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Author Topic: LPFL reconstruction, derotational tibial osteotomy  (Read 8261 times)

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drmark

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Re: LPFL reconstruction, derotational tibial osteotomy
« Reply #30 on: July 18, 2010, 12:58:27 AM »
Crankerchick and Ed (my Houston PT who you haven't met yet) are right. Control your leg rather than let it  control you.  Everyone can do more than they thing:  Thats me talking.   At this point the only thing to frear is fear itself.  Nothing will come apart.  Get your a$$ in gear and go for it!  Nothing will happen until you make it!

Offline acheek71

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Re: LPFL reconstruction, derotational tibial osteotomy
« Reply #31 on: July 18, 2010, 04:30:00 AM »
Wow!!! Okay guys....I will try harder!!!  I'm working through the pain, believe me!!!  I guess I just need to trust it more.  I was excited the other day.  The pt has me doing this exercise where lay on this board and slide myself backwards to straighten me leg.  And I could do it without my knee cap popping out!!!!!!  Doc has done a wonderful job, it's just the mind set I have.  I have to get over it. 

But I do something new every pt, and I do the regulars at home.....or at least try them.  My hold back has been behind the knee, it just feels like the tendons or something are In a bind. 

I've already told my husband I'm in the pool tomorrow.  Just gotta find an easy way in and out!!  Will tell you how it goes!!
« Last Edit: July 18, 2010, 05:27:03 AM by acheek71 »

Offline smartdriver

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Re: LPFL reconstruction, derotational tibial osteotomy
« Reply #32 on: July 18, 2010, 12:46:04 PM »
The pool will be good - everything will seem "easier" since it does take the stress off.  When I did go to PT, they gave me a list of pool exercises to do - about a 45 minute workout.  Unfortunately for me, the pool, even though good, was way too BORING!  So I would do my regular workout and then do one or two pool exercises before my boredom kicked in.  They had me doing lunges, squats, walking forward/backward, SLR's, "biking", side stepping, etc. in the pool.

Getting into the pool wasn't a problem - I just jumped  ;D  Getting out wasn't too bad either. The pool at the gym has stairs, so I just used a railing to hold onto. While still on crutches, I went on vacation to the Dominican Republic - the pool had no stairs - but that didn't stop me from taking advantage of it. 

As DrMark said, nothing will come apart. 

Where there's a will - there's a way...

Offline Teacher2Many

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Re: LPFL reconstruction, derotational tibial osteotomy
« Reply #33 on: July 21, 2010, 10:18:13 PM »
Hi acheek71,

I've had the same procedure as you, in additional to a derotational femoral osteotomy and a bone graft done on 7/8.  Just wondering how you are progressing in PT and if you had any specific protocol to follow or not.  Am set to start PT on 7/27 and just wanted to see what those first few weeks would be like-needless to say, these surgeries are not common so my PT was looking for some sort of 'guidance' re: protocols as to what to do and what not to do and unfortunately, my surgeon does not use protocols for PT.

Hope you are continuing to progress and that things will keep improving!  Just out of curiosity, what was the main factor that led up to your surgery?

Beth
6/07-L TTT & LR
6/08-R TTT & LR
6/09-Bilateral ACI
7/10-R derotational femoral & tibial osteotomies, LPFL reconstruction
6/11-L derotational femoral & tibial osteotomies, R hardware removal
1/12-L tibial hardware removed, R scapulectomy
4/12-L femoral hardware removed
7/12-L & R MPFL reconstruction

Offline acheek71

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Re: LPFL reconstruction, derotational tibial osteotomy
« Reply #34 on: July 23, 2010, 04:31:25 AM »
Hi Beth!!  Needless to say you have been through a lot more than I have!!  Crankerchick can probably give you more guidance than I can on protocols.  Doc has had me doing the pt exercises for the tibial osteotomy, nothing different for the LPFL reconstruct.  I'm surprised you haven't started pt yet.  All of docs patients start pt same day.  But he's very aggressive.  Lots of cannonballs, lifting your Thigh to your chest and lowering your tibia.  I used my other foot to guide my leg, if I didn't have help.  Suppose to do that for 5 minutes an hour as long as your awake. Then hamstring curls( that I could not do at first, but after about 2 weeks it got easier), quad sets(leg straight, tightening quad so knee would push down), attempting straight leg raises( still haven't done it yet!), leg slides(lay on back, straighten leg, then slide foot toward your hind end to bend your leg), and biking it.  There is more I have forgot, I'm sure.  But that is the main part.

I was not able to do a full revolution on the bike until this past week, which is terrible.  I started working it in the pool Sunday and have been doing so everyday.  It has seemed to help some.  And my pt has me working on this contraption called shuttle.  He has me stretching my calves.  I can only do 20lbs weight bearing.

I wish you all the luck in your pt!!  Mine has not gone as smoothly as I would have hoped, but um praying it gets better.  I've lost some of my range of motion due to another issue I have developed, and I'm hoping it will heal soon.  If you have any more questions please ask.  I'm hoping this has helped alittle!!

