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Author Topic: Derotational osteotomies of the femur and tibia then femur plating for non union  (Read 39595 times)

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Offline cbrady

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Hello everyone!

Today is Tuesday night the 11th and on Thursday the 13th bright and early at 7:20 am I will be having derotational osteotomies done on my femur and tibia in San Diego, CA by Dr. Santore and Dr. Sechriest. My personal favorite surgeons! I am not nervous but excited to finally be on the other side of this issue of miserable malalignment and working towards a recovery.

If you haven't read any of my posts before I will give a "brief" history. Knee pain started in 2003 when I was in eighth grade. Several doctors all told me nothing was wrong and there was nothing that they could do because I was fine. And that it was normal for a young female to have knee pain. Fast forward to November of 2011 when I diagnosed myself after learning about miserable malalignment on the Internet. Then I researched and researched to find a surgeon I knew would see what I saw. That lead me to Dr. Santore and I couldn't be happier. I did see a few other surgeons who finally saw what I saw when I went in knowing what I had already but decided to go with Dr. Santore. I had a hip surgery to correct hip impingement with Dr. Santore in November 2012 and now am finally ready to move on to this surgery. It's weird, I actually had this nagging feeling that there was a surgery to fix my problem back when I was in eighth grade but I just didn't know what the surgery was or even my problem. Anyways, now I am 22 and am prepared to take this head on.

I plan on keeping a good post op diary if for nothing more than myself to look back on. I am told my summer job description is physical therapy attendee and I have accepted that challenge! My surgeons are going to be using a rod and screws on my femur and a plate and screws on my tibia.
« Last Edit: December 29, 2013, 06:50:02 PM by cbrady »
11/19/12 R femoral neck osteoplastyFAI scope labrum
6/13/13 R femurtibia derotational osteotomies rod 2 screws femur plate 6screws tibia
12/18/13 femur plating non union
6/30/14 tibia hardware removal
11/3/14 femur hardware removal
5/11/15 L PAO
12/7/15 plating PAO nonunion
8/14/16 hardware removal

Offline cbrady

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Re: Derotational osteotomies of the femur and tibia
« Reply #1 on: June 13, 2013, 12:40:01 PM »
Today is my surgery. I have everything ready and am just waiting to leave in about 45 minutes. I am just so ready to be on the other side. So here we go!

11/19/12 R femoral neck osteoplastyFAI scope labrum
6/13/13 R femurtibia derotational osteotomies rod 2 screws femur plate 6screws tibia
12/18/13 femur plating non union
6/30/14 tibia hardware removal
11/3/14 femur hardware removal
5/11/15 L PAO
12/7/15 plating PAO nonunion
8/14/16 hardware removal

Offline cbrady

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Re: Derotational osteotomies of the femur and tibia
« Reply #2 on: June 14, 2013, 02:49:00 AM »
I arrived at the hospital at six this morning. Was taken back into the SPA! Surgical procedure area and did all the normal pro op things. Took some meds to get started on pain control already. Was wheeled back about 745. Got some calming drugs. Sat up for my spinal. Laid back down and that was all she wrote.

Woke up at 1120 the Dr. came to see my and show me my new external rotation abilities! Then I fell back asleep, woke up at 1135, asleep again and awake for good at 1150. Got X-rays taken in the pacu. My parents came in, then we headed up to my room. Shortly after my doctor came in again then pt. I got up with a walker and "walked" to a chair next to my bed. Sat for an hour and a half then got back in bed to the calf pump on my non op leg (left) and cpm on the right going from 0-40. I have a boot for when I am ambulating but don't need it when laying down. I have six small incisions. Three on my thigh...one at the top of the hip, one in the middle, and one by the knee. And three on my lower leg. One in the middle, one on each side of the ankle.

I feel great. No pain or nausea. My surgeon came in to see me again. I love him! He is the best. Just icing, laying, and cpming away.
11/19/12 R femoral neck osteoplastyFAI scope labrum
6/13/13 R femurtibia derotational osteotomies rod 2 screws femur plate 6screws tibia
12/18/13 femur plating non union
6/30/14 tibia hardware removal
11/3/14 femur hardware removal
5/11/15 L PAO
12/7/15 plating PAO nonunion
8/14/16 hardware removal

Offline cbrady

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Re: Derotational osteotomies of the femur and tibia
« Reply #3 on: June 14, 2013, 02:34:37 PM »
Post op day 1

Last night was good. I still don't have much pain. I am a little swollen and have been icing a lot. I am back in the cpm for 8 hours again today. Last night I woke up every hour until 4 when I slept until 6 and got woken up again all by my Iv machine saying there were air bubble in the line. I kept having to hit my call button to have my nurse come in and stop it. And she was nice enough to turn my fluids off for a few hours in the middle. All the nurses, cnas, and other staff members have been great. They are all so nice. I like my pt too. She should be coming in to get me walking a little bit.

