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Author Topic: NickiAnn's Crazy Derotational Osteotomy  (Read 31453 times)

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Offline NickiAnn

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Re: NickiAnn's Crazy Derotational Osteotomy
« Reply #30 on: July 30, 2012, 01:56:56 AM »
My baby is pulling himself up, cruising around the room while holding onto furniture, and treating my walker like a jungle gym.  Yes, I said walker because I am now two weeks post-op on my second femoral and tibial derotational osteotomy.

This second decision was just as difficult as the first.  My left leg which was derotated in November 2011 is still in recovery, so I had to think long and hard about compromising my right leg.  Finally, I decided that while my left leg isn't perfect, I figured it was good enough to bite the bullet and get this show on the road.  My goal is straight, metal free legs by the summer of 2013, and maybe, just maybe, a second baby by summer of 2014!   

My more cautious loved ones were of course concerned about me having the second operation before I was completely able to evaluate the effectiveness of the first, but my personal timeline and biological clock had to play a role in the decision.  Also, after careful consideration of my progress thus far, I think that odds are in my favor that the legs will feel great once the hardware is out and a couple of years go by.

First, the left leg which is now 9 months post-op.  Since I haven't updated in a few months, let me summarize:

April (6 months post-op)-This is the month that I started to feel more normal and began taking short walks.

 May--Continuing short walks.  Shopping and running errands as much as I like, carrying baby up and down the steps a million time per day.  My biggest complaint continues to be a sharp pain in the front of the hip that is exacerbated when taking weight on and off.  It bugs me when I take my walks, but I push through and walk my mile anyways.
 
June--Doing as much yard work and housework as I want.  My continuing complaint is the sharp pain at the front of the hip.  Short strides around the yard don't aggravate the hip nearly as much as the long strides I take when walking around the neighborhood.  Also, hip continues to be stiff when I stand up after sitting.  Sometimes I feel that the sharp hip pain alleviates the more I walk and warm-up, but as my baby won't tolerate being in the stroller more than about a mile, I can't really test the theory.  I take occasional ibuprofen to help with the hip issues and find it very effective.

July--Hip pain still my issue, but I feel that overall the leg is stronger. Still have a slight limp--not too bad--more an ambulatory stutter.   I hypothesize that if I go through with the July 18th surgery, the left leg will hold me and that pain meds for the right leg will help with any residual left leg pain.  Which brings me to....

Today, July 29th!  Here I sit with my newly straight right leg. It's almost nine in the evening, and I am getting ready to take my percoset.  Have weaned myself off the narcotics during the day, but now that I am no longer nursing baby at night, I have decided not to be a martyr to the nocturnal pain.  Baby's bedtime means it's mommy's time to get loopy and comfy.  By the time my poor, exhausted hubby comes up the steps I should be tucked into bed and giggling softly at the bright colors on the t.v.

More later on the benefits I have noticed from my straight left leg and my next challenge--going downstairs on crutches...           
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 #31 on: July 30, 2012, 02:33:39 AM »
Nicole,

Funny, I had popped onto KneeGeeks earlier today to see if there were any updates on you!  Glad to hear you went ahead with the other leg; not an easy decision to make but one that you will be grateful having made in about six months.  Surprised to hear you went the walker route vs. crutches, only because I find the walkers to be less supportive (not to mention worse on your back from 'hunching' over).  But then again, I am an old pro on crutches so anything out of the norm can take a while to get used to.

Hoping for a speedy recovery for you...only 4 more weeks till you can ditch the walker (if not sooner), return to work, and carry on with resuming a normal, pain-free, and straight leg lifestyle!

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 #32 on: July 30, 2012, 03:03:34 PM »
Hey Beth!

So nice to know that someone out there is thinking of me!  I only use the walker for the first couple of weeks post-op because I am pretty weak and I feel it provides me with a little more stability.  I have already started using my crutches most of the time.  However, I think my balance still needs to improve, so at night, when I get really tired, I switch to the walker.  Overall, I much prefer the crutches, though, and find them far less cumbersome than the walker.

Hope your summer is going well and you're able to become more active.  I know that you still face another surgery to correct the ligaments around the knee.  You said you were anticipating this type of procedure, but I'm sure that it's still difficult to face another surgery, expected or not.

I don't know how you have coped so well with repeated procedures.  I know that I am much more prone to the blues this second time around because I am getting fed up with lack of mobility.  It had felt so good the past month to be home with baby, walking and working in the yard, albeit with some hip pain.  After months of recovery from the first operation, I was finally feeling almost normal.  It's been a real drag on my spirits to be laid  up again.

Any tips on staying upbeat?

