Banner - Hide this banner





Author Topic: Holly's Tibial tubercle osteotomy and lateral release  (Read 3083 times)

0 Members and 1 Guest are viewing this topic.

Offline twiggyholly

  • MICROgeek (<20 posts)
  • *
  • Posts: 10
  • Liked: 1
Holly's Tibial tubercle osteotomy and lateral release
« on: September 19, 2013, 12:43:11 PM »
Hi all,

I've been quietly stalking this forum for a while now in the hope of gaining some insight into what to expect from my tibial tubercle osteotomy and lateral release. I'm actually already 19 days post-op, but thought it only fair that I shared my experience as a lot of you have done for me!

A bit of background first. I'm in my mid-twenties and have only started have trouble with my right knee during the last couple of years. This has exactly coincided with when I started taking up running and triathlons. At first it was just a bit of ITB friction syndrome so I went to see the physio and got some treatment with the assurance that with massage and strength work on my glutes I would slowly but surely get better.

This didn't happen. It got worse and worse until I could no longer run even 200m without pain for day afterwards. I saw 3 different physios all of which thought they could help but it didn't seem to work.

I had a steroid injection into my knee - no change

So my surgeon decided that I wasn't going to fix this through any means other than surgery. My patella was too high, too lateral and on a tilt and no amount of glute exercises was going to change that! I was very likely to end up with arthritis at a young age which ended up being the main reason for me agreeing to the surgery. After all, I had never suffered from injury, dislocation or any other knee issues so surgery seemed quite drastic!

I am lucky enough to have great medical insurance so could have the surgery at a private hospital in the UK. I can honestly say the experience was brilliant. I was in for one night as my operation ended up being quite late (mid afternoon). I came round after the surgery at around 3:30pm in NO pain. :)
The worst bit of the experience is that when my dinner arrived I was too dizzy to sit up straight and it took me a good hour to get any food down me which was torture as I hadn't eaten since the day before!
I slept all night apart from one trip to the bathroom which I managed with no assistance. I couldn't believe it but I felt fine.
The hospital physio informed me that I could be full weight bearing straight away (with a locked brace) and could allow non weight bearing bending to around 60 degrees. I was amazed to be walking straight away but it felt fine (though it was exhausting!).

The next couple of days at home I was tired and my knee was swollen but still no real pain. I was taking ibuprofen and sometimes paracetamol and codeine but mainly because I felt I should. I spent at least the first week with my leg elevated and iced most of the time. I also slept absolutely fine from the first night even though for the first week I had to sleep on my back (I'm usually a side sleeper). I didn't wear my brace in bed at all which I think helped with the comfort levels.

Week 2 and I had worked out how to get myself in and out of the bath with my leg dangling over the side with no assistance. This was heaven! My painkillers had reduced to an ibuprofen once a day, and I began to go out a little. One day I spent almost all day out the house with only a couple of hours nap in the middle. I've been able to go out for dinner and to see friends although I'm very much struggling still with other peoples toilets. It really is very hard to use a non disabled friendly loo in your knee brace!

I'm now in week 3 and have stopped taking any painkillers. I'm not in pain at all (the worst I get is a numb aching which I think is more stiffness than anything else). I have seen my physio who tested by ROM (75 degrees) and got me trying to do some static quads work as well has training me to walk better on my crutches. This week I have really noticed the muscle loss in my thigh. It dips in on the top and on the inside. I'm also really struggling to get my quads to fire at all which is frustrating, but something I have to keep trying.

The one issue that I have been really struggling with is the impact of the surgery on your digestive system. For nearly 3 weeks now it hasn't been working properly, leaving me with a combination of indigestion, diarrhoea (not great when you are very slow moving) and constipation for the last 3 weeks. I don't think I even went to the loo for the first week at all which was exceedingly uncomfortable! Its not a pleasant subject, but it was a side-effect of the surgery that I wasn't expecting. Can anyone tell me if this is normal?

So far so good. I know there is a long way to go but I have been surprised by how it has been so far. I was expecting to be in a lot more pain and I was also expecting to be incapable of doing things like having a bath by myself after only a week. It can be scary to read other peoples stories where there have been set backs but I want to reassure others that for me, so far, it has been just fine.

