was surprised.  We started with cannonballs.  I made it to 120 again...tearfully.  The pain is once again, all over the leg.  We did some other exercises and he decided it would be ok if I go home that day.  Started getting more shaky toward the end, so the PT insisted on me eating some crackers.  Took the trip around the hospital to see doc's nurse.......she said that I had bone chill.  She told me to watch my temp.  But other than that....if I wanted to go home, I could.  So we loaded up for the 4 and a half hour trip home!!
 

Offline acheek71

  • MINIgeek (20-50 posts)
  • **
  • Posts: 32
  • Liked: 0
Re: LPFL reconstruction, tibial osteotomy, and MPFL tightened
« Reply #2 on: July 04, 2010, 01:48:41 AM »
Day four:  The pain in the tibia is terrible.  It is more like....ON FIRE!!!  The pain meds are still not agreeing with me......if I take them, I feel like crap.....if I don't I feel like crap!!  So, I think I am taking half of one plus a tylenol twice a day.  Then at bedtime a whole one with a tylenol PM.  The cannonballs actually make me feel alittle better, for a small amount of time.  And rotating my ankle, relieves the burning sensation temporarily.  During the cannonballs....the tightest portion on my leg has been the outside thigh.  I'm assuming because thats where he took a piece of the IT band to repair the lateral ligament.   Other than that, I don't notice the pain there very much.

Day five:  which is today!  It has been horrible!!!  By every meaning of the word.  My knee, more below the knee has killed me.  And getting up to use the restroom is an unbearable act.  And the shower this morning.......that was interesting.  It was a speed shower.  And speaking of showers......not that you guys want to know this....but I still stink.  Anybody else have this issue??  I am supposed to wash with Hibiclens, and that only.  I have been cheating and using MY bodywash on parts other than that leg.  But then again, I literally have not left the bed, except to use the restroom and shower.  I am also supposed to be wearing the TED hose 24/7.  I took a break for alittle today so they could get a good washing.  My appetite is still not there.  My husband tries real hard!!  And my head is killing me!! 

Sorry for my pitty party!!  The swelling is still pretty bad.  It's not really any worse than it was in the hospital.  And when I asked they said it was normal....I sure hope so!!  I had serious atrophy in my left thigh before I went in....and now, it is bigger than my right thigh!  Of course, my whole leg is one big bruise...as to be expected!  But now, even my ankle looks bruised.  I'm thinking its from the swelling.

Hope you guys aren't reading this, thinking I am crazy!!    I have really made some great friends on this site...I like to call them my cheerleaders.  I hope this will help someone else either facing this same surgery or recovering.  If you have any questions, please feel free to ask me. I will try to keep you updating on progress!

Amanda

Offline crankerchick

  • SuperKNEEgeek
  • *****
  • *
  • Posts: 1863
  • Liked: 26
  • How 'bout them Cowboys!
    • Derotation osteotomy & TTT Post-op diary
Re: LPFL reconstruction, tibial osteotomy, and MPFL tightened
« Reply #3 on: July 04, 2010, 02:28:10 AM »
Hooray for making the post-op diary!

Girlfriend you are doing awesome. I know it doesn't seem like it but you are!

It sounds like you had not as pleasant of an experience in the hospital. I'm sorry your nurse was pushy, all the better they let you go the next day.

For the nausea, did you try the nausea med he prescribes? I know he presribed it for me but I never took it. It might help you tolerate the pain pills better.

The pain sucks but it does get better, just hang in there. I know I was SOOO ready for cannonballs every hour even though they are evil. Its damn near impossible to get comfortable but it does get better. I wish I had tips to make it better but really the only answer is tough it out. Make sure you are elevating above the heart and using the cryocuff religiously.

Oh yeah, the hibiclens. Maybe I was cheating but they let me use my own soap for my body aside from my leg. This was even during my first shower at the hospital. You may want to ask Michelle about it.

Once again super glad to see your diary. It will be helpful for someone coming down this path. You rock!
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 acheek71

  • MINIgeek (20-50 posts)
  • **
  • Posts: 32
  • Liked: 0
Re: LPFL reconstruction, tibial osteotomy, and MPFL tightened
« Reply #4 on: July 04, 2010, 02:44:11 AM »
Thanks Crankerchick!!  Today was just bad all around!!  I am learning to tolerate the pain.  I think the hardest part, is relying on everyone else.  I just get so frustrated that I can't do anything myself.  I am blessed that I do have wonderful people around me.

Doc was gone by the time I was released from the hospital, so I didn't get the nausea meds.  I may email Michelle about them.  I am trying to tough it out.  The crazy thing is that I don't even crave sweets...all I want is watermelon. cantaloupe, etc.  What a freak!!!

The other knee IS starting to hurt though.  I use it for everything.  When I am impatient, I use it to pick up my bad leg to do a cannonball, etc.  I must learn to chill out!  Otherwise, doc may see me sooner than later for it!! 

