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Author Topic: NickiAnn's Crazy Derotational Osteotomy  (Read 31452 times)

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Offline Lottiefox

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Re: NickiAnn's Crazy Derotational Osteotomy
« Reply #15 on: November 14, 2011, 08:50:14 PM »
Hey,

I am glad that the milestones are being achieved! Good work! I think seeing this as a blip in the bigger longer journey of life is a great way to see it. What a great analogy with the bruise from the IV not having healed yet. I remember burning my little finger really badly (accident with tealight and wooden fireplace and removal in fast time!) - it wasn't bad enough to need hospital treatment but it took SO long to get normal. And thats skin only. When we get our bones chopped up...well, it takes such a long time. You're doing brilliantly. I smiled at flipping onto your stomach and getting stuck there - kind of like a large beetle that needs assistance?!  :P

Ah the English versus British description. Well, I wouldn't mind how someone refers to me. I am British by nationality. Great Britain and all that. But I do come from England so i am more than happy to be called English. I suppose, being politically correct it would be British but hey....just my view!

Yes my foot was chopped up. I had a bunion (long standing from my teenage years) so to correct that they undertake a Scarf osteotomy. This is chopping the bone lengthways and shifting it across, to remove the abnormal angle. But unfortunately I also had bad arthritis in my toe joint. Goodness knows why at 42, but it was totally trashed! Anyway when he corrected the bunion he said he'd try and salvage the joint but it wasn't possible. In that case if you want to be active and do stuff they fuse the joint. I was quite scared at that, but the fusion has been awesome. I have 3 screws and a plate and can't wiggle the big joint of my big toe, only the top bit. Unfortunately I have developed CRPS in the toes, and have had a long and painful recovery. But...I am getting there. So - a mini osteotomy!

Keep up the good work and keep us posted. These diaries are so helpful to people. The good, the bad, the ugly....people get so much from reading things. Plus you'll look back on it and remember so much you'd forgotten. I have a blog from mine!

Take care

Lottie xxx
Bilateral patella OA since 2009, no surgeries.
Euflexxa working well x3 to current
Right forefoot CRPS post fusion surgery 2011
Refusing to let the ailing parts stop me....

Offline jumpi5d

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Re: NickiAnn's Crazy Derotational Osteotomy
« Reply #16 on: November 18, 2011, 01:04:12 AM »
Nicole!!!! I didn't see your posts here until now! I'm so glad you're doing good... and yes its normal to not feel much when you tighten your muscles. It's only been 2 weeks! I remember rolling over in bed the first time. It was such a big deal....until  I couldn't get rolled back over! haha Glad it wasn't just me.  ;)

I'll try to catch up with you sometime this week.

<3 <3
Paige
-Paige

3/5/09 Right Distal Femoral Osteotomy for Patella Alignment 
11/19/09 Left DFO for Patella Alignment.

Offline NickiAnn

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Re: NickiAnn's Crazy Derotational Osteotomy
« Reply #17 on: November 28, 2011, 11:53:42 PM »
I haven't been posting for over a week.  Fortunately my diary hiatus is not because I've been sick but because my computer has been sick!  My faithful laptop that was my bedside companion for my first two weeks of recovery has a terminal illness.  At first, my husband, computer genius extraordinaire, blamed the laptop's symptoms on me.  Apparently laptops get too hot if you use a down pillow for a computer desk and have a cat cozied up on one side and a baby on the other.  How was I supposed to know that these dang computers are so finicky!  As it turns out, though, my husband found out that my laptop has a "hijacker."  Some sort of nefarious virus has been monitoring my every key stroke.  The big computer, the one with the Fort Knox anti-virus software is in our basement and my mom forbade me from crutching down the basement stairs until this week.  When mom is taking care of me, it doesn't matter if I'm 35, I still have to obey her rules!

So I am now over three weeks post-op, coming up on nearly a month.  My recovery is still coming along nicely, and I am overall feeling glad that I made the decision to go ahead with surgery. Do I still have pain?  Yes, I must admit that this is still one sore leg, but I didn't expect it to be any other way.  Still, the pain is manageable.  In fact, at no point in the process have I found the pain unmanageable.  For more than a week I have been getting by on no more than one 600 mg ibuprofen each day.  I only take a narcotic pill once in a great while if I am particularly sore.

