DIARIES > Post-op diaries (<50 posts)

Laura's trochleoplasty and TTO

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I'm going into hospital on Monday (17th December) for a trochleoplasty.

A bit of background - my left knee started dislocating when I was 11 and has been a problem ever since (I am 31 now). I had a lateral release and a Roux-Goldthwait procedure when I was a teenager, which didn't fix the problem.

This year my knee has been particularly bad so I went to see a specialist (Mr Mark Forster in Cardiff, UK). This led to an MRI scan which showed that I have a dome instead of a trochlear groove. It was great to finally understand what the problem is after all this time, and I'm hoping this surgery will sort it out for good!

I have health insurance with work, and tried to get the operation done privately, however AXA PPP the insurance company refused to fund it as the trochleoplasty is classed as an 'experimental' procedure. Luckily, Mr Forster also works for the NHS and I have only had to wait about 4 months.

I've been told I will be staying in hospital for 1-2 nights so I will hopefully start my post-op diary when I return home...

I was in the hospital for only one night, and arrived home yesterday. I'm currently in quite a lot of pain so will be doing the diary bit by bit. I wanted to start it before I forget too much of the detail...

Day 1:

I went into hospital on Monday morning at 7am. They showed me to my bed and the nurses went through some questions and I saw the anaesthetist. I very briefly saw the doctor who marked my leg - I guess to make sure they operate on the correct one! He said they were planning on doing the trochleoplasty, and possibly some further stabilisation work depending on how it looked. I also saw a physiotherapist who gave me my crutches and showed me the brace they would put on.

I was third on the list for surgery that morning and so I was then waiting around (nervously) until around 11am when they came to fetch me. I walked to the pre-surgery room where I was given a local anaesthetic in my hand, they gave me something to help with the anxiety (not sure what) and then I had the general anaesthetic. I came round in the recovery room at about 2:45pm. There was quite a lot of pain when I woke up. I was given some morphine straight away for the pain, this affected my breathing slightly so they gave me some oxygen. They then hooked me up to a machine that gave me a dose of morphine when I pressed a button. The brace hadn't been fitted yet and I was worried about moving my leg, but I was wrapped in the bedding quite tightly so I don't think I could have moved anyway. The physiotherapists came to put the brace on while I was still in the recovery room and I felt better knowing that my leg was fully supported.

I was back in the ward by about 3:30pm and pressing my morphine button quite frequently. Later on that afternoon my oxygen levels were low so I had an oxygen tube in my nose. I think this helped with the pain as well. I had some tea and toast at about 5pm. The physios came by around 6pm to see if I wanted to try a few steps with the crutches but I didn't feel ready yet. My husband came to visit for a couple of hours.

Since I wasn't able to walk to the bathroom they brought a commode to my bed (like a wheelchair with a bedpan in it). This was quite tricky and I got the feeling that the nurses didn't really know what to do with me as most of the other patients in the ward were having knee replacements and they seemed to be able to bend the knee straight away and had no brace. So they weren't really prepared for me having my leg stuck out straight and needing something to rest it on.

The pain was bad during the night I slept on and off and was using the morphine button a lot. The nurses came in throughout the night to give me antibiotics and to check my blood pressure and temperature. My leg swelled up quite a lot during the night and my foot was going numb so they loosened the brace, I think the pain was partly due to the pressure of the swelling so that helped as well.

Day 2:

In the morning I saw the physiotherapists who got me up walking a few steps with the crutches. I was able to put some weight through my leg without too much trouble but had difficulty moving my leg forward to take steps.

I saw the doctor who confirmed that they had moved my patella tendon as well as the trochleoplasty, and they had also done some medial reefing. My leg brace has been locked at 30 degrees, and the restricted movement is mostly to protect the work on the tendon, rather than the trochleoplasty.

I felt a bit dizzy from the painkillers I'd been given (tramadol) which delayed things a bit but later on the physios came back and took me to practice going up and down steps. As the physios were happy with my mobility I was discharged at 3pm. Just before I left the nurses changed my dressing as the wound had bled out a bit. The dressing was underneath a load of tightly wrapped bandages, so they removed them but didn't put any more bandage on. I found it more difficult to walk with just the brace, so I think the bandage might have been helping to support it.

My husband (Martin) came to pick me up and I sat across the back seat of the car as I couldn't fit in the front seat. The journey was quite painful and when we got home I had real problems walking into the house, and Martin had to push my leg forward for me. Once home we put a tubigrip on under the brace which gave me a bit more support. The stairs were difficult but I managed to get upstairs, with Martin's help, and settled. I was pleased to be home at this point!

Day 3:

Stayed in bed, just getting up to go to the bathroom.  I've had my leg elevated on a pillow to try and help with the swelling. I noticed when I woke up in the morning that my foot was less swollen. in general the pain has been quite bad, although it does come and go. I have been taking Paracetamol, Ibuprofen and Tramadol for painkillers, which they gave me at the hospital.


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