Offline Teacher2Many

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Re: LPFL reconstruction, derotational tibial osteotomy
« Reply #35 on: July 23, 2010, 07:11:15 PM »
Thanks for the response-it was a great help!  Am glad to hear that you are progressing and hope that the other issue you've developed resolves itself soon!  I know how frustrated it can be when we lose a little bit of ROM, etc. but sometimes the road to recovery involves taking two steps forward and one step back.

Am excited to finally start PT on Tuesday-I know it will go smoothly!  Funny how different docs who do the same surgery have different thoughts re: PT.  No PT was said to start for me until about 6 weeks post-op but since I've been down this road before and didn't want to wait for 6 weeks (that's when I need to be back at work getting my classroom set up), he said I can start at 3, after my first post-op visit w/xrays, removal of stitches, etc.  There was some PT while in the hospital but nothing since-didn't even get discharged with a list of exercises to do.  But since I've been down this road many times before, I know some of the basics (quad sets, etc.) and have been doing them as tolerable.

I do get frustrated w/the limited ROM, etc. but I think I got spoiled after the bilateral ACI surgery last year-was sent home full weight bearing with the braces locked in extension, crutch use as needed for balance/comfort, CPM for 6 weeks, and Game Ready for about 1.5 weeks.  PT started at 8 days post-op so when I compare where I'm at now to then, I feel so far behind.  BUT then I look back at the first two major surgeries, which were the Fulkerson Osteotomies (and everything else that went with it) and each time the operative leg was casted in a full leg split cast (plaster supports from the upper thigh to right above the ankle on the entire medial and lateral side of my leg-the top and bottom were open to allow for swelling, etc.) for two full weeks-no exercises, no CPM, etc. and after the cast came off, then PT could start.  So I guess I am spoiled after the ACI surgery as far as what I can do and how soon I can do it but am sure that this time next week, things will be so much better after 3 sessions of PT, use of the Game Ready (I so love that machine), etc.  And I'm hoping that some of the nerve damage and the issue with my extensor hallucis longus muscle is alleviated with PT as well-it's so annoying to not be able to control your toes and the swelling, etc. in the ankle is ridiculous.  Not to mention the fact that my foot feels like it was casted for 6 weeks and the cast just came off-if I don't have socks on at all times, the foot hurts.  The wind, feel of the sheets/blankets, water when taking a shower, etc. all causes the most uncomfortable feeling ever, which I know is from the nerve and muscle issues but still.

As for the shuttle-it was one of my favorite machines in PT.  Prior to surgery, I was up to 280 lbs. double leg, and about 180 lbs. (sometimes more, sometimes less) single leg.  Great for building up quad strength, even more so when you're working on doing jumps w/the added weight!  Something to look forward to!

Thanks again for the reply!  Happy healing!!!!

Beth
6/07-L TTT & LR
6/08-R TTT & LR
6/09-Bilateral ACI
7/10-R derotational femoral & tibial osteotomies, LPFL reconstruction
6/11-L derotational femoral & tibial osteotomies, R hardware removal
1/12-L tibial hardware removed, R scapulectomy
4/12-L femoral hardware removed
7/12-L & R MPFL reconstruction

Offline acheek71

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Re: LPFL reconstruction, derotational tibial osteotomy
« Reply #36 on: July 28, 2010, 03:57:02 AM »
Hello all!!  It has been a while since i have been on here.  I am now 4 weeks post op.  I decided it was time to visit doc again and visit my favorite pt, since my local pt visits have not been up to par.  So I have been down in Gainesville since Monday.  Before I came my ROM was terrible...-7 and 115.  Yesterday was my first day with Alan and between him and doc they got me to 0 and 1
30.  Not gonna lie there was screaming and crying involved, but it got there. 

Doc also took xrays and my leg looks great, almost completely healed at the tibia.  He has now allowed me to go to 50% weight bearing.  It is wonderful but I'm trying to learn how to walk again.  It is completely different.

Saw Alan again today and he got my leg to where it would hyperextend like my good leg and got my bend to 135....with lots of screaming again!  I think he may change his name for tomorrows!!   This has been the worst part yet, but yet the best.  I am so thankful for the opportunity to get to spend time with the whole crew here
in Texas, that I don't want to go back to my Locals.  Just gonna have to push myself more now that I know I can do  it.
« Last Edit: July 28, 2010, 04:03:26 AM by acheek71 »

Offline crankerchick

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Re: LPFL reconstruction, derotational tibial osteotomy
« Reply #37 on: July 28, 2010, 01:42:12 PM »
Just gonna have to push myself more now that I know I can do  it.
^Definitely this!^

I'm happy to read that Alan (who is unequivocally awesome) and the doc (also unequivocally awesome) bent your leg up good (yes I've decided 2 people can both be unequivocally awesome). Even though I'm a gazilion miles away, I knew it would do it, it just needed to be pushed.

Now that you see that your leg isn't going to break, you can step up your game and get it moving!