Before I had decided to take the chance on the osteotomy surgery, I was so curious to know what it would feel like to have straight legs. I'm sure that many people who are also struggling with rotational abnormalities are curious as well, so I will describe some of the benefits I've noticed this past year while getting around.  It had been interesting to notice the differences between the straight left leg and the the formerly crooked right leg.

When walking, I noticed that my left leg felt much more efficient than the right.  It rolls in a straight line from heel to toe when I take a step.  Whereas my previously wonky right leg seemed always to be pulling my stride outwards.  This past year I have noticed that when I was walking with a straight left leg and a rotated right leg, I was very prone to tripping over my right foot.  It always seemed to be in the way.

Also, when I go up the stairs, my left leg didn't seem to need to work as hard as the right.  I feel that when the plate comes out, and I no longer have the icky feeling of the muscle catching on the metal, doing activity that  requires some muscular strength will actually require less effort than it ever has before.  After all, there's a reason why it was always hard to keep up with my straight legged friends on hikes; my legs just weren't working as efficiently.  Moreover, when I went swimming over the summer, I could feel that my straight left leg was catching the water and propelling me forward much better than the right. 

The difference in my swimming was hugely satisfying.  When my knees started hurting over a decade ago, I took up swimming, hoping that I could excel in the water in a way that I could never manage on land.  I even joined a swim club so that I could take part in organized practices.  However, I was always frustrated because no matter how hard I trained or worked on technique, I could never keep up with my teammates.  I knew that the weakness was in my legs because my slowness was especially noticeable when I did kick laps with the kick board.  Finally, one day I was practicing at the local university at the same time that the swim team was using the other side of the pool.  The swim coach had some spare time, and I asked him to evaluate my kick.  He said that technically I was doing everything right, but my kick somehow lacked power.  I was almost certain that my crooked legs were once again the culprit.

So, I certainly noticed some big differences between the function of my straight leg and my crooked leg.  If the aches and pains of surgery end up going away, I will be starting a new chapter of life.
1997 Diagnosed with miserable malalignment
Nov. 2011 Left leg femoral and tibial derotational osteotomies
July 2012 Right leg femoral and tibial derotational osteotomies

Offline joanfan123

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Re: NickiAnn's Crazy Derotational Osteotomy
« Reply #33 on: July 30, 2012, 10:11:29 PM »
Hi,

I am 16 and after years of pain I was recently diagnosed with internal rotation. I always thought even after I get my knees fix I will never be able to keep up with other people when it came to sports. Your post gives me a little hope I won't always be as un-athletic as I am now.

Joan
May '10- PT LK
June '11- PT LK
October '11- Cortisone LK
11/8/11- Arthroscope Fat Pad trimmed LK

Offline Teacher2Many

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Re: NickiAnn's Crazy Derotational Osteotomy
« Reply #34 on: July 30, 2012, 10:24:45 PM »
Nicole,

I know all too well the vicious cycle of surgery, then recovery, then surgery, then recovery.  Thus has been my life for the past 6 years, with 22 surgical procedures done within that time frame and 9 of them done in the last 13 months!

I think the tip to staying upbeat is to do everything you normally do!  I have tried really hard not to let any of the surgeries get me down in regards to activity, etc.  Granted, I may not be able to do everything as fluidly or as quickly but I don't give in to the fact that "I can't do that right now until I've healed".  It is nice to have help with certain things (right now, it's getting both of my legs in/out of bed due to the bilateral knee braces) but I can also do it independently.  I went back to grad school 2 weeks after the last major derotational surgery (would have gone back at 1 week post-op but wanted to wait an additional week due to the nerve damage and blood clots), have always been back to work to start the school year after every surgery, which not only is good for self-esteem but what better form of daily PT could there be.  I ditch the crutches as soon as I can and hobble along with a limp and pain, as I know it will eventually go away but for me, I always felt the longer I stayed with crutches, the harder it would be to ditch them. 

I've been on the floor with my twin nephews after surgery, shopping two weeks after, visiting the zoo, sitting outside, walking around, etc.  True, there are things you simpy can't do but for the most part, I try just about everything and just know it will take me longer to do it and might be more painful than not.  Plus you have to really relish in the little joys.  I remember the first time I was able to actively dorsiflex my left foot to neutral (about 5 months post-op).  I was thrilled-I e-mailed all of my surgeons at the restaurant that I was meeting my friend at for dinner, as I just came from PT and had to share the wonderful news.

And when all else fails, stock up on old comedies on DVD to add some laughter to your day!  Helps pass those days when progress isn't as notable, when you are having a little pity party, and when the pain is a bit too much because you pushed too hard-just know the next day you push, the pain won't be as bad!