I am also starting to take pleasure in looking at my straight leg.  The swelling has gone down quite a bit.  As my sister says, if you only saw the untwisted leg, it would look normal.  The swelling is only apparent when compared with my still twisted leg.  The doctor was also quite pleased with how much my swelling has diminished, and my x-rays look good.  My biggest worry was that my steadily growing baby would have somehow detached my hip hardware.  The little guy is always kicking his little legs right into the place where my femur was broken, and he is turning into a strong little chunk-a-chunk!  I guess Dr. Teitge's engineering is sound because nothing has budged a bit.

Other good things, my range of motion and strength are slowly but steadily improving.  I can now sit on the edge of the bed and do leg extensions.  I can't quite get the leg all the way straight, but that has more to do with a very tight area on the medial side of the knee than it does with strength.  To stretch it out, I loop a belt around my foot and gently pull the whole leg up.  I'm being my own physical therapist!  I can also do small straight leg raises while lying on my back, so that's awesome!  Regarding the very, very tight area on the medial side of the knee, the doctor says the tendons are simply stretched more tautly than they used to be, so I'm guessing they will loosen up in time.  I have been approved to put down about twenty pounds of weight while walking with my crutches, and I can gradually increase as comfort allows.  Doctor thinks it's possible I may ditch crutches by week five, yaay!  At that point, I may try a little physical therapy.

Not all is roses, though.  My shin is still very tender, and the area where the femoral hardware is gets quite sensitive when I have been sitting too long.  Also, when I try to put a little weight on the leg, I can clearly feel where the break in the tibia is.  The doctor says that's very normal, though, and I remember having a similar sensation when I broke my fifth metatarsal a few years ago (and that was just a teeny, tiny, insignificant little bone!)  I'm also very tired.  This is a result of surgery and midnight feedings.  However, I am not nearly as tired as I was when baby was first born.  I guess having an infant puts it all in perspective.

My readers who are considering this surgery may want to know some of the strange things that I didn't anticipate, but make perfect sense.

1.  My whole foot is tender.  Come to think of it, though, it would be weirder if it didn't hurt!
2.  The skin around the incision is numb.  Friends and family who have had surgery tell me this is completely normal.
3.  On the x-rays, the bone is not healing in one smooth vertical column.  There are ledges sticking out.  This is because the shape of the bone is irregular, not a perfect cylinder.  When the bone was rotated, it was like twisting two perfectly aligned triangles so that the corners no longer match up.  This will be o.k., I guess...
4.  I'm starting to get a little depressed being at home all day with not much to do.  I'm an outdoor sunshine junkie, and the only thing that keeps me sane during the grayness of a Michigan winter is brisk walks in the fresh air and keeping busy.  Sitting at home doesn't help much.  My mom bought me a full spectrum lamp to give me a sunshine sensation, so we'll see if it does the trick.
5.  I dream about walking.  I guess that's how much walking and hiking mean to me, which is why I had this surgery in the first place.

So, four weeks is just around the corner and hopefully walking as well!

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

Offline NickiAnn

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Re: NickiAnn's Crazy Derotational Osteotomy
« Reply #18 on: December 06, 2011, 06:11:16 PM »
I shaved my legs for the first time in five months today.  Let me explain.  As my readers may know, I have an infant.  For the last two months of my pregnancy I gave up on any activity that required bending, hence the hairy legs.  After the baby was born, I was lucky to wash my hair, much less shave.  Then the surgery was imminent and I figured I had other things to worry about with my legs than a little hair.  Which brings me to yesterday.  It was the first time in five months that I felt good enough, inspired enough, and rested enough to care.  I must be recovering!  How has my husband felt about the state of my legs?  To be honest, after being pregnant and birthing up his baby, he dared not say a word!  Poor guy!  He has been the soul of patience the past year.

So, I am now approaching the five week mark.  What strikes me the most at this point in the healing process is how the pain has plateaued.  For the first three weeks, every day saw slight reductions in soreness.  Now, it's just kind of gotten stuck.  I can still be relatively comfortable if I take care, but if something hits my hip or I spend too long sitting in one position, ouch!  Strength, however, continues to improve.  I can do very nice straight leg raises and leg extensions, though the tight feeling on the medial side of the knee persists.

I am healing, but it is slow, and by no means feel that I have the energy to return to work.

