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Author Topic: Osteotomy Post-Op  (Read 40002 times)

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Liftline62

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Osteotomy Post-Op
« on: June 22, 2013, 05:40:37 AM »
Hey all,

I had a tibial osteotomy today, it was an outpatient procedure so I'm at home now trying to get comfortable.

My surgeon was absolutely wonderful, I am so thankful to have fought to find a doctor as great as him. I knew I was right to walk away from those who offered surgeries I didn't need and ignore those who said I was fine, when clearly, I wasn't. He is just awesome.

To start:
I got to the hospital, which was 3 hours away, registered checked in, all that stuff then got ready.
I was really relaxed throughout the whole thing, no nerves, the doctors, nurses and I had fun getting to know each other, they have a great staff.

They told me they were going to do a Femoral nerve block and a Sciatic nerve block, so I got set up for those. I was a lot more tolerant to them than they thought, so they had to use a lot of the medicine for the Sciatic nerve... no pain though, a little prick here and there but manageable.
They also had to use a lot of medicine (Propofol I believe) to put me under, the anesthesiologist came over after and said that it would have been easier putting a rabid cougar under haha

Then things went south. The nerve blocks wore off sometime during surgery. I don't remember anything after the sciatic nerve block. I was out for the Femoral nerve, don't remember going into surgery, coming out, or waking up the first time. I kinda thought it was odd that they didn't have me awake going into surgery, but whatever.
So, when I woke up for the second time I was in a lot of pain, they tried to manage it based off of the scene I created when I first woke up (again, I don't remember) and eventually they got a decent combination. The ride home was rough, mostly because they started construction so t was really bumpy.

I have an ace bandage from my ankle to my thigh, haven't seen the incisions yet and I'm dying to. I can unlock my brace, take the wrap off and shower in 2 days, so not too  long.

The next few days are not going to be pleasant, I can tell... I just need to make it to day 4 or 5 and the pain should hopefully be under control.

Anybody have any good positions that they liked sleeping in (Usually a stomach sleeper, so being on my back is going to be a challenge)? Or any position that worked well for being in the least amount of pain?

Thanks!!

Offline schnops

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Re: Osteotomy Post-Op
« Reply #1 on: June 22, 2013, 02:57:13 PM »
I'm sorry surgery went a little roughly! It's always kinda a shock to your body when you first wake up and the Dr's don't know how much pain you will be in, so they can't always predict what meds to give you. 

Glad you were relaxed through the process! I was the same way, but I was awake when they wheeled me into the OR.  I was sedated for the nerve block, but still awake (little loopy!) when I was brought in. 

BIGGEST piece of advice: Stay on top of your meds. Take them religiously and BEFORE you feel any pain.  I learned from experience that pain rises quickly and if you only take meds once you feel the pain then it can become really hard to control.

Did you have the tibial osteotomy with anything else? Do you have a CPM machine?

I slept on my back (with my brace on) for the first week or so.  Then as I became a little more comfortable and less cautious I slept on my side.  Put a pillow in between your legs to make it a little more comfortable.  I had several sleepless nights because it can be hard to get comfy.  I still have trouble sleeping on my stomach and I'm 9 weeks post op

Hang in there!
TTO, LR, arthoscopy, medial tightening R leg -03/'13
Hardware Removal- 9/'13
TTO, LR, athroscopy, medial tightening L leg- 10/'13
VMO advancement, LR, trochleoplasty

Liftline62

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Re: Osteotomy Post-Op
« Reply #2 on: June 22, 2013, 07:15:29 PM »
Yeah, they said that's how I would be too, but I guess I just fell asleep or don't remember haha.

Oh yes, the pain medicine is being followed religiously. I have a strict schedule of every two hours my parents give me something. It was really good for the ride home but as the anesthesia's wearing off and my body is adjusting to it the pain is getting worse. I can't imagine not taking something.

For the most part when I'm sitting still I just have pressure and then when I go to move or to the bathroom then I'm more sensitive. Getting up and down for the bathroom makes me really light headed, and it's only a few steps on crutches, so getting used to that is something too.

No CPM machine, my doctor is letting me removed the dressings and brace in two days so I can get a shower. After that he wants me to keep the brace on, but unlock it and do quad and ankle stretches along with leg raises and work on bending, about 5 times a day and have it locked the rest of the time at 180, especially for sleeping.