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 #35 on: August 08, 2012, 06:58:39 PM »
I went for my three week check up and x-rays yesterday, and I got some good news.  I really needed some good news as I was getting pretty discouraged about this whole osteotomy business.  Of course, only being three weeks post-op, my right leg is still very sore, but it's the continuing soreness in the left leg that is the most psychologically troubling.  I have had moments when I have said to myself, "What the heck have I done?"  I really needed some encouragement, so I was delighted to hear that my tibia will probably join much faster with this surgery than it did with my previous one.  My surgeon explained that it is extraordinarily difficult and tedious to simultaneously secure the tibia with plates (creating enough pressure to mash the bone ends together) while maintaining the appropriate rotation.  Every time he does this surgery he gets a slightly different outcome. 

This time, the outcome was excellent.  My tibia is very firmly joined, and I have already been cleared to do some weight bearing.  He thinks there is a great chance that I might be off crutches as six weeks.  That would be amazing.  Hopefully, if I can get walking sooner, my muscles won't atrophy as much and my limp won't be so extreme for so long.  Yaay!

Joan--It's rough not being able to participate in all the athletic activities that your friends enjoy.  If you've read my diary, you know that my leg issues were always in the background of my life.  I'm just starting to see a little bit of the benefit of my surgery, but I by no means know what the final outcome will be.  I will keep posting periodically as I continue healing over the next couple of years so that people debating surgery can get the long-term outcome.  Luckily for you, Joan, you are young enough that as long as the pain and activity level is manageable, you can take some time to make your decision.  Good luck!
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 #36 on: August 08, 2012, 07:07:13 PM »
Nicole,

Great news indeed!  My first osteotomy that Dr. T did on the right side ended up with a non-union of the tibia for at least 9 months; not even sure it was fully healed when he took the hardeware out at 11 months while untwisting the left side.  When he did the left side, he tweaked the procedure a bit to add extra pressure (which also meant some extra incisions as I believe it was with external fixation) to get a better fit of the two bones and then added the screws and plate and then removed the external fixation.  Needless to say, no problems with the non-union that time around (although think I'd rather have the non-union than all the other issues that came with that surgery but I don't regret any of it)!

I was weight bearing with both of the derotational surgeries at 3 weeks (although last time I was touch toe weight bearing from day 3 post-op)-Dr. T had me initially at 20 lbs. and the increasing it about 10 lbs. every 3 days as tolerated and if it got too sore, hold off on the increase for another 3 days.  I was full weight bearing and off crutches by 5-6 weeks both times, even with the nerve damage and blood clots last year, so hopefully you will be too!  And it's such a great feeling to not need them!

Can't remember...did he remove your hardware from the first surgery when he untwisted your other leg?

Here's to continued improvements!!!

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 #37 on: September 05, 2012, 02:48:15 PM »
Well I am now seven weeks post-op from my second leg "untwisting" surgery.  The good news is that when I am in my house or doing short bouts of walking I am crutch free.  When I have to do longer amounts of walking, like from a parking lot into a store, I am using one crutch.  This week I have even started carrying baby around a bit!  This was a huge accomplishment because he's now about 25 pounds and getting heavier every day!

At five weeks post-op I started using one crutch, and began dropping it altogether six weeks out.  I am way ahead in terms of mobility and swelling than I was at this point when I had my left leg fixed in November 2011.  In good measure, my more rapid progression to crutch free walking is due to my surgeon achieving a very firm fix on my tibia. 

In fact, yesterday, I had seven week x-rays, and they looked so good that my surgeon said I needn't come back for any follow up visits until I'm ready for my hardware removal this summer.  Yipee!  I can do without the two hour drive to his office!

Overall, the right leg has been much easier that the left, even in the initial post-op days. I was rereading this diary and laughed to see that I described my left leg as an "overstuffed kielbasa"  right after the surgery.  The right never swelled that badly.  Also, the first time I put weight on it, it didn't feel as odd or weak as the left did.  I regained my flexibility and strength much faster too.  Definitely, my right leg has been my easy leg.  Well...if you can every call a surgery of this magnitude easy...

I have been racking my brain to figure out what's different this time around.  My surgeon says it's impossible to know for sure why the right leg has gone better, but he believes that the better joining of my tibia has led to less of an inflammatory response.  Also, my baby was so much older this time.  I was still somewhat recovering from childbirth the first time around and was insanely sleep deprived.  Finally, and maybe this is crucial, the first surgery, the nurses did not put me on the CPM machine until the second night.  This time, three hours after surgery, my leg was up in the machine, and it stayed in machine all night long.  Maybe this made a big difference?  I know that even in the hospital within 48 hours of surgery, I was able to bend my operative leg quite a bit.  One other thing...  Despite the fact that my surgeon aimed to make my legs match, my right leg seems to out-toe more than my left.  It seems that the internal correction to my tibia isn't quite as pronounced as on the left.  My surgeon says that sometimes just as he's putting the last couple of screws into the hardware the bone will slip from its perfectly calibrated alignment a tiny bit.  He doesn't remember that happening during my operation, but it must have because I am not an exact match.  But, I'm wondering if slightly less correction yielded less overall trauma to my leg?