A few days ago my mom and I went out for a big adventure to Target and the grocery store.  Every time my mom turned left while driving I rolled toward the incision side, and those tissues are still very, very sore.  I managed to crutch around Target for a few minutes, but by the time I got back in the car I was woozy and my shin felt inflamed, tight, and throbbing.  Though I have been avoiding narcotics, that night I felt I had to take a percocet to get comfortable enough to sleep well.  Feeling the way I am, I can't imagine driving forty minutes to work, much less putting on my tailored work clothes. The thought of pulling dress pants or tights over these fresh scars is completely cringe worthy.  The doctor said he would find it reasonable to take as many as 12 weeks off for this surgery.  I believe it. 

My five week anniversary is Thursday, and I am supposed to experiment with more weight bearing.  So far, I have been trying to put more pressure on the leg, but when I do, I believe I can feel soreness at the exact place where the tibia was cut.  Maybe my imagination is contributing to the sensation because I know that the tibia is one of the slowest bones in the body to heal.  Plus, the doctor told me that the plate never completely immobilizes the tibia--there is always micro-movement.  This description gives me the eerie sensation that whenever I step on the leg the ends of the tibia are rubbing together.   I think I will feel more comfortable experimenting with weight bearing if and when I hear my six week x-rays look good.

Emotionally I'm holding up well.  Perhaps the toughest part is the sleep I lose when feeding baby, but this is the road I chose and my husband and I agreed that if I was going to go through with the surgery, I had to stay positive.  Overall I am.  I won't lie, though, after the nanny leaves and baby is crying, my reserves are almost at rock bottom.  I'm afraid that even with my mom's help, my husband's reserves might be bottoming out too.  Still, this is how it is for all new parents and the little guy brings a lot of cheer and distraction too.

Plus, the good news is that he is only waking up once per night for feeding.  For eight weeks, he woke up every two hours!  Hey, I can't complain.  My legs are smooth and I slept for at least six hours last night.  It could be worse!
1997 Diagnosed with miserable malalignment
Nov. 2011 Left leg femoral and tibial derotational osteotomies
July 2012 Right leg femoral and tibial derotational osteotomies

Offline NickiAnn

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Re: NickiAnn's Crazy Derotational Osteotomy
« Reply #19 on: December 18, 2011, 02:29:21 PM »
Six weeks!† I can hardly believe it!† Well, it's becoming apparent that this is the point where I've got to toughen up and "man-up" so to speak.† I knew ahead of time that six weeks is tiny when it comes to healing from a surgery like this, but knowing it and living it are two different things.  I very much want to be all better at this point, but I'm going to have to give my patience a good work out.

When I went for my six week appointment I was hoping to hear that my bones were healed and that I could throw my crutches in the closet until this summer and leg number 2.† Alas, nothing is so simple.† While my femur is nicely healed, my tibia still has a ways to go.† It is healing, but is nowhere near fused.† I have been cleared to walk with one crutch, though, and the doctor says that I can put as much weight on as is comfortable.† Apparently, a little bit of weight bearing will stimulate the healing.† Now the trick is bearing enough weight to get my leg functional without getting totally sore and miserable.†

I definitely feel a sharp area of pain where the tibia is broken whenever I take a step.† But this is just one of many, many pains.† I try not to focus on every little sensation because I knew going in that this surgery would throw the whole leg into a state of catastrophe for weeks, but I need to be honest so that anyone out there considering the surgery knows what they're in for.

When I try to bear weight, I have not only the tibia pain, but also quite a bit of discomfort behind my knee.† The doctor tells me that I could be feeling various tendons stretching or I could be feeling the pointy ends of the screws where they protrude on the other side of the bone (eek!)!† I hope not.† If it is the pointy end of the screws, that means I could be feeling them for quite some time.† I can't quite imagine anatomically how that could be causing pain at the back of the knee, but who knows.† I can only hope that if they are irritating the tissues, then the tissues will somehow toughen up.† † I also have pulling pain around the knee cap when I take a step.† My foot is still touch tender, and the incisions are very sore.† The skin has healed completely but the tissues underneath are very, very traumatized.†

Despite this litany of complaints, I can get comfortable during the day and it's not unbearable.† The worst thing is that I need to get on with my life, but my body's not quite ready.† Mom is leaving this week.† The woman has been a saint to stay with me and manage baby, but it's time for her to go home.† I have the nanny during the day, but there will be two hours each day when baby and I will be home alone.† My plan is to camp out on my bed with diapers handy.† I can hold baby, feed him, and even stand up with him for short periods.† I should be able to keep him comfortable for a short time, but I'm still a little scared.† We will see how it goes, and mom is willing to come back if it's a total disaster.† As it is, though, there have been many, many times that I have entertained baby in be for a couple of hours to give my mom a break, so it should be feasible.