My restrictions that I know so far are Only being touch weight bearing for 6-8 weeks with the cam boot on. I am also not allowed up by myself yet and my catheter is still in. My great aunt and uncle visited last night and I expect lots more visitors today.

That's all to report for now. Besides the fact that my leg looks amazingly straight and I am so excited about it! Thanks surgeons!!!!
« Last Edit: December 09, 2013, 06:01:20 AM by cbrady »
11/19/12 R femoral neck osteoplastyFAI scope labrum
6/13/13 R femurtibia derotational osteotomies rod 2 screws femur plate 6screws tibia
12/18/13 femur plating non union
6/30/14 tibia hardware removal
11/3/14 femur hardware removal
5/11/15 L PAO
12/7/15 plating PAO nonunion
8/14/16 hardware removal

Offline cbrady

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Re: Derotational osteotomies of the femur and tibia
« Reply #4 on: June 16, 2013, 09:55:27 AM »
Post op day 2
6/15/13

I slept very well last night. My nurse only came in once to check my vitals which was nice. I didn't need my Iv connected anymore so that wasn't a problem. Cpm for 8 hours again. Got it up to 75 degrees by the time I was discharged. Got my catheter out which was nice because then I could put clothes on but then I had to keep getting up to go to the bathroom. I was drinking so much water because the medicines make my mouth really dry.

Getting my leg out of bed and back into bed is the most painful part. It makes me wince and my mom too haha. The place where a lot of that pain is, is at the bottom of my femur. The Dr. said he isn't quite sure why it is there but there is one screw there. Which reminds me, I got the cd with my X-rays during discharge and I was so excited to see them and they didn't disappoint.

Pt got me up and walking with crutches and the walker. We did an entire flight of 13 stairs with the crutches, up and down. It wasn't too bad. My house is one story but to get into it the only way is five stairs or more all the other ways. The pt then gave me a sheet of a few simple exercises to do at home twice a day until I start formal pt with chad at two weeks post op. I will also have a post op with Dr. Santore then as well.

I was ready to leave at 430 but we were waiting on the walker to be delivered to take home and my wheelchair will be delivered to my house on Monday. I'm glad Dr. Santore ordered me one because I really need to use it to attend my sisters graduation from high school on Wednesday. We will see how that goes.

I had a few more visitors today. My boyfriend and my very good friend both came. That distracted me for awhile. We play a game and it was quite entertaining. My parents played too. They when I got home about 6 the family I nanny for stopped by for a quick visit. It was so nice to see them!

My ankle is pretty swollen...I mean my cankle. Haha and my ankle/heel bone is the only place with bruising so far. My thigh is a little swollen as well.

When I got home I took a nice shower which felt so refreshing. I have waterproof dressings over my 8 incisions and am allowed to shower whenever I want which is so nice. My surgeon used his minimally invasive technique so even though I have 8 incisions the longest one is the one lateral on my ankle and about 3 inches long. The rest are smaller, a couple two inchers and a one incher. It is very nice not having huge incisions covering my whole leg. Just another thing to add on the list of reasons I LOVE my surgeon.
« Last Edit: December 09, 2013, 06:04:03 AM by cbrady »
11/19/12 R femoral neck osteoplastyFAI scope labrum
6/13/13 R femurtibia derotational osteotomies rod 2 screws femur plate 6screws tibia
12/18/13 femur plating non union
6/30/14 tibia hardware removal
11/3/14 femur hardware removal
5/11/15 L PAO
12/7/15 plating PAO nonunion
8/14/16 hardware removal

Offline smartdriver

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Re: Derotational osteotomies of the femur and tibia
« Reply #5 on: June 16, 2013, 07:24:57 PM »
Glad to hear you are doing so well  :) and are home.  Let the healing begin!

Yes, one of the worst parts during the first 2-3 weeks is the "blood rush" feeling in your leg when you get up.  I found that the slower you move your leg when getting up, it's not as bad.