Pain wise, I am still very sore.  As far as medication goes, I take a little bit of ibuprofen during the day, as needed.  At night, I take ibuprofen and half a percoset.  I could probably make it without the percoset, but I find that I am sore enough at night that it's hard to get nice and comfortable.  The little bit of narcotic helps my body relax so that I can get a good night's sleep and not thrash around all night looking for a good sleeping position.

While I am so happy to start limping around my house and yard, my continuing complaint is the sharp pain at the front of my left hip when I take weight on and off.  I had so hoped that by ten months post-op, my left leg would be finished with its griping. Also, in addition to the sharp pain at the front of the hip, my left ankle gets very sore after I do some walking, especially when I am using my crutch and leaning heavily on the left.  This is a continuation of the ankle soreness I had in my left leg since the surgery; it never went away fully.

 I asked my surgeon if hardware removal would help the pain in my left hip, and he was a bit ambiguous.  While it's not impossible, it seems that hardware removal is more helpful for lateral hip pain.  He did say, though, that the front of hip pain would most likely resolve at some point regardless of the hardware, and that sometimes it takes a couple of years...  Sigh...  I hope I won't have similar pain on the right.  It's still too soon to tell as that pain wasn't really apparent until I started trying to resume normal exercise.  Nevertheless, there are improvements on my left leg.  As the weeks have gone by, my left knee feels better and better and is now virtually pain free.

So, today it's off to the garden shop so that I can buy some seeds.  I'm hoping to hobble out to the garden and put in the cool weather lettuces tomorrow as we are supposed to have glorious pre-fall weather.  I will be going back to teaching in October and I am trying to make the most of the fact that my recovery is going a bit better this time, and enjoy my extended summer.

Best wishes to all, and I will most likely update again in a few weeks after I have tested this new leg out at work.

P.S. Caught a glimpse of myself in a plate glass window as I walked into a department store.  I couldn't believe how straight my stride was, even with the small amount of out-toeing I still have on my right, the improvement was remarkable.  After living 36 years with my trademark duck walk, I could barely recognize the girl in the reflection.  That felt pretty darn good.
1997 Diagnosed with miserable malalignment
Nov. 2011 Left leg femoral and tibial derotational osteotomies
July 2012 Right leg femoral and tibial derotational osteotomies

Offline Tarlie86

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Re: NickiAnn's Crazy Derotational Osteotomy
« Reply #38 on: October 13, 2012, 05:54:12 AM »
Hi Nicki,

Im going through the motions at the moment to have just my right leg done. As a baby I had issues but like most kids the Dr said I'd grow out of it. By the time it should of sorted itself out I was playing alot of high level sport and wasn't one to complain at the fear of missing out on a game or even one practice. I had many arthroscopes on the knee and a Physio who would try tape my knee cap to the other side of my leg everyday for 2 years telling me it would re-train it. Ive also had chroinic lower back pain since I was about 12. Around age 16-17 I knew there was something really not right with my leg but it was bearable. I didn't do anything because my goal was to join the Navy and didn't want to miss out.

Now at 26 I've had enough and doing something about it, I can no longer sit in the car for longer than an hour or lay on my right side, my thigh feels dead all the time plus the knee and lower back pain. Your blog is fantastic, I feel like I'm a little more prepared! I'm not looking forward to it but it has to be done.

Do you know of anyone else having the lower back pain?

Thanks,

Natalie

Aussie Pride

Offline NickiAnn

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Re: NickiAnn's Crazy Derotational Osteotomy
« Reply #39 on: October 20, 2012, 06:54:19 PM »
Hi Natalie,

I'm glad my blog has helped you know what to expect as you face the surgery.  Lower back pain was never a symptom for me, but when your walk is completely out of alignment, it makes sense to think that the lower back could hurt as well.  Have you had a rotational study yet?  Is it just your tibia that's out of alignment or your femur, or both?

Well...a quick update...

I have been back at work teaching full time for about three weeks now.  I am about fourteen weeks post-o.p. for the derotation of my right femur and tibia.  I no longer use a crutch, but occasionally when I need to walk a long distance, I use a hiking pole for extra stability.  I still have a pretty bad wobble when I walk, and it get's exhausting.  When I use my hiking pole it helps me minimize the wobble which helps a lot.