Yes, it was just the osteotomy. He scoped it first, and said my cartilage is in great condition and no ligament on tendon issues so he just moved to the surgery. 8 degrees total. He moved it a different way though, to account for the medial subluxation, so I'll check on that when I see him at my post-op in a few weeks.

Thanks for the sleeping ideas! Last night I put my right leg over my left (left is the surgery leg) and kinda positioned myself to the side and that worked well. Not today though because I have more pain. Can't wait to try your ideas.

Thanks so much!

Offline JessJess28

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Re: Osteotomy Post-Op
« Reply #3 on: June 22, 2013, 08:46:47 PM »
Glad you are on the other side of surgery now! Sorry it went a little rough. What schnops said is good advice. It might take awhile to sleep comfortably again. I am still trying and I'm 12 weeks out. I can sleep on my stomach though.

Stay on top of the meds and watch out for the blood rushes. I didn't feel them the first few days but then finally I knew what everyone was talking about. It hurts when you first get up but once you start moving it gets better. Just bite your tongue and go to the bathroom or wherever it is you are getting up for. I think mine became more tolerable come day 12-14.

Keep us posted!
History of Dislocations
12/08 Scope
3/2013 TTO, Lateral Release, Medial Reefing, Grade III Patella lesion.
11/2013 TTO L knee, LR, Medial Reefing, R knee screw removal

Offline schnops

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Re: Osteotomy Post-Op
« Reply #4 on: June 23, 2013, 01:39:46 AM »
Hope you're doing okay! It's hard to adjust to everything the first few days, so just hang in there! I got really light headed when getting up too.  Just get up really slowly and I had a parent walk me to the bathroom just incase I passed out or something! If you're laying in bed or something and need to get up then slowly lower your leg down and keep it there for a few minutes before getting up. Should help with blood rushes. 

How long do you need the brace? Do you know what your Q-angle was before surgery?

Hope you sleep comfortably tonight!  :) I'll check in tomorrow!
TTO, LR, arthoscopy, medial tightening R leg -03/'13
Hardware Removal- 9/'13
TTO, LR, athroscopy, medial tightening L leg- 10/'13
VMO advancement, LR, trochleoplasty

Liftline62

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Re: Osteotomy Post-Op
« Reply #5 on: June 23, 2013, 06:18:20 AM »
Oh my, the pain keeps getting worse  :o
This may sound ridiculous but it's because of the hiccups. I keep getting them. Whenever I eat or drink something I've been getting the hiccups and the movement jostle's me just enough to make my knee hurt A LOT! I've got towels and pillows around it to try and make it stable but it doesn't work that well.

I need help getting my leg out of bed so when I get up there is always someone there to make sure I don't topple over.

I keep reminding myself that I am just barely over 24 hours post-op, so obviously I will be uncomfortable, but it's harder than I thought.

As for the Q-angle, I'm not sure what that is... I know I had varus alignment (bow legged) and mixed with the medial subluxation of my knee cap is how he decided the angles and direction to correct it. Do you have an example of a Q angle? I may know it, just can't remember him saying anything about it.

Yeah, I got a little stool to put my foot on for going to the bathroom and brushing my teeth and stuff because there was just too much pressure having it all the way on the floor.

Thanks so much again, it's so nice to know I'm not crazy and I love hearing what worked for you all!

Offline schnops

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Re: Osteotomy Post-Op
« Reply #6 on: June 23, 2013, 08:09:16 PM »
I'm sorry about your pain! Either it will get better or you will get more used to it as the days go on! I had the same issue except mine was with coughing.  I think the breathing tube irritated my throat a little so I kept coughing which hurt my leg! I never really found a solution, but maybe pack your knee with pillows. You could even use an ace bandage to wrap the pillows onto your knee. 

Do you get to see your incision tomorrow?

You are so early on, all the discomfort is completely normal. I started feeling well enough to go out of the house for an hour or so once I was one week post op.  Anytime before that I was in bed and only got up to use the bathroom. 

Can you see any swelling in your foot or calf? Bruising?

If you don't have one already, I would suggest getting a shower stool so you can sit down and not have to worry about standing for too long. 

My Q-angle was 32 degrees and in surgery they moved my knee 15 degrees, so yours was probably a little smaller. Your OS may have measured it from x-rays so he may not have specifically told you what it was.