The Hibiclens......I have cheated from day one!!  And I can't get it to lather up like the nurse did before I left.  I have tried.  The incision looks good though.  He did not use staples.  Michelle called it some kind of new suture that he is trying on the females.  It is supposed to minimize the scarring.  Down the tibia looks really good, like I don't think it will scar much at all.  Across the knee to the lateral side looks alittle more drastic.  Doc has done a phenomenal job on it all.

Speaking of doc...saw where kneeguru took away the website!!  How funny!!  Oh well.....he is amazing!! 

Offline crankerchick

  • SuperKNEEgeek
  • *****
  • *
  • Posts: 1863
  • Liked: 26
  • How 'bout them Cowboys!
    • Derotation osteotomy & TTT Post-op diary
Re: LPFL reconstruction, tibial osteotomy, and MPFL tightened
« Reply #5 on: July 04, 2010, 01:49:50 PM »
I hear you on the relying on others part. That was hard for me too. I just did as much as I could on my own and let others help me when I had no other choice. It gets easier.

Craving watermelon and cantaloupe is a good thing. I was craving fatty deliciousness which doesn't go well with post-op nausea LOL. But I did right and stuck to the low fat, high protein diet as instructed, even though all I wanted was macaroni and cheese, pizza, and french fries LOL.

It is important to chill some the first week. Do the exercises 3x a day and do the cannonballs, but otherwise rest and relax.

I'm so jealous you don't have staples, that's pretty sweet. My incisions themselves look good, it's the darn staples that left dark marks in some areas.

The funny thing about the link being removed is the site is a good site for patient education. A few people have said they got useful info from it.

Oh well, I'm off to work out now. Happy Independence Day and I hope your pain is better today.
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

  • Guest
Re: LPFL reconstruction, tibial osteotomy, and MPFL tightened
« Reply #6 on: July 04, 2010, 06:58:31 PM »
  Its is supposed to be hurting over the first few weeks.  Thats normal.  The cannonballs actually decrease the pain.  0-120 degrees is excellent.  Bedrest witht he foot elevated 8 inches above the heart and the Cryocuff is equally important.

I didn't have to do the MPFL reconstruction as the knee was tight enough on that side.  My  OS friends thought the X-rays were a work of art. (pardon my arrogance here)  Email me and I will forward them to you.

Crankerchick, I appreciate that you had put the link to my website, but I understand that the KNEE GURU has to sell advertizing space and I am  not an advertizer on the internet because everyone thinks those advertizements are spam.  My "advertizing" comes from people like yourself who are now free of the doctor. If anyone googles, my name, the websites comes right up, anyway.   I just updated the site re the PF joint, too. Oh, wel....l.

doc
« Last Edit: July 04, 2010, 07:03:14 PM by drmark »

Offline acheek71

  • MINIgeek (20-50 posts)
  • **
  • Posts: 32
  • Liked: 0
Re: LPFL reconstruction, derotational tibial osteotomy
« Reply #7 on: July 04, 2010, 09:21:30 PM »
Thank you DrMark!!  I asked Michelle about the MPFL and she said she thought you did it but was not completely sure.  I will remove that part!  And I believe you when you say it is a work of art!!  I will be emailing for copies, though!! Things are going alittle smoother today.  Except when I get up, it just feels like there is 300lbs on my tibia. It also feels so funny, I guess its possible to tell already the untwisted part?  I feel like I am walking funny (without baring weight of course!)  I suppose that will get better.  For now, I think I will stay in bed as much as possible, it seems to be the safest bet!  I even passed up going and watching Eclipse!  Brandon did rig me a wheelchair with a platform to elevate my knee........he's so creative!!   

The swelling is definitely going down in the leg.  The atrophy is becoming more evident.  I was enjoying it being the same size as the other thigh!!  DrMark, I can't thank you enough for all you have done!!  Hope you are having a better weekend, and that everything worked out this past week.

Thank you
Amanda

Offline crankerchick

  • SuperKNEEgeek
  • *****
  • *
  • Posts: 1863
  • Liked: 26
  • How 'bout them Cowboys!
    • Derotation osteotomy & TTT Post-op diary
Re: LPFL reconstruction, derotational tibial osteotomy
« Reply #8 on: July 04, 2010, 11:48:28 PM »
You passed on Eclipse?!?!?

Blasphemous!

Just kidding of course. Rest is best right now. But I'm sure it took a lot of willpower to pass on that! Soon chica, soon. You will be seeing movies and racing before you know it!
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

  • SuperKNEEgeek
  • *****
  • *
  • Posts: 1863
  • Liked: 26
  • How 'bout them Cowboys!
    • Derotation osteotomy & TTT Post-op diary
Re: LPFL reconstruction, derotational tibial osteotomy
« Reply #9 on: July 05, 2010, 05:12:42 PM »
Lame me for replying to myself but i just checked out the updates to the PF section of the website. Ace job. Now maybe I can stop repeating myself like a broken record and just send inquiring minds to the website for all things patella.