Pain wise I have lots of aches and pokes and twinges.  After a long day, the area near the femoral break is very, very, tender, and I need some ibuprofen to get comfortable at night.  Also, the tibial area gets sore too.  My leg is still very weak and the knee aches sometimes too.  I think the knee pain is almost certainly due to the lack of muscular support it gets as I raise my activity level.  I don't take percoset anymore, and haven't since I was about nine weeks or so post-op.

Activity wise, I have resumed walking baby, and I can push the stroller about 3/4 of a mile.  I also managed to take a short hike in the woods with the help of my hiking pole.  All said, I am much further along than I was at this point with my left leg.  There was no way I could have walked 3/4 of a mile at thirteen weeks post-op when I had my left leg done.

Speaking of my left leg, my perennial complaint has been pain in the front of my hip joint.  It's still there.  Is it getting better?  Maybe...  Sometimes I swear it's letting up, but at other times I think it's just my imagination.  Speaking as objectively as I can, though, I think it's slightly better.  It's like the pain has receded from 80% of the time to 70%.  There are times when I'm out walking that I kind of forget about it.  I'll walk a few minutes then suddenly realize that it hasn't been bugging me.  Then, as soon as I think, "Oh!  It's better!" it starts to bug me again.  I think it's getting better but at a glacially slower pace.  Hopefully hardware removal this June will help speed up the process.

So, as fall marches along, I'm feeling more normal (though to look at me walking without my hiking pole, normal might not be the first word to pop into mind!)  When I had my right leg done in July, I had Christmas in mind as the date at which I would begin resuming more normal activity.  So far, I appear to be ahead of schedule!

For those of you considering this surgery, I would like to take a moment to mention a couple of issues that you should know.  First, the lumps.  I have a small lump on the outside of each thigh just where the femoral scar is.  I have never had thighs of steel, even though I'm slender; nevertheless, it does bother me a bit to have a "saddlebag."  My family swears that it's not noticeable, even when I wear my slim fitting jeans, but there's no denying that my body is different than it was.  The lump is the result of the muscle and fat bunching up when the leg is rotated.  I knew this was a possibility, but I sort of hoped it wouldn't happen to me...  Hopefully, as I regain muscle mass elsewhere in my legs, the lumps will become less noticeable.  Second, on my left leg, just by my tibial scar, there are a couple of ridge like lumps that stick out when I am putting weight on the leg.  The doctor says they may very well go away when the tibial plate is removed, let's hope so.  On the bright side, is some ways I think my thighs look slimmer and better than before because the quadriceps muscle is centered and not pulling inward anymore.  When my thighs rotated inward it was kind of like you were always viewing them side on, hence at their thickest!

Oh well...a bikini model I'm not, so when it's all said and done, I think that if I can be active and fit I will learn to live with my lumps and be happy for my straight legs in spite of the saddlebags.

Will post again as we near the holidays and the six month mark.  For now, busy, busy, busy, many papers to grade and diapers to change!
1997 Diagnosed with miserable malalignment
Nov. 2011 Left leg femoral and tibial derotational osteotomies
July 2012 Right leg femoral and tibial derotational osteotomies

Offline ArtByCassie

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Re: NickiAnn's Crazy Derotational Osteotomy
« Reply #40 on: November 17, 2012, 03:40:30 AM »
Nicki- I want to say thank you so much for your blog!! I have read every entry and it was exactly what I needed right now.

A little info on me, I have gone through 6 knee surgeries. My first I can't say count as I found my doctor did not know what he was doing and the surgeries were useless. I then found a new Doctor that told me I needed to have Patella realignment surgery on both knees. One at a time of course. While in there is when I found the first surgeries were useless as he found the lateral releases done were not completed. So he did a lateral release and inner reefing in there while fixing the patella. My right knee gave me hell. I was in a brace for 4 1/2 months which is WAY longer than I should have needed however I had absolutely NO stability in this knee.. By about 9 months I had stability and was pretty much pain free. So we went a head with the same surgery on the left knee. This one was NIGHT and DAY different from each other. I was out of the knee brace by 10 days and walking on my own!! NO crutches! It was amazing.

Pain was coming back in the right knee as well as I was having beyond terrible back pain, ankle pain, my hip would freeze on me (OUCH) and I could NEVER get comfortable.. Did all the MRI's, X-Rays and what not. So we decided to do a scope to see what was going on and take out the hardware while in there. My doctor had called me the morning of surgery and tried to talk me out of the surgery. He said the MRI was too clear for there to be any trouble. Well I knew something was not right. It is my body after all.  Well as soon as I woke up I asked what he found. He told me that there was a very large scar band that was tacking my patella to my knee cap which was the cause for a lot of the pain. He also said that I had at least a 30* rotation in my tibia. Which I had been telling him all along it was not right. He said it could be fixed and that if after 6 months and I still have the great deal of pain I need to come back and we will discuss our options as the tibial derotational osteotomy is a last resort sort of surgery (his words).