Are you nauseous at all from the meds?
TTO, LR, arthoscopy, medial tightening R leg -03/'13
Hardware Removal- 9/'13
TTO, LR, athroscopy, medial tightening L leg- 10/'13
VMO advancement, LR, trochleoplasty

Offline dm

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Re: Osteotomy Post-Op
« Reply #7 on: June 23, 2013, 08:29:46 PM »
Ice, ice and more ice.... Put an icepack on your knee between the pads in the gap at the hinges and see if the cold can get through the bandaging to help some. A trick I tried when they had me in an immobilizer was to put an icepack on my thigh at the edge of the bandaging where it was thinnest, as close to the knee as I could, and just having that spot of coldness right near the pain area gave me another sensation to feel in the area besides the pain, and it also helped with the swelling of the tissues near the knee. When the bandaging comes off and is not so thick, you can do more with the ice to try and help the pain some.

weird thing, but an icepack behind the bend in the knee, where the blood vessels run past it, strangely helps me sometimes.
multiple arthroscopies 2/00,3/01,6/01,1/03, 12/07,10/10. chondromalacia, severe medial joint space narrowing following 3 partial menisectomies, chronic pain problems, kneecap problems, OCD lesion, failed mfx.

Liftline62

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Re: Osteotomy Post-Op
« Reply #8 on: June 24, 2013, 03:30:05 AM »
Today was rough, but hopefully the worst of it and it'll be more manageable from here on out.

I went to the bathroom this morning around 7 and it was the worst pain yet. My leg feels alright getting out of bed but the process of going to the bathroom and getting back into bed is the worst. I have a stool to put my foot on, but having my leg down just to wash my hands or brush my teeth is the killer
When I get back into bed it feels like my knee is going to collapse inwards and it just kills. This morning it took, me, my mom, sister, and brother almost 2 hours to try and get me back into a manageable position.
I was exhausted after that and slept for the rest of the day, I woke up to take my pain meds but that was it. Just got up about an hour or so, and a lot of discomfort again, but a little easier to manage.

Yes, I will be taking my dressings off tomorrow. Which I'm hoping will help me determine how to manage my pain. I can't really see anything now, so hopefully once I can see I'll be able to position myself around what I can see. If that makes  any sense?
My ankle/foot is swollen, but not severely, also not black and blue yet from what I can see.
I am anticipating a large bruise on the lateral side of my thigh, because when I get up to crutch around or even touch that area there is a lot of pain.

Once the dressings are off I have the cryo-cuff that will pretty  much stay in position around my knee that I can filter water in and out of throughout the day so getting ice shouldn't be a problem, just have to watch for frostbite. Sometimes when I put ice on my knee now it feels like I'm crushing it, so hopefully I can find a happy medium somewhere and get everything I need

You're all so awesome for helping me! I just need to get pas this week (I hope!)

Liftline62

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Re: Osteotomy Post-Op
« Reply #9 on: June 25, 2013, 12:24:09 PM »
Dressings are off and everything is cleaned and feeling good!

I was surprised by the lack of bruising, there really isn't any, besides where the incision is, but that's pretty much it. My knee feels a lot better when it is out of the brace than in it, so it's been a challenge to put it back on,

Whenever I have my brace on my knee hurts, which makes me think that I'm doing something wrong, so I get worried. But I guess it's ok to hurt?
It just always feels much better without the brace on.

I got a shower yesterday too and having a shower chair is a big help. Not sure what I would to without it.

Offline crankerchick

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Re: Osteotomy Post-Op
« Reply #10 on: June 25, 2013, 03:38:31 PM »
I don't know if this helps, but I'm not a back sleeper either (side sleeper). I got one of those wedge pillows to kind of prop me up a bit instead of laying flat on my back. I elevated both legs instead of just one, since it made it easier on my back. Sleeping was much easier after a few days passed from the surgery and I got the wedge. I don't know how I made it sleeping on my back for like 6 weeks, but I did.

I also, I got a body pillow when I started sleeping on my side. I had a femoral osteotomy as well and it really hurt to sleep on the non-surgical side without anything between my knees to elevate the surgical leg so it wasn't "drooping" if that makes sense. Lifesaver.
Mar '07 - plica excision
Oct '09 - femoral + tibial derotational osteotomy & TTT
Aug '10 - hardware removal
"You control your leg. Don't let it control you." -Smart trainer
"Get your a$$ in gear and go for it! Nothing will happen until you make it!" -Smart doctor

Offline schnops

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Re: Osteotomy Post-Op
« Reply #11 on: June 26, 2013, 02:19:11 PM »
Hope you're doing okay today! You really are going through the absolute worst of it now. You should start to feel better in the next few days.  It took me a week to really be able to go out to lunch or go out of the house for a little bit. 