Amanda, hope you are feeling a bit better today. Every day gets a little easier.
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 acheek71

  • MINIgeek (20-50 posts)
  • **
  • Posts: 32
  • Liked: 0
Re: LPFL reconstruction, derotational tibial osteotomy
« Reply #10 on: July 05, 2010, 09:30:10 PM »
Today has been alittle better.  Thanks to the advise of Crankerchick!!  It takes me a few minutes to get out of bed.  Apparently, the 3000lb elephant on my tibia is a blood rush!!  WOW!!!  The bruising is getting prettier, and the one on the thigh is getting more tender!  Start PT locally tomorrow...so that will be interesting. 

Started making laps around the house everytime I get up to use the restroom!  It's slow, but I guess I have to start somewhere.  I am noticing that my foot is turned more to the inside.  Hard to get used too.  It's almost like I'm gonna have to learn to walk all over again.

The cryo-cuff and I aren't getting along real well.  I think its putting too much pressure on the tibia.  Trying to find ways around that.  Any ideas??

Today was the first day without my husband all day, sure do miss him!!  My grandmother and mother are here putting my house back in order.  Which is nice, but they are asking sooooo many questions!!!  Guess my days of quiet are over!! 

drmark

  • Guest
Re: LPFL reconstruction, derotational tibial osteotomy
« Reply #11 on: July 05, 2010, 10:36:28 PM »
You don't have to fill the cryocuff up that much.  The more its filled up (the higher you elevate the cooler) and the longer time the two are connected) the more pressure it exerts on the knee/leg.   Also you should be wearing the TED stocking.  That will decrease, but not eliminate the "blood rush" feeling.

Glad to hear  you are having a better day.  Get used to the foot turning more to the inside.  Thats the way should should have been in the first place.  You inherited it from at the least one of your ancestors. Perhaps you should lay the blame on your Mother and visiting Grandmother! (Women always seem to complain that they have inerited their Mother's thighs, so why shouldn't they inherit their Mother's tibias?)
« Last Edit: July 05, 2010, 10:41:45 PM by drmark »

Offline crankerchick

  • SuperKNEEgeek
  • *****
  • *
  • Posts: 1863
  • Liked: 26
  • How 'bout them Cowboys!
    • Derotation osteotomy & TTT Post-op diary
Re: LPFL reconstruction, derotational tibial osteotomy
« Reply #12 on: July 05, 2010, 10:48:21 PM »
Glad today is going a little better!

My foot turns in a little too. I read in one of Dr. Teitge's papers that would happen. When I opened my eyes from the surgery, I said "Ouch" then I looked at my knee then I looked at my foot to see if it was straight. I will say that as I have gotten the leg stronger and gotten used to it, it feels normal of course and doesn't seem so odd. But looking down at my dead weight of a leg after surgery, yes my foot pointing in seemed very obvious and exaggerated.

When I started walking, I was tripping over my foot, which I blamed on it turning in, but who knows maybe it was just weakness causing me to trip.

As for the cryocuff, not sure, maybe don't put it on as tight? I don't recall the cryocuff really irritating the tibia for me. The tightness and pressure and vice grip feeling was there all the time, cryocuff or not.

FWIW my moms legs look funny too.
« Last Edit: July 05, 2010, 11:55:58 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

drmark

  • Guest
Re: LPFL reconstruction, derotational tibial osteotomy
« Reply #13 on: July 06, 2010, 12:42:04 AM »
Cranker, you had a correction of external rotation at the femur amd internal rotation of the tibia.  The net wasn't so far from zero Acheek had on one correction, so the net should be about 15 degrees.  Accordingly it will take some getting used to .

Offline acheek71

  • MINIgeek (20-50 posts)
  • **
  • Posts: 32
  • Liked: 0
Re: LPFL reconstruction, derotational tibial osteotomy
« Reply #14 on: July 06, 2010, 03:26:38 AM »
Lol.....something tells me I can blame this on someone on down the line!  Everything I have "inherited" has come from generations upon generations!!  I find something, or shall I say, they find me every year!  Can't wait for next year!!

I'm hoping tomorrow goes smooth.  Tonight hasn't been so good.  I don't want to sound like a whiner, but this has been one heck of an emotional rollercoaster for me.  I'm hoping tomorrow will help. And it's only been one week.  I am learning patience,or shall I say I'm trying to learn patience. 

The knee has decided to give me fits tonight, maybe all the extra activity.  I did get out and lay in chaise on the porch today.....which was nice.  The leg cooperated for about an hour.  I can't wait to see my new leg in full action!! 

Thanks DrMark and Crankerchick!!