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Author Topic: Derotation  (Read 2042 times)

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Offline mellzie22

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Derotation
« on: November 06, 2011, 12:02:24 AM »
Hi everyone!

I have been lurking this site for a couple days and finally decided to register tonight. I have just found out that I need a derotational osteotomy to correct what seems to be miserable malalignment. I am 23 years old and I have known I had twisting in my legs since I was about 6. The docs then said nothing needed to be done because it was causing no problems. I recently graduated from college and started working as a teacher at a residential school for kids with autism. This is a VERY physical job as the school teaches not only academics, but also activities of daily living, recreation and uses physical exercise to diffuse the energy that the kids may use to engage in destructive/maladaptive behaviors. This is causing me a lot of pain. I also have the autoimmune disease lupus (and a couple other ones) and thought that my pain previously was due to lupus arthritis. My blood work shows that the lupus is in remission and thus is not causing my pain. The only other thing left is my rotation.

I have a bilateral external tibial rotation that I know needs to be corrected. On Tuesday I will find out if my femur needs to be derotated as well and anything else that needs to be done. I was hoping to start graduate school in nursing (also very physical) this summer or fall. It seems like everything is going to be put on hold until I figure out what is going on with this surgery. It seems like such a huge and daunting procedure. Is there anyone out there who has had a derotation of their tibia and/or femur and can tell me about it?? Is the 6-12 month recovery period really accurate. I need it done on both legs and the surgeon wants to do one leg at a time. So does this mean that I will be out of work for close to a year?? I'm really overwhelmed with all the information, but I also see no other alternative to fixing my pain.

Thanks so much in advance!

Offline oohheykate

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Re: Derotation
« Reply #1 on: November 06, 2011, 12:45:11 AM »
You should make a post in the patello-femoral joint section. You should get some replies there.

And check the post-op diaries section. There are a few people on here who have had that surgery (crankerchick, wenikio, and Teacher2Many).
« Last Edit: November 06, 2011, 12:49:47 AM by oohheykate »
-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 crankerchick

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    • Derotation osteotomy & TTT Post-op diary
Re: Derotation
« Reply #2 on: November 06, 2011, 05:00:22 AM »
Hi there. As oohheykate said, I had derotation surgery on both femur and tibia of my left leg.  I also had a TTT at the same time.  I had the surgery just over 2 years ago. Like Kate said, you can post over the patellofemoral section, as there a few of us over there that have had the surgery.  You can check out my post-op diary (just click on my name and the link is there).

I would say that recovery did not take 6-12 months for me. I was on crutches for 7 weeks and then from there the sky was the limit.  It took me a while to be able to do sporty activities, but everyday activities was certainly not 6 months. I guess this really depends on both the patient and doctor, as the doctor has the give the ok to do things and the patient has to be willing to put in the work.  My surgeon employs early active motion of the involved limb, including range of motion and strengthening exercises in the recovery room. He has his patients on the stationary bike jut days after surgery. I can say that for me this was huge for getting back to everyday activities and even sports faster than it probably would have been with other surgeons that wanted to put me in a straight leg brace for weeks, and without any real PT for weeks. How long it will take you, therefore, depends on your doctor's protocol, you, and how quickly your body recovers.

For some reason my femur seemed to take a bit longer to recover than I was hoping for, but even still it was not 6-12 months for returning to normal activities.  It was probably 12 months for a "full" recovery, but that also included my second surgery to have the hardware removed at 10 months. I was certainly running and jumping and what not before that point.

The big thing is just making sure you have a surgeon that approaches the rehab with the same mindset as you.  There are different doctors that take different approaches for the same situation.
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 schinz

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Re: Derotation
« Reply #3 on: November 10, 2011, 03:06:15 PM »
Crankerchick...did you ever have the other leg done?  I could be wrong but I thought you had mentioned that the other one needed to be done?  If not, why have you chosen not fix that one?  Thanks.

Offline crankerchick

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Re: Derotation
« Reply #4 on: November 11, 2011, 04:52:02 AM »
Yes, my right leg also has issues, pain mostly but no instability. There is increased anteversion and tibial torsion with surgical indications. The only reason I opted not to fix that leg after the first one was simply that it wasn't unstable and therefore wasn't stopping me from doing things. For so long it as my left leg that was my "bad" knee and the right, while it hurt, wasn't even on the radar. It was only after fixing the left and experiencing the results that i begin to realize how much the right was actually a legitimate problem too. However, I opted to go on and get on with life and things I had put on hold and deal with this leg if it ever got worse with pain or ever became unstable. I have pretty much felt since I started walking after the derotation that having the surgery on my right leg would be worth it if it ever got any worse, and would totally be on the table.  I just wanted to play it by ear and do other things in life at the time.