How big is your scar? It can take a little while for the bruising to surface.  I didn't notice any bruising for a little while, but then I looked at the back of my knee and it was crazy how bad it was! So many colors! ;)

Move that knee around as much as you can. It'll help with early ROM and prevent some scar tissue from forming. If you're more comfortable without the brace then just keep it off as much as you can.

Have you been able to sleep at all?

Hang in there!
TTO, LR, arthoscopy, medial tightening R leg -03/'13
Hardware Removal- 9/'13
TTO, LR, athroscopy, medial tightening L leg- 10/'13
VMO advancement, LR, trochleoplasty

Liftline62

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Re: Osteotomy Post-Op
« Reply #12 on: June 29, 2013, 12:53:39 AM »
Hey all,

Sorry it's been awhile, I've had a rough couple of days. ONE WEEK POST-OP TODAY

I went and got my brace re-adjusted today and it was very painful. My guess is from being out of it for a while and then the bruises constantly being pushed up against it. OW
The pain kind of feels like a twisted my knee, but in a sever way, with intermittent bruise pain here and there.

I pretty much lost my appetite on Wednesday, I don't know why but I am just not hungry at all and feel nauseous all the time. Even for something like water-ice or watermelon, just simple stuff to stay hydrated I have to force down.

I was sleeping really well until Tuesday/Wednesday now sleep is kinda scarce and I get it when I can, any sudden movement increases the pain.

My doc has been really helpful and understands what I'm saying but I mean I did just have surgery a week ago, so I have to keep myself in check. I seem to have gone backwards over the past 2 or 3 days which is not what I expected. Oh well, these things will happen on occasion I suppose.
« Last Edit: June 29, 2013, 12:59:19 AM by Liftline62 »

Offline JessJess28

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Re: Osteotomy Post-Op
« Reply #13 on: July 01, 2013, 03:34:10 PM »
Sorry you are having a lot of pain. Hang in there! Around Day 10 I had one of my worst days pain wise. I was just so frustrated waking up so swollen and in so much pain. I hated that I couldn't help get the kids ready for school and could only sit on the couch until the meds kicked in. The worst should be almost over.

Can you nap during the day? I napped a lot at the beginning, mostly from the meds I think. Hang in there and try to take it easy. Vent away if you need to.
History of Dislocations
12/08 Scope
3/2013 TTO, Lateral Release, Medial Reefing, Grade III Patella lesion.
11/2013 TTO L knee, LR, Medial Reefing, R knee screw removal

Liftline62

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Re: Osteotomy Post-Op
« Reply #14 on: July 06, 2013, 06:53:10 AM »
Two weeks post-op!

I'm actually doing really well!

I ventured into society a little bit this week, went out to dinner. That went pretty well. I had to adjust my knee a couple times, from having it propped or just hanging down, and it was a little painful but good overall.

Other than that no significant pain. I pretty much just swing it around to get into  bed and to shower (I do use a shower chair though), I can bend it pretty well do, definitely not 90 degrees, maybe around 40-45? I have my first checkup on Tuesday so I'll get some more solid information then.

My brace continues to irritate me. I just wish I could take it off and sleep the way I want to, but obviously, I'm not allowed to do that. So I find myself sleeping in 2-3 hour intervals. It's not ideal but thankfully it's summertime so having an irregular sleeping schedule is alright for the time being.

I usually take something for pain between 3-5a.m from rolling around all night but other than that I'm just taking aspirin still, for blood clots, and that's it. I don't really need ice anymore either, my knee just stopped hurting the other day and I'm really surprised (and happy) with how much I've progressed just from that. The only thing is, now that I feel a lot better I'm ready to roll and start walking... I do however have quite a few weeks before that happens. My doc said between 8-12 weeks, so I've got to sit tight. Hopefully physical therapy will help, although I predict it's not going to be pleasant and I'll be needing that ice again.

How are all of you doing? Were you guys like this, and how painful did you find physical therapy to be?















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