No going back to work until the end of January, which is such a relief....† Crankerchick, if you're still reading, let me say I think you're amazing for going back to work at seven weeks.† I can't imagine it. However, I should mention that I have a forty minute commute, and I'm a teacher at a huge high school.† My job requires me to be on my feet, patrol the halls, write on the board and generally get up and down a thousand times a day.† Hopefully by January I will be much improved.

Hope everyone is having happy holidays.† My family has decided to celebrate with good food and good times rather than gifts this year.† No one has the energy to Christmas shop this December.† Even my handicapped parking permit doesn't give me enough courage to brave the mall this year!† I think it will be enough for me to dress baby in his little red outfit, play scrabble, and sit on the couch looking at the tree.
1997 Diagnosed with miserable malalignment
Nov. 2011 Left leg femoral and tibial derotational osteotomies
July 2012 Right leg femoral and tibial derotational osteotomies

Offline NickiAnn

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Re: NickiAnn's Crazy Derotational Osteotomy
« Reply #20 on: January 09, 2012, 08:25:46 PM »
So it's been a while since I've posted.  Life has been very hectic between managing baby and getting ready to go back to work.  So, some updates.  The week of Christmas marked the eight week point, and I have to admit that this week was a low point for me.  Before surgery, I had told myself that I would be walking by Christmas.  This was the goal that I looked to in the first weeks of recovery.  I guess I based this date on the fact that the doctor's office projected 6-8 weeks on crutches.  Sadly, walking was not on the agenda.  I had been using one crutch, but had actually gotten the tibia area so sore, that I reverted to two crutches for most of Christmas week.  This was definitely a low point for me.

Since Christmas, I have weaned myself down to one crutch again and am now, at week ten, 50/50 between walking unaided and using my crutch.  However when I say walking, I really mean "walking."  I'm more lurching than walking like a regular human being.  I knew that I would have some limp, but I did not anticipate that it would be so severe. I try to analyze why I'm limping, but I can't quite put my finger on it.  There is definitely pain in the tibia when I roll from heel to toe, so it might be that I hesitate to completely flex my foot.  It may just be that the angles are so different that I can't quite adjust.  Sometimes I think it's because my untwisted leg is shorter than the other.  Anyhow, I am no way near normal.

For me, this is the hardest part of the recovery, trying to resume normal life while lurching around like Quasimodo (well, not quite). 

I have started walking in the pool and doing some aquatic exercises under the supervision of a physical therapist.  It feels good to get in the pool and get everything moving.  Plus, I don't limp when I walk in the pool, which is a good feeling!

Next week is my twelve week appointment and I am hoping that x-rays will show that the tibia has joined so that I can feel confident that I'm not hurting anything when I lurch around.

Until then, just trying to practice optimism and set new, more realistic goals.
1997 Diagnosed with miserable malalignment
Nov. 2011 Left leg femoral and tibial derotational osteotomies
July 2012 Right leg femoral and tibial derotational osteotomies

Offline Teacher2Many

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Re: NickiAnn's Crazy Derotational Osteotomy
« Reply #21 on: January 28, 2012, 03:37:56 AM »
Hey Nicole,

Hang in there my dear...things will continue to improve!  I can't imagine being on crutches at 10 weeks-I ditched mine the first time at 6 and this last time at 7 (the delayed healing w/the blood clots kept me on them a week longer than I wanted).  I refused to be on them for more than 6 weeks so at 3 weeks post-op we started putting 30 lbs. of weight through the operative leg, adding 10 additional pounds every 3 days.  If it was sore, I was told to wait to add more but I just kept going.  Crutches, for me, was too confining and limiting and I needed to be back at work with my kiddos which meant no crutches.  Plus I felt that for me, they personally hindered progress and caused other issues from the way I was leaning, etc., etc. 

PT was started at 10 days post-op both times around, which was a great help.  Stim, stretching, quad sets, SLR, short arc quads, long arc quads, etc., etc., etc.  Plus I have a stim machine at home from a past surgery so those muscles were getting extra shock!