I can't imagine where my leg would be if I had relied solely on my PT. Thank goodness I was pushing it myself and then eventually fired the PT and got a trainer to get those last few degrees that I couldn't get on my own. Don't be afraid to push your leg, it's not going to break. If doc says you can do it, you can do it!
« Last Edit: July 28, 2010, 01:46:06 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 acheek71

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Re: LPFL reconstruction, derotational tibial osteotomy
« Reply #38 on: August 16, 2010, 08:05:37 PM »
It's been a while so I wanted to update!  Saw Doc today and he officially took the crutches away!  It gas been a rough road, and still have a ways to go but doc has done a magnificent job.  I now HAVE to strengthen the quad!  The incision looks great and I honestly think in a few months it will look even better, almost not noticeable!  Between my magnificent Doc and amazing therapist I think I will be able to live again (and maybe race!!!)  Don't get me wrong I still have a long ways to go, but I know what the end result can be!  So once again thank you!!  And thank you to my cheerleaders!!  You know who you are!!!

Amanda

Offline crankerchick

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Re: LPFL reconstruction, derotational tibial osteotomy
« Reply #39 on: August 16, 2010, 09:19:40 PM »
Well I have to say, I'm a tomboy, so being called a cheerleader doesn't rank high on my to-do list LOL. But I'll take it as a compliment nonetheless.  :)

So, I'm glad to read you are released from the wrath of the crutches. This is awesome and encouraging. Now you can get to more hard core exercises. You will really start to see improvement once you walk on the leg more and do more intense exercises. You are right, it's a long road ahead of you, but look at where you've come from and use that to propel you to where you want to be.

Damn right you've got a magnificent doc! And an amazing therapist! <--- like like like

You sound very positive, hang on to that attitude. Nothing left to do now but to giterdone!
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

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Re: LPFL reconstruction, derotational tibial osteotomy
« Reply #40 on: October 15, 2010, 12:05:22 AM »
Time to bump this thread!  Seems like I deserted my post!  Want to give an update.  I have been waiting for that turning point everyone keeps talking about and I think it's starting!  Did some plyometrics for the first time today and it held up quite well.  Tried skipping, now thats funny! I look like a bird flapping it's wings!  I can do a sQuat without favoring that side, and am in the process of practicing lunges without holding on to anything.  I can lunge forward with the surgery leg, it's the dipping with it that is still giving me fits.  I can also ride the elliptical....which I love!  This is the first time in a year!

I am now 3 1/2 months post op.  I am still having swelling, and some pain under the knee cap, mainly when I do a leg extension from the sitting position.  That really ticks it off!  And alittle pain in the tibia every once in awhile.  It was really bothering me two weeks ago, and I think a screw has backed out some, but since the bump(screw, I think) has shown up, the pain has settled!  Should probably get an xray on that one!  But it relieved the pain!  And I have what looks like bruises where the plates are but I think they are broken blood vessels.  And my knee cap still pops around in the grove every so often, mainly when it's swollen.  It has got much better, with strength.

I am still determined to run again and after this past weekend, I know it's possible.  My husband races motocross and dirt late models.  Well je crashed his car this weekend and my first instinct was to run and make sure he was ok......so I did.  Ok, ok so it started out as a jog then turned into a limpy-walky-jog!  At least it started right!  And my limp is gone most days!  My flexibility is still not there, and my tendon pain behind the knee is there sometimes, but it's getting better!  I am definitely better than I was this time last year!! 

I am getting excited about the future!  Still have a long ways to go and a lot of training, but I know it will be worth it!!

Offline crankerchick

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Re: LPFL reconstruction, derotational tibial osteotomy
« Reply #41 on: October 15, 2010, 03:40:44 AM »
It's about time you updated this thing! I was *this close* to poking you to come and give us an update.

I'm glad to read things are improving in the strength and pain departments and that you are starting to be able to do things that you couldn't do even before the surgery. Just keep on with the strength training and stretching. It all works in hand-in-hand. Things will keep improving in time and with effort, believe that.

Glad to read you are excited for the future. That makes 2 of us! Dirtbike anyone?! ;)
« Last Edit: October 15, 2010, 03:43:17 AM 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 acheek71

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Re: LPFL reconstruction, derotational tibial osteotomy
« Reply #42 on: October 15, 2010, 05:00:12 AM »
Lol......me, me, me!!!!  That will be hopefully next year!  Got to get some amazing knee braces!  Then it's time for someone else to come to Arkansas and take a few lessons!!!

Offline crankerchick

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Re: LPFL reconstruction, derotational tibial osteotomy
« Reply #43 on: October 15, 2010, 05:07:45 AM »
I'm so there! ;D 8)
Mar '07 - plica excision
Oct '09 - femoral + tibial derotational osteotomy & TTT
Aug '10 - hardware removal
"You control your leg. Don't let it control you." -Smart trainer
"Get your a$$ in gear and go for it! Nothing will happen until you make it!" -Smart doctor

drmark

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Re: LPFL reconstruction, derotational tibial osteotomy
« Reply #44 on: October 17, 2010, 02:00:58 AM »
Glad to hear your are doing good.  I was wondering what happened to you.
Perhaps you had gone to a better doctor.















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