Offline cbrady

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Re: Derotational osteotomies of the femur and tibia
« Reply #6 on: June 17, 2013, 01:36:13 AM »
Hi smartdriver,

Thanks for the reply And for checking in. So after 2-3 weeks that pain gets better? Yes, slower is definitely better.
11/19/12 R femoral neck osteoplastyFAI scope labrum
6/13/13 R femurtibia derotational osteotomies rod 2 screws femur plate 6screws tibia
12/18/13 femur plating non union
6/30/14 tibia hardware removal
11/3/14 femur hardware removal
5/11/15 L PAO
12/7/15 plating PAO nonunion
8/14/16 hardware removal

Offline cbrady

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Re: Derotational osteotomies of the femur and tibia
« Reply #7 on: June 17, 2013, 03:03:02 AM »
Post op day 3
6/16/13

I slept well again, especially since I was at home! I used mostly the walker today but the hand pads aren't very cushy so I used the crutches a little bit too. Iced a lot today and stayed on top of my meds. I just hung out today. Didn't do much. Walking from one end of my house out to the other is enough of a work out. It makes me hot and I have to go extremely slow. I watched a movie, played a couple games, and took a nap. Tomorrow my grandma is coming to visit and is staying for a week so that will be nice. She is coming for my sisters graduation but extended her stay because of my surgery. Oh and my family is having a good time trading off who does my lovenox shot. So far my mom and sister have done it. Well, I'm glad I can provide them with some entertainment.
« Last Edit: December 09, 2013, 06:05:08 AM by cbrady »
11/19/12 R femoral neck osteoplastyFAI scope labrum
6/13/13 R femurtibia derotational osteotomies rod 2 screws femur plate 6screws tibia
12/18/13 femur plating non union
6/30/14 tibia hardware removal
11/3/14 femur hardware removal
5/11/15 L PAO
12/7/15 plating PAO nonunion
8/14/16 hardware removal

Offline cbrady

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Re: Derotational osteotomies of the femur and tibia
« Reply #8 on: June 18, 2013, 02:07:18 AM »
Post op day 4
6/17/13

I sort of slept on my side last night with a pillow under my leg and was pretty comfortable even though I'm pretty sure I looked like I was in the most awkward position.

I pretty much used only crutches today because the hand cushions are so much better. Wheelchair details are still getting worked out with the delivery company because apparently the leg extension was not on the prescription so we had to get a new prescription faxed. I mostly stayed in bed today. I took a nap and watched a movie. My cousins and aunt are coming to visit in a few and my grandma gets in tonight. I had a good day overall. My pt exercises were harder today. The straight leg raises and short leg arc are really difficult and kinda painful. I iced a few times as well. Nothing else new to note. At least I'm not bored yet. I don't get bored very easily so recovery isn't too bad for me.
11/19/12 R femoral neck osteoplastyFAI scope labrum
6/13/13 R femurtibia derotational osteotomies rod 2 screws femur plate 6screws tibia
12/18/13 femur plating non union
6/30/14 tibia hardware removal
11/3/14 femur hardware removal
5/11/15 L PAO
12/7/15 plating PAO nonunion
8/14/16 hardware removal

Offline cbrady

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Re: Derotational osteotomies of the femur and tibia
« Reply #9 on: June 19, 2013, 07:20:10 AM »
Post op day 5
6/18/13

I only used crutches today. They are easier now. My wheelchair was delivered, my dr ordered one and said I have to use it if I am walking more than just inside the house. I am taking it to my sisters high school graduation and then lunch tomorrow. It will be weird because I've never been in one before. Anyways, it came with the standard length leg extenders so my leg can be out in front of me and they are at least 4 inches too short on their longest setting. And I am not tall. I am only 5'5". So my dad is rigging it so it will work for tomorrow and we are going to order longer ones. It makes no sense though that their standard adult length is too short. Whatever.

I only took pain medicine twice today and only one pill each time. I was fine all day but I do have to say that ANY pressure on any point on the back of my thigh is extremely painful. When I was trying the wheelchair two different times the end of the seat pushed the back of my thigh when we were trying to lift my leg to straighten it and it hurt so bad I jumped and pulled back and gasped and broke out in a sweat. So now I am a little weary of how the wheelchair will be all day tomorrow. We are bringing a pillow to sit on and I will make sure I am seated all the way back. It should be fine.
11/19/12 R femoral neck osteoplastyFAI scope labrum
6/13/13 R femurtibia derotational osteotomies rod 2 screws femur plate 6screws tibia
12/18/13 femur plating non union
6/30/14 tibia hardware removal
11/3/14 femur hardware removal
5/11/15 L PAO
12/7/15 plating PAO nonunion
8/14/16 hardware removal