As for the abnormal gait pattern, it won't fully go away until the plate comes out.  For some reason, the plate seems to interfere with the muscle conductivity and strengthening.  I thought this was just an idea I had (after the R plate came out this past summer when the L plates were put in), I was able to do a single leg stance perfectly, and it was so difficult prior to removing those plates, at 11 months post-op.

I consulted with a local doc here about getting the femoral plate out, who also does this crazy surgeries.  I told him my thoughts behind it (the muscle aspect and the pain) and he totally agreed that the plates interefere with normal gait patterns, muscle strength, etc. and as soon as it's out, things are so much better!  I'm 7 months post-op and still limping, although not as badly as before, all because those muscles aren't strengthening and firing like they should. 

So, advice:  keep pushing to be able to walk without that crutch, even if it means with a bit of a limp/lean!  Determination is the biggest motivation.  I was bound and determined to get to jumping again and there was fear by both my PT and OS in Chicago as the bones weren't healing but we started slowly and really got things moving with that aspect.  New goal:  running by the end of summer!

And talk to your PT about the tibial pain...maybe they can do some active release on different muscles to see if that helps at all.  There might be some IT band tightness which can feel like tibial pain and Dr. T has told me numerous times that the IT band can cause a bunch of issues after this surgery.

Happy healing...let me know how your 12 week appt. goes!

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 NickiAnn

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Re: NickiAnn's Crazy Derotational Osteotomy
« Reply #22 on: February 10, 2012, 12:27:42 AM »
My new mantra:† This is a year long recovery.† This is a year long recovery.† Repeat as many times as necessary to stop the "Oh my god what have I done to my leg?!" thoughts.

So, haven't posted in a while as I have returned to teaching full time and am now a working mom who just happens to have had massive orthopedic surgery.† I will try to briefly describe how the last few weeks have gone while I have a precious free moment.†

As of my eleven week appointment back in January, my tibia was still not fully healed though my femur was fully joined.† Doctor did not seem very surprised, and after reading up on how stubborn the tibia can be, I guess I'm not unduly surprised either.† Today, I am fourteen weeks out, and I'm guessing the tibia has made some progress because I am noticing diminished pain in the area.† Unfortunately, while the tibia pain is reduced, other pain has surfaced.

Going back to work was a huge adjustment.† At home, I felt that I was recovering well, but as soon as I got on my feet all day and started walking the long hallways at the high school where I teach, all thought that I was getting back to normal flew out the window.† While the bone breaks are not troubling me anymore, my joints are--and that's scary.† I have quite a bit of knee pain on the medial side and some pain behind my knee.† I also have sharp pain just to the front of the hip joint.† To top things off, my still twisted leg is giving me grief.† I suspect it is starting to resent carrying more than its fair share of the load, and the knee is up to its old tricks.

So, I am hoping that the joint pain I feel is the result of temporary adjustment pains as the tendons and ligaments protest their new position.† I know that my muscles are far weaker than normal, so perhaps tendons and such are screaming at having to take so much of the burden to keep me walking?† Anyhow, I can't say that I am completely crutch free.† I don't use my crutch at home, nor in my classroom, but when I need to make to the other side of the school, it just hurts too bad to do it without the crutch.† I've tried.

As far as my limp goes, it's not a lurch anymore, but is still very noticeable.† My first week back to work I could get very little done, so many people were stopping to ask me what the heck happened.† It's a hard surgery to explain, so I've just been saying it was a complete leg overhaul.

As some readers know, I got kind of trapped between my biological clock and my† bad knees last year.† So, I knew that if I wanted to do this surgery in my 30s, now was the time, while my baby is still a teeny little guy who has limited mobility.† I have been making the best of the situation, but one unhappy reality is that† †physical therapy is impossible for me right now.† I have no free time.† So, I am trying to be as active as possible at home.† I make my self go up the stairs with my good leg and my bad leg.† I doing pretty well with that, but every time the muscles in the thigh move I can feel them catch on the plate.† Not painful, but creepy!† I am also starting to do lunges with the bad leg.† Other than that, I put baby on my lap and we both do leg extensions.† He thinks it's hilarious.

So, I'm just trying to patiently hold out and not dwell on the pain.† After all, I'm still early in the process, and it is a year long recovery.