Well my pain was not any better. In fact it was worse. WAY worse. Hubby and I had a trip to Disney World and by day 2 I was in the most unbearable pain ever! I could not walk more than 20 minutes without having to sit. I could not walk like a normal person and stand straight up. My low back on the right was pinching. To the point I could not breath. It was out weighing my knee pain even!!! I just wanted to go home but we were there for 9 full days!!! 

Well needless to say I came home and had my back checked, my hip checked, my everything checked!! MRI's of my spin, my hips, my knees. Full body x-rays. I was determined to figure out what on earth the problem was. I was 28 during our trip. NO WAY should I feel like that!!I can't sweep without being in pain.. Sitting in a car for more than 45 minutes is ridiculous. Between the knee, hip and back I feel like I am 80 years old!! So when I went back to my ortho Dr. he told me he NEVER told me that he said I had tibial torsion. He said he can't fix something he does not agree is there.. But then in the same conversation said yes there is tibial torsion which is why we did the Patella Realignment. I was MAD!!! Fuming even!

He told me to try another dr.. This Doctor was at the same clinic I first saw that did the pointless surgery. He told me I have femoral torsion. Which I knew was NOT the case. My knees are straight when I stand normal. My toes on my right point out like a duck which says its the Tibia. So onto the next Dr. This Dr agreed that it was my tibia and that it WAS the problem but he was not comfortable fixing it as its a big surgery so he sent me to my doc I have now which I LOVE :)

This Doc being a VERY thorough Doc was the one that wanted to look at EVERYTHING first. Yes he said I had a GREAT deal of tibial torsion but wanted to make sure there was not other issues as well. Hips clear, ankle clear, back mild arthritis (I have had this forever and is NOT what is causing the back pain). So he suggests he does a scope to peak around since scar tissue will NOT show on an MRI.. So this past July I had my scope done. He was absolutely amazed at the amount of scar tissue my last doctor left in there. My knee he said was completely encased in scar tissue. In fact I had 4 stitches from my big surgery that were in there encased in the scarring. He removed everything that was NOT supposed to be there which put me right back to where I was after my big surgery.. NO STABILITY!!  Its so frustrating. Of course he did nothing wrong. He said the lack of stability is because the scar tissue was holding me together which is NOT ok.. The way I walk do to the torsion was causing the scarring to build up and without it being fixed its going to be an ongoing problem. We did the CT scan and I have 57* of torsion in my tibia.

My tibial derotational osteotomy is scheduled for December 18th. I know its so close to Christmas but I want to get it in since by the date of surgery I will have met my out of pocket expense for the year so it will be completely covered by insurance. I also have family all lined up to help me as I recover and I work from home so I can recover at my speed without needing to rush getting back to a work place.

 I am very nervous about this surgery and about the long recovery. It is so nice to read what others have experienced with the same surgery. Of course your surgery was worse than what I am having done as I only need my tibia rotated. Sorry for the long winded info about me. Probably more than anyone needed to know.

Couple questions, if you don't mind. These can be answered by all that have had this surgery.. How long did you spend in the hospital after the surgeries? My Doc is telling me that typically only 24 hours is needed? I would have expected at least 2-3 days.. How long did you need someone babysitting you more or less? My surgery is on a Tuesday so if my doctor is right I will be home on Wednesday. Hubby is home with me from Wednesday till he has to go back to work on Christmas eve so I planned on staying at the in-laws till I feel I can take care of myself. So curious when you all found that was possible for you.  Hubby works nights so need to plan for a sitter if need be. LOL Thank you again for your blog and thanks for listening to me jibber-gabber :)

Sincerely,

Cassie

Offline NickiAnn

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Re: NickiAnn's Crazy Derotational Osteotomy
« Reply #41 on: November 19, 2012, 02:20:15 AM »
Hi Cassie,

Wow you have sure been through a lot.  I'm going to answer quickly as it's a work night and I still have to review lecture notes for tomorrow, but I want to answer your questions.

I was in the hospital for three nights.  Mainly for pain management and to forestall the difficult car ride home.  You'll be pretty weak and tender.  It's nice to just stay put for a couple of days and get the happy drugs while eating chocolate pudding.

I think you will need someone with you for a couple of weeks.  My last surgery I lost a lot of blood and was pretty woozy for a couple of weeks.  I would not have wanted to be home alone.  My mom would sit in my bedroom and listen for any odd thumps (indicating me fainting) while I was in the shower!  Then she would help get my stuff together so I could get dressed.  I think you start to get a bit more energy and strength about three weeks in, though your husband should help get you set on one level of the house in the morning before he leaves.  You do not want to do steps on your own for a while. 