Offline cbrady

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Re: Derotational osteotomies of the femur and tibia
« Reply #10 on: June 20, 2013, 01:07:09 AM »
Post op day 6
6/19/13

I went to my sisters graduation and then to lunch with my family today. It wasn't bad except for it was super hot. I used the wheelchair at graduation and everything went smoothly. My leg was fine and Made it through! It was really nice getting out of the house. I haven't been anywhere since I came home from the hospital. That gets pretty old even if I have had visitors and haven't been bored. It was nice.
« Last Edit: December 09, 2013, 06:07:16 AM by cbrady »
11/19/12 R femoral neck osteoplastyFAI scope labrum
6/13/13 R femurtibia derotational osteotomies rod 2 screws femur plate 6screws tibia
12/18/13 femur plating non union
6/30/14 tibia hardware removal
11/3/14 femur hardware removal
5/11/15 L PAO
12/7/15 plating PAO nonunion
8/14/16 hardware removal

Offline cbrady

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Re: Derotational osteotomies of the femur and tibia
« Reply #11 on: June 20, 2013, 06:48:06 AM »
Also, I can lift my leg and move it a little more today by itself, without using my arms or someone else lifting it for me. Not completely but better. I do feel a big difference between my good leg automatically lifting and my bad leg seems to take a great conscious effort before it budges. Like mentally I need to think to lift the leg then I start to engage my muscles then there is a few second time lapse before it actually slowly starts to lift. It's pretty weird.
11/19/12 R femoral neck osteoplastyFAI scope labrum
6/13/13 R femurtibia derotational osteotomies rod 2 screws femur plate 6screws tibia
12/18/13 femur plating non union
6/30/14 tibia hardware removal
11/3/14 femur hardware removal
5/11/15 L PAO
12/7/15 plating PAO nonunion
8/14/16 hardware removal

Offline cbrady

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Re: Derotational osteotomies of the femur and tibia
« Reply #12 on: June 21, 2013, 06:35:25 AM »
One week post op
6/20/13

I had a little more distal femur pain today. Same pain spot but it just hurt with every movement today it seemed. Nothing much different besides that. Sat around. Bed. Chair. Ice machine. TV. Cribbage. Watched my family get ready and decorate for my sisters graduation party tomorrow night. My friend came for a visit and brought lunch so that was nice and that describes my whole day.
11/19/12 R femoral neck osteoplastyFAI scope labrum
6/13/13 R femurtibia derotational osteotomies rod 2 screws femur plate 6screws tibia
12/18/13 femur plating non union
6/30/14 tibia hardware removal
11/3/14 femur hardware removal
5/11/15 L PAO
12/7/15 plating PAO nonunion
8/14/16 hardware removal

Offline smartdriver

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Re: Derotational osteotomies of the femur and tibia
« Reply #13 on: June 21, 2013, 01:05:25 PM »
I do feel a big difference between my good leg automatically lifting and my bad leg seems to take a great conscious effort before it budges. Like mentally I need to think to lift the leg then I start to engage my muscles then there is a few second time lapse before it actually slowly starts to lift. It's pretty weird.

I experienced the same thing.  My mind would be thinking "lift!", but my leg wouldn't move  :)  Leg extensions were easier for me than leg lifts.  It's amazing how quickly your muscles can change.  It took me a couple weeks before I could really do a good leg lift by myself and not have that time lapse.  Once I got to that point though, things became alot easier. 

One thing that I noticed too is that once I started to wear longer pants (and capris), the seam of the pants really bothered me (strange, I know).  I went back to work a week after surgery and was also driving then as well, so I couldn't wear shorts to work.  But I tried to keep my leg propped up as best as I could under my desk with my cryo-cuff on to help with the swelling.

Sounds like you're doing great though! 

Offline cbrady

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Re: Derotational osteotomies of the femur and tibia
« Reply #14 on: June 21, 2013, 07:17:52 PM »
Good to know that it's "normal" I agree that leg extensions are easier. Which leg was your surgery on that you could drive a week after? And if you don't mind sharing, what exactly did you have done?

Thanks for commenting!
11/19/12 R femoral neck osteoplastyFAI scope labrum
6/13/13 R femurtibia derotational osteotomies rod 2 screws femur plate 6screws tibia
12/18/13 femur plating non union
6/30/14 tibia hardware removal
11/3/14 femur hardware removal
5/11/15 L PAO
12/7/15 plating PAO nonunion
8/14/16 hardware removal















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