Nice to hear from you, Beth.  I am keeping in mind what you said about the plate affecting gait.  I will wishing you lots of long runs this summer.  My new goal is to take a walk by spring break.
1997 Diagnosed with miserable malalignment
Nov. 2011 Left leg femoral and tibial derotational osteotomies
July 2012 Right leg femoral and tibial derotational osteotomies

Offline Teacher2Many

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Re: NickiAnn's Crazy Derotational Osteotomy
« Reply #23 on: February 10, 2012, 02:03:07 AM »
Hi Nicole,

After I got home from PT I thought to send you a message to see how you were doing with heading back to work!  Iím very surprised to hear that they let you back on crutches, even if you only use them to get to the other end of the building.  They wouldnít even let me back to work here with a sling to use for comfort after my shoulder surgery; if you canít perform all your duties independently without braces, crutches, slings, etc. you canít come back (probably a bit liability on their end and I get that but it makes it harder when youíre stuck at home longing to be back with your kiddos).  Returning to work always is a major adjustment but is usually the best one to make as it keeps you more active and gets things moving.  As hard as it was for me to go back to work at a mere 8 weeks post-op (especially this past summer after both hips and knees being worked on, the nerve damage, and blood clot issue), it was the most beneficial as well.  I am quite stubborn at work and insist on doing for my kids what they need, even if it means getting down on the floor to play with them, transfer them from one area to another, etc.  It just takes me a bit longer!

The issues you describe with the new found knee pain are not uncommon and will be resolved when the hardware is removed.  It makes such a huge difference!  My tibial plate was taken out in early January when part of my scapula was surgically removed and that never-ending aching and sharp pain that I was feeling that was being blamed on the plate and screws was gone the next day.  I too had the catching on the femoral plate as well after the first surgery; it was so bad that my surgeons contemplated the thought that my hip was dislocating but luckily for me, active x-ray should that wasnít the case.  Dr. T said he never saw (yes, you could see the jump in tendons, as well as feeling them jump) it that bad and as soon as that plate came out at 11 months post-op, that was gone too.  Luckily for me, that issue didn't surface this past summer but many other ones took its place.

I totally understand the frustration with the tibia not healing.  They donít usually consider it a true non-union until 12 months post-op (at least from what I read).  My tibia didnít completely heal after the first surgery until 9.5 months post-op.  This time, it seemed much better as they took out the plate 2 weeks shy of 6 months post-op.  But I know Dr. T did some extra steps with this surgery to compress the bones prior to inserting the plate and screws to give it a little extra Ďhelpí with healing quickly, knowing how long it took last time and all the pain it caused.

PT is a mustÖI was going 5 days/week after the first set of derotational osteotomies (3 days a week of regular, aggressive PT and 2 days a week of ART).  If you canít squeeze in formal PT due to your little one at home (although must clinics have evening appts. but that might depend on location-here they can get you in as late as 7:30 pm), look into a gym that offers childcare and maybe one that has a personal trainer that you can meet with at the start of every week to get a protocol of things to do there during the week.  Sounds like you need some IT band work to help with the plate catching among other things; Iíd even recommend some kinesio taping as well as that helped with the catching on my femoral plate.  It is a lifesaver and makes a world of difference with recovery.  Maybe you can even do PT on SaturdayÖone day a week isnít all that helpful but it could give you the guidance to then carry out exercises in the gym a few other days during the week.

If I could help in any way or if you just need to vent on those really bad days, know that Iím here and totally get it after having gone around this specific block twice and even more when you consider the 16 different knee/hip surgical incisions/procedures Iíve had over the last 4.5 years! 

Happy walking over spring breakÖmaybe Iíll even be able to do a light job around Ĺ the block!

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 Leeno

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Re: NickiAnn's Crazy Derotational Osteotomy
« Reply #24 on: March 15, 2012, 09:33:48 PM »
Hi, I was doing research on tibial rotational osteotomy and found your blog.† NickiAnn, I canít thank you enough for blogging your experience!

I have been on a healing/holistic journey of sorts for the past 4 years and part of that is healing the emotions of the past. Well, something came to my attention, out of the blue, which I believe may have had a huge impact in my life and I never knew about it in depth until recently.

When I was around 14 months old my feet turned inward and if my research is correct, I had a tibial rotational osteotomy. I asked The Pediatric Orthopaedic Society of North America what they thought I had and this was their guess. Both my parents are deceased so I canít ask about the details, but I remember hearing when I was growing up that when I was a baby, they crushed or cracked the bones in my legs and straightened them and I had to be in casts for a while. I asked my sister about this who was 7 at the time and she said she remembers it was summer and I was SO uncomfortable and crying ALL the time. My father was so upset, he wanted them to remove the casts but I doubt they would let that happen, especially after reading your blog and others who posted who said you must be very gentle with the legs for a while.† She thinks they may have been on for 3 months.† (Her memory is very vague because she was just a child herself.)