Good luck! :)
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 #42 on: December 30, 2012, 10:25:01 PM »
Hello all!

A quick update before my son wakes from his nap!  I am just shy of six months post-op for the derotation of my right femur and tibia.  My left femur and tibia are now about thirteen months post-op. 

The most important development is that I am FINALLY seeing improvement to the hip pain on my left leg.  After ten and eleven months post-op rolled around, I was starting to give up hope!  But, all of a sudden it started to get better.  Now, several days will go by and I will realize that I haven't had any joint pain in front of my left hip.  I now feel that 90% of the pain on the left can be directly attributed to the hardware.  I can pretty much feel exactly where that plate is biting into my femur.  The left leg has also continued to gain strength as my one year straight leg anniversary has rolled by.  So, bottom line, when they say a one year recovery, think of one year as a loose deadline with healing still occurring at thirteen months and more!

My right leg never had quite the same hip pain as the left, so that has never been a concern, but it is generally still pretty darn tender up near the break in the femur.  I really don't notice the break in the tibia much at all.  The right leg is also still very weak.  I still wobble when I walk (meaning I lean towards my weak side--if that makes sense), but that is to be expected.  Still, I'm trying not to let the wobble slow me down.  I have been out hiking and walking plenty, and I know it will only get better. 

At this point I am cautiously optimistic that I will eventually be feeling fantastic.  I think next Christmas will be amazing as I hike around in the snow on my straight legs.  Hmmm...what else...  It occurs to me that I never posted my formerly wonky angles, so here they are for the curious: Left femur is 40 degrees, left tibia 55 degrees.  Right femur 41 degrees, right tibia 48 degrees.  All quite irrelevant now that I'm straight.

 Another thing I never mentioned that might come in handy for those preparing for this surgery.  Before my second surgery, I donated two pints of blood so that I wouldn't become anemic if I lost a lot during surgery.  The evening that I donated my second pint, I developed an infection (totally unrelated to my legs) and the second pint had to be destroyed.  Turns out that the Red Cross accidentally destroyed the first uncontaminated pint too.  Anyhow, I didn't want a transfusion, so my doc said he wouldn't give me any blood unless I was at death's door.  I was pretty anemic; I think I went down to a 6.  The nurses were all very concerned, and couldn't believe that my doctor didn't have me transfused.  But, my ortho is kind of old school, and was just like "she'll be fine."  Long story short, I was a little woozy, but it's not like I was going mountain climbing or anything, so I just lived with it and it was all good.  I guess my point is that if you don't want to be transfused from the blood bank, you can opt out, unless of course it's life or death!  The funny thing is that I read that after giving birth women often drop that low and are never transfused.  As a matter of fact, after giving birth not only are most women anemic, they are also expected to start nursing and changing diapers around the clock!  I remember after having my son, I looked in the mirror and thought, "Wow I pushed so hard I pushed out some new freckles."  Actually, I was so pale that I could just see freckles that aren't usually visible.  Kind of like seeing the Milky Way when you drive away from the lights of the city.  I suppose I lost a lot of blood on my son's birthday, but no one seemed to care much. 

O.K. now that I have totally gone off on a tangent, I'll list some cool things and some not so cool things about my current post-op state...

Cool:
When I wear my skinny jeans with my knee high boots over them my legs look awesome.  I used to really see my ducky out-toeing in an outfit like that.

When I walk in the snow my foot prints are nice and straight like everyone else's!

My pain is getting much better!

I jogged a few steps the other day, and it felt right, not wacky and crooked.

Not cool:
I still have those little saddlebags at the top of my thighs.

My muscles are still atrophied on both sides (though the left is getting better)

The femoral scars are pretty wicked.

I was terrified on the sledding hill today that some cannonball kid was going to whack me and re-break my legs thus making me a really great story for my orthpaedic surgeon to tell at his New Year's Eve party.

The other day I asked my husband if I was limping more or less on my right than I was at this point after my left leg's derotation, and he said that I had been limping for so long that he doesn't even notice it anymore because it's just how I walk.

My left ankle gets sore.  Weird, after a year, my ankle hurts.  Go figure...

Happy New Year to all!  I'll post again as the winter snows begin to melt!

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

Offline cskurda109

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Re: NickiAnn's Crazy Derotational Osteotomy
« Reply #43 on: January 05, 2013, 01:40:08 AM »
Hey Nicki -

I am so glad I found your blog, thank you! It has truly helped me.

My name is Cassidy, I am 17 years old, and graduate high school this June. As you experienced, growing up I went to countless doctors who all said I just "looked a little funny" and left it at that. They never hurt when I was younger, I was in gymnastics for 8 years. In fact, no discomfort started until I entered high school.