I forsee a derotation of this leg in the future though. I wouldn't hesitate to do the surgery if it ever got increasingly worse. It's not the surgery, the recovery, or the results that have stopped me, only my own desire to bowl and play basketball and pursue other things that were important to me, more important than more surgery. If anything, the previous surgery results and recovery are what make me more inclined to do it, simply because it has been worth it for the left and would be worth it if the right worsened.

That said, it really kind of sucks because the leg is feeling increasingly more like it is going to be unstable. It hasn't dislocated still, hooray, but the pain seems to come more often and the overall apprehension and feeling of potential instability is happening more and more. I am not ruling out a derotation sooner rather than later at this point, but still have fingers crossed. Life happens, and surgery isn't even really feasible at the moment.
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 NickiAnn

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Re: Derotation
« Reply #5 on: November 11, 2011, 02:35:05 PM »
Melzie:


After years of agonizing over the decision, I finally bit the bullet and had a derotational osteotomy of my left femur and tibia.  I am one week post-op and am journaling my experiences in the post-op diaries section under the heading NickiAnn's Crazy Derotational Osteotomy.  Feel free to check it out if you want to know about my recovery process in order to make your own decisions.  I certainly referred often to other people's diaries, including Crankerchick's before I made my decision.

Nicole
1997 Diagnosed with miserable malalignment
Nov. 2011 Left leg femoral and tibial derotational osteotomies
July 2012 Right leg femoral and tibial derotational osteotomies

Offline belle9

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Re: Derotation
« Reply #6 on: November 12, 2011, 07:45:44 PM »
hi melzie,
i had distal derotation osteotomies of my right femur and right tibia in april this year.  If you want any info you can private message me.  My consultant says i have the largest rotational abnormality he has ever come across and i am something of a fascination at the hospital (its kind of embarassing having everyone come to have a stare!).  I went back for consultation on tues am have made so much progress that i am now on the list to have my left leg done early next year.  I will also be having the plate on my distal tibia out as it is causing pain.  So far i am pretty pleased with the results (thats not to say it hasn't been a pretty rough ride) and am glad i went through with it.  Hoping the next one gets as good a result
belle x
*Mal-alignment issues due to torsion or both femur and tibias
*Derotation osteotomy of right distal femur and distal tibia 12/04/11

Offline mellzie22

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Re: Derotation
« Reply #7 on: November 18, 2011, 01:30:38 AM »
Sorry everyone! I never realized so many people responded to the post (still very new to the site). I will definitely be checking out those post-op diaries.  I have scared away two surgeons in the past couple months and I am going to see my third on Tuesday. Hopefully I will get some answers about the surgery and have some imaging on my hips to see how those are doing.

This is quite a big decision to make and I am really happy that I found this site for some support!

chrissy taylor

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Re: Derotation
« Reply #8 on: November 18, 2011, 07:46:32 PM »
Hi i am from the UK as well in Cheshire where are you located
My problems with my knees started at the age of 16 when I had my 1st dislocation I had numerous dislocation after that up to the age of 24 when I had my knee realigned I did not have any trouble after that till last October when I slipped and dislocated my right knee due to all the trouble I had already had with my knees I had to wait for x-rays before they would put it back into place must have been about 2hrs waiting, I was referred to physio that went ok was discharged then 2 weeks later in march it dislocated again, to cut a long story short Mr Mc Nicolas sent me for a MRI which showed I have a shallow trocheala groove so he decided i needed a trocheala plasty op which was due on the 14 sept but was cancelled on the day as he found out it was not successful and would only last for 3 yrs,
he said he wanted to refer me to another OS Mr Sherry and have more scans and tests so I had a CT scan from my hip to my ankle plus a keyhole investigation which revealed I had a very loss knee and have a twisted femur so I am having it de-rotated  on the 13 dec he said I may need my tibia de-rotated as well but another OS has advised him not to do them both at the same time, When that has all healed I my be having a knee replacement to sort out the tracheala groove and arthritis pain  so I think I have a long road of recovery head of me he thinks it will take about 12 months before I will be walking properly
I am a waitress and have all ready been off work 13 months

Offline Driden

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Re: Derotation
« Reply #9 on: November 19, 2011, 01:02:12 AM »
belle9, your osteotomy cut is toward your ankle?