This sounds very similar to what I am reading in yours and the others posts. I really want to know what I experienced at that time in my life. As a baby getting ready to cruise or possibly even walk, this must have been such a trama on my mind and body. I canít help thinking, I was so young and in the stage where this must have really been confusing and frustrating since I could not speak, could not move and on some level I must have thought my body is not supporting what my brain is telling it to do.† Talk about not trusting oneís body! I have two young children and the thought of them going through such a barbaric treatment at that age is unthinkable. (thanks for using that word in one of your postsóthatís what it reminds me of too.) What I found is that this kind of surgery was performed a lot in the 1960ís (I was born in 1963) but that they do not perform them anymore in babies because they usually outgrow it or if not they wait until they are at least 8 years old before even thinking of surgery.

NickiAnn, I think your mom was a very smart woman to keep you from doing this surgery too young. It is different because YOU made the choice WHEN you were ready.† My parents did it because they were immigrants who trusted what the good American doctor was telling them, but from what my sister remembers, they were very sorry they allowed it to happen. I donít think anyone was prepared.

Anyway,† thank you for letting me share my story. If you or anyone else who would like to share what you suspect it may have been like for me all those years ago.† Time frame for healing, delays, sensations, how long the casts were on, pt, etc.. anything at all, I would love to hear. I read the first 5 or 6 posts but couldnít read all of themósorryóI am blind in one eye and canít stare at a computer screen for too long.

Thanks so much (and to others who shared their stories)! I hope you are feeling much better now!!:)

Offline NickiAnn

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Re: NickiAnn's Crazy Derotational Osteotomy
« Reply #25 on: April 15, 2012, 03:16:17 PM »
First, Leeno, as the mother of an eight month old, it is unimaginable to think of subjecting a baby to this surgery.  It is very traumatic on the body, and, yes, usually babies do grow out of it.  It's unusual for rotational issues to persist to adulthood, though, it does happen--I'm proof!

I hope that your surgery has not left you with any lasting difficulties and that the trauma is now a thing of the distant past!  Thank you for posting, and I will be sure to tell my mom what you said.

So, I am now almost six months post-op, and the  biggest take away is that recovery for this surgery is measured in months not weeks.  I knew that intellectually beforehand, but I didn't really understand what that meant as I kept waiting to turn big corners at twelve weeks and sixteen weeks, etc.  Only now at nearly six months do I truly feel that I am making progress. 

Anyhow, I still have a bit of a limp, especially at the end of the day when I get tired.  The pain in my tibia is gone completely, other than a bit of soreness around the site of the screws and plate.  At my last appointment it appeared that my bones were completely healed.  The area up  by the femoral plate is still tender, and I can't wait for that plate to come out.  It is creepy, creepy, creepy.  Every time those muscles flex I can feel the little click of them moving over the plate.

My knee pain is diminishing somewhat, but it's still twingy depending on the day.  The doctor says that the knee is just taking a beating because all the surrounding muscles are so weak.  I believe this theory because the leg is noticeably less bulky than the still twisted one.  The biggest area of pain though is right at the front of the hip joint.  I feel a sharp pain there when I take weight on and off.  It gets worse the more I walk, but is very responsive to ibuprofen.  The doc seems to think it's just adjustment pains.

Teacher to Many, I totally hear you on the importance of physio, but, alas, my time is very, very limited.  I did, however, find a personal trainer to work with me twice a week for a half hour.  I wasn't particularly impressed with the quality of the therapists near my house, but I am very happy with the trainer.  He's has great ideas to get me fit.  Mainly, we work on balance and stability to strengthen the muscles around the joints.  We do work on the exercise ball and with resistance bands.  But, the most exercise I get is of course carrying baby up and down the stairs!

My biggest accomplishment to date, though, is taking half hour, one mile walks. 