It started with random outbursts that would last weeks. Being in gym class freshman year I could not run like everyone else and it caused a lot of pain. My knees would become red, swollen, stiff, and very hard to walk on. Also like you, I decided from then on not to participate in sports for fear of it coming back. My summer of Junior year I started again with cheer leading. To no fail, it started back up. Finally this past September, I hit my peak. My knee gave out on me and I knew something was not right. I got an appointment to see Dr. Teitge, who knew right away I was another "twisted sister".

Now here I am with all these surgeries up ahead, along with graduation, and I am flustered. Everyday at school is a struggle for me. Some days are worse, but for the most part walking causes pain and so does sitting down for long periods of time. It got so bad so fast! But thanks to your blog I can know exactly what is involved with this surgery and it definitely makes me feel better.

Dr. Teitge diagnosed me with miserable malalignment in December. I need to have femoral and tibial rotational osteotomy on both legs. The same thing as you! I don't think I could have found a more helpful source! :) As for now, I do not know much else. I go back down to Teitge this coming Tuesday to find out how twisted my bones are and then schedule my first surgery. I am scared but I am ready.

I have a few questions as well... How much school would I be missing? I have A's, and am dual- enrolled in college, quite an accomplishment for me right now and wouldn't want to miss too much!
If I'm missing school because I'm not supposed to walk do you think I could start off using a wheelchair?
It's crazy to think that I need all of this at 17, do you think that is a young age for this procedure? or does age not matter? Thank you soooo much again, after reading your blog I feel almost jittery to get this done and over with!

- Cassidy
December 2012 - Diagnosed with Miserable Malalignment

Offline NickiAnn

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Re: NickiAnn's Crazy Derotational Osteotomy
« Reply #44 on: January 23, 2013, 02:41:51 PM »
Dear Cassidy,

Sorry it has taken so long for me to write back.  As you probably know, it is midterm test time and I have been working extremely hard trying to keep up with my grading.  Today, I am home with the flu :( so I have a little time to write.

First off, you asked me if 17 is too young an age for the procedure.  I think that quality of life is the biggest consideration when deciding whether or not to get the operation, assuming that you're done growing, of course.  I have heard that it's best to not do the procedure on kids, unless they are incredibly severe, because their bone angles might favorably adjust as they grow.  I'm thinking you are probably done growing.  I'm sure Dr. Teitge takes all of this into consideration, thought it doesn't hurt to ask.  Other than that, if you can't enjoy life, that's the biggest indication that it's time.  I have talked to several other women who have had the surgery, and it seems that the young ones bounce back the fastest.  Sometimes, I wish that I had gone through with the surgery when I was 21 and first met Dr. Teitge.  However, that's a useless line of thinking.  My quality of life simply wasn't bad enough at that point.  So, while it may have been easier in some regards to do the surgery while younger, if things had gone wrong, I would have really regretted the decision.  When I did have the surgery done, my knees had hurt badly enough all summer that I felt I had to try something because doing nothing wasn't going to work.  In other words, after having such a lousy spell of knee pain, I knew that I would have no regrets.  Bottom line, if you are currently having knee misery, then the pain of the surgery will seem more worth it.

As far as time off of school goes, that's really hard to say.  Everyone is different.  And while I said that many young people bounce back fast, there are exceptions.  A young woman named Lyndsie-- she has a post-op diary somewhere on here--really struggled for a long time with pain near her femoral break.  I believe that she eventually healed up--she no longer posts, and the last time I communicated with her she had been hiking in New Zealand--but she suffered for over a year.  So be prepared for long haul healing!  But, hopefully it will go easy for you.  All I can do is give you some general guidelines as to how I felt:

2 weeks post-op on my most recent leg I felt strong enough to sit in bed and start work on some online grad classes.  I could work for a couple of hours, then would usually fall over and take a nap.  So you could maybe start doing some homework in short spurts. 

At 4-6 weeks post-op you might feel well enough to get out some.  I'm not sure about a whole day of school, though, until at least 6 weeks.  The problem is that it's hard to sit on the femoral break for long periods of time.  It get's awfully sore.  If you start back at school at 6 weeks post-op, you can probably manage, but count on getting sore.  A wheelchair can help if you are dizzy and weak, but it won't help with pain because you will be sitting on the femoral break.  You will probably want to get up and stretch the leg between classes.  In fact, Dr. T will advise you to move as much as possible to prevent blood clots.

All that said, did you schedule surgery yet?  Did you find out your angles?  Let me know how things are going!
1997 Diagnosed with miserable malalignment
Nov. 2011 Left leg femoral and tibial derotational osteotomies
July 2012 Right leg femoral and tibial derotational osteotomies















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