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Author Topic: derotational osteotomy of the femur  (Read 1298 times)

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Offline hpymomof3

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derotational osteotomy of the femur
« on: January 11, 2011, 12:30:36 AM »
My 15 year old daughter has been suffering with severe knee pain for the past year as well as her knee constantly dislocating.  We finally found out that her femur bone is severely rotated and that is causing her knee not to track correctly.

She is having a derotational osteotomy in two weeks on her femur bone.  I was hoping that someone on this board would be able to answer a few questions.  We have the pre-op appointment with the surgeon in a few days and I'm also trying to think of more questions to ask him.

Right now these are my questions:

How long does the surgery last?  How long should she expect to be non weight bearing?  How long will she need to be on pain medication?  Will she be in a cast or what kind of bandage will she have?  Will she be able to wear regular clothing after surgery such as jeans or will she need to wear shorts or sweat pants? How long until she can return to bowling and karate?

Also what kinds of things would be helpful to have at home for her recovery.  Right now I have a seat for the shower and will get a hand held shower.  Other than that I can't really think of anything else that will be helpful.  I'd appreciate any suggestions.

Offline KneeDoc1

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Re: derotational osteotomy of the femur
« Reply #1 on: January 12, 2011, 05:41:39 PM »
Hi,

I take it by 'dislocating knees' you meant  'dislocating Patellae!! am I right?

Derotational Osteotomy or 'Trochlear reorienting Osteotomy' involves breaking the Femur and fixing it over some metal work. In my practice, I use an intramedullary Nail. Your consultant may choose another appropriate fixation.

To answer your questions:
To an extent it depends on the type of fixation, however the rough figures are, 4 weeks of non weight bearing (we may allow her to toe touch only during that time) Then 4 weeks of partial weight bearing. xrays around this time and if alls well proceed to full weight bearing, depending on the amount of healing seen.

Having a hard cast (POP) depends on your surgeon and the fixation. can wear any type of clothing that suits your daughter.
Once she can weight bear comfortably and confidently, she can return to bowling which at a calculated guess, will be around 2 and half to 3 months. Karate will take longer.

With regards to changes at home, the  Occupational therapy department in your local hospital will be able to advice. You need to discuss with them what is availabe and then they will be able to tell you the necessary changes.

KneeDoc1
The KNEEguru confirms that KneeDoc1 is a Consultant Orthopaedic Surgeon specialising in Knees and Paediatric Orthopaedics.

Offline vlm020

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Re: derotational osteotomy of the femur
« Reply #2 on: January 12, 2011, 07:27:09 PM »
Hi hpymomof3,

Out of interest, what Country are you based in?  I'm trying to find someone in the UK having this type of surgery as it's something I may have to consider myself.

Thanks!

Offline crankerchick

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    • Derotation osteotomy & TTT Post-op diary
Re: derotational osteotomy of the femur
« Reply #3 on: January 18, 2011, 07:51:36 PM »
I'm a bit late seeing this, but thought I'd chime in and share my experience.

I had derotation osteotomy on my femur and tibia along with a TTT. I had internal fixation using plates and screws as opposed to a rod. I was 25# weight bearing for 4 weeks and then allowed to up it to 40#. After 6 weeks I had an x-ray and was released to full weight bearing as tolerated. I went to 1 crutch pretty quickly, but took a while to shake the limp enough to ditch the single crutch.

My surgery took a bit of time for 3 osteotomies at once. It was about 6 hours or so.

How long a person takes pain meds really depends on the person and the doctor to some extent. I had spinal anesthesia and my pain was very well controlled from the start. I took the percoset for I think 5 days or so. I started on 2 every 4 hours in the hospital and weaned down to 1 with a tylenol on I think my second day post op.

I wore regular clothes and showered the next day like a normal person. I had staples though, and found I was most comfortable in loose fitting clothing like sweat pants or athletic shorts in the beginning. I did have compression stockings to wear for the first 10 days so mostly I just wore shorts.

I had regular tape and non-stick bandages on both incisions. My doctor said that I did not need to cover the incisions once the bleeding stopped, but i opted to bandage for a few days anyway, specifically for the femur, because I was worried about the staples catching on my clothing.

She bowls?! Awesome, so do I! She will probably bounce back and return to sports quick at her age. How long before she can return depends on her and her doctor. Specifically, if the doctor gives limitations then she will be restricted as such. Otherwise, it will just be something she will figure out as she goes.

The shower items you've obtained were very helpful for me. I also got a wedge pillow for my back, as sitting/lying was starting to take a toll on my back. I also found the ice regimen using the cryocuff to be helpful and soothing. Bending and "exercising" often, as instructed by my doctor, was very helpful to me. Moving around made my leg feel better, while sitting around not bending it made it feel worse. The meds can do a number on a person so a stool softener and maybe a laxative might be helpful if it comes to that.

That's all I can think of, I'll have to look back at my post-op diary to see if anything else might be helpful to you.

Best wishes for a speedy recovery.
« Last Edit: January 18, 2011, 07:54:50 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