So, I will soon need to decide if I'm going to have my other leg untwisted in July.  It will not be an easy decision!
1997 Diagnosed with miserable malalignment
Nov. 2011 Left leg femoral and tibial derotational osteotomies
July 2012 Right leg femoral and tibial derotational osteotomies

Offline guam

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Re: NickiAnn's Crazy Derotational Osteotomy
« Reply #26 on: April 21, 2012, 03:53:20 AM »
Totally feel you on healing in terms of months, not weeks.  It gets so frustrating to do 2 hours a day of therapy for a week and not feel like you've made any improvements. Then, all of a sudden, without any therapy or exercise, it just feels better.  Then, you hit a bad day.  Ah, the joys of a healing knee.
My favorite exercises right now are swimming, stationary bike, and elliptical.  I feel they are fairly practical exercises.  Although, I should really do more with bands, stepper, and bosu ball.  Basically, stability exercises.
Keep it up and good luck on your recovery
9/2007: diagnosis: discoid lat. meniscus with tear-rk
10/2007: part. lat. menisectomy-rk.- failure
5/2008: fix previous surgery
2/2010: diagnosed with discoid lat. meniscus with tear-lk
5/2010: partial lat. meniscectomy-lk
11/2011: scope on rt. knee. diagnosis: varus knee
12/2011: HTO

Offline JoJo1

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Re: NickiAnn's Crazy Derotational Osteotomy
« Reply #27 on: April 22, 2012, 05:29:57 AM »
Hi Nicki, you are sooo brave to go through all that. I also have miserable malalignment, so reading your diary is helping me a lot. Im still searching for a dr. Problem is every doctor I talk to has a different approach and thats making me so confused.
Have you or anyone on this forum ever heard of someone who had both legs done at the same time? Is this even possible? I can't figure out , specially after reading your diary, how one could even do normal things like having a shower or going to the bathroom with both legs done, its hard enough with only one, but yes, I was given this as an option.
Please please do keep posting, I hope you go back to 100% before july so you can do your other leg. You are indeed a superwoman!
Chris

Offline NickiAnn

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Re: NickiAnn's Crazy Derotational Osteotomy
« Reply #28 on: April 27, 2012, 01:27:00 AM »
Jojo

I do not think it is possible to do both legs at once. Since you can only put toe touch weight on the operative leg for six weeks, you are completely right in thinking that it would be impossible to bathe etc.† Plus, being bed ridden like this would open you up to a much higher risk of blood clot.† To be Honest, I would distrust any doctor who would suggest otherwise!† Im glad you find my story helpful and please let me know if I can offer any other insight.† This condition can feel lonely sometimes.
1997 Diagnosed with miserable malalignment
Nov. 2011 Left leg femoral and tibial derotational osteotomies
July 2012 Right leg femoral and tibial derotational osteotomies

Offline wenikio

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Re: NickiAnn's Crazy Derotational Osteotomy
« Reply #29 on: May 15, 2012, 02:33:11 AM »
Hey Nicki,

I just sent you an email, but I thought I'd put a quick post here on your diary too- keep up the good work! Everything you've said so far in your post-op journal sounds very familiar. As frustrating, painful, and tedious as they've been, I don't have the faintest regret regarding my derotations. As I said in the email, my first derotated leg is 100% pain free and functional. It's been over a year since it was done and I still notice improvements.

I'm in week 24 post op for my second leg, and while that sounds like a lot of time, you understand that in the grand scheme of things, it's not. By this point in my first surgery, the bone was healed. This time around, the tibia is not. I was devastated to learn that I'd have to wait several months more before having the hardware removed because the pain and limitations are wearing me down. I have another xray in a few weeks to reassess for hardware removal, and you'd better believe my fingers, toes, and eyes are crossed for the bone to be completely ossified! I've been taking Citracal and multivitamins religiously :) So I hear you- it's a helpless feeling waiting for the bones to heal. It gets better though!

It sounds like you understand that your leg will continue to recover for 2 years, so you know that if/when you get your other leg fixed, the first will still be healing. Don't let that discourage you. I had my second done three months after the hardware was removed from the first. When all is said and done, it will have been 4 major surgeries in about 15 months, so I'm here to say it's doable (sucky... but doable). Sounds like you've got good family support!

Thanks for keeping your post op journal. I'm sure you're helping others going through the process, and it's validating for those of us having gone or currently going through the process :)
'97-'02  -  4 Left knee surgeries (plica removal, meniscal tear, LR, & TTT) & 3 Right knee surgeries (plica removal, meniscal tear, & LR)

3/11 -  Left fem. & tib. derotational osteotomies, TTT, LPFLr

12/11 - Right fem. & tib. DRO's, TTT, M&LPFLr's















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