I do have to caveat that with the fact that I actually have very healthy knees, and so I guess I started from a better place than most. But if you are having this op - don't worry!

Offline chondro...huh?

  • Forum Faithful
  • ****
  • Posts: 194
  • Liked: 4
Re: Holly's Tibial tubercle osteotomy and lateral release
« Reply #1 on: September 20, 2013, 10:49:27 PM »
Holly it appears that we are practically surgery sisters! I just had my TTO Wednesday. Sounds like you are doing great! As to the pooh? ??? The drugs used during surgery and the pain meds are all very constipating. I havent gone since Tuesday and so am starting Colace (docusate) which is a stool softener. So far no results, I took 1 tab yesterday, 2 today and will take 3 tomorrow. Lots of water and fiber are best to help regulate your bowels. Colace is over the counter in the US. Do your bowels when they are loose have a 'sandy' texture? I had PT today and was able to get to 89 degrees! So now I am supposed to do exercises to get to 110 by Tuesday. The exercises hurt like heck! :o :o well, my mother in law is making jelly and is asking where my supplies are at, so I better get off of here for a while to answer her questions. I'm lucky she is here right now to take care of us!
Susan
07/12 - injury
03/13 - scoping, cleaning
09/13 - TTT

Offline twiggyholly

  • MICROgeek (<20 posts)
  • *
  • Posts: 10
  • Liked: 1
Re: Holly's Tibial tubercle osteotomy and lateral release
« Reply #2 on: September 27, 2013, 06:40:15 PM »
A little update:

I'm now nearly 4 weeks post op and everything is going ok (though it feels very slowly!)

I've still only seen my physio once though I am now due to set my brace at 90 degree bend. My concern with this is that I don't feel like my range of movement is anything like 90 degrees and I haven't had any exercises to do to increase my ROM. I feel like I might be a bit behind with this!? I'm also potentially going to be allowed to start doing a little bit of work on the exercise bike or in the pool which is something I am desperate to start doing. As a triathlete 4 weeks of doing NOTHING has been agonising!

Its been a big week with my mother in law having major surgery for cancer. This has meant that I have a lot of time walking through hospitals, on my feet and sat in vehicles. Its been difficult and I can definitely see that my knee gets very swollen and a bit sore after a lot of activity. It seems to go back to normal (ish) after a good nights sleep though. Today has been a day of doing absolutely nothing in the hope of giving my poor knee a little rest.

In good news it appears that my digestive system appears to have finally recovered after the surgery. Yipee!



Offline chondro...huh?

  • Forum Faithful
  • ****
  • Posts: 194
  • Liked: 4
Re: Holly's Tibial tubercle osteotomy and lateral release
« Reply #3 on: September 27, 2013, 09:16:14 PM »
Congrats on the digestive track! ;D

Sorry to hear about your mother in law. I will keep her in my prayers as well as your family.  Being just over one week post op, I am not sure how you can possibly be on your feet that much! All of my bruising drained down to my ankle and bottom of my foot (despite having my leg constantly elevated) so there is a great deeal of pain and pressure there. I take it that you are weightbearing then? I am to be NO weight bearing for 6 weeks. I chuckle at how different the protocols are from Dr. to Dr. on this procedure.

As to ROM, from what I hear I am a medical marvle in that catagory. 2 days post op at PT he measured my flexion and I was 89 without pushing too awful hard. I mean it was certainly uncomfortable I did not feel like I  was maxed out. He had wanted me to get to 110 by my next appt. My understanding is that most people do not hit 90 degrees until well into their second week or later. However I ended up back in hospital the next day with infection and my surgeon said absolutely NO MORE than 90 degrees in the first 2 weeks... so now I am just doing exercises to maintain. My exercises are VERY basic... laying on my back I bend my good knee to 90 degrees then using the stregth from my bad knee I pull my bad leg up dragging my heal on the bed to match that bend of my good leg. At this point I really feel like it is child's play and while there is a good stretching feeling, I really feel like I could/should be doing more. I will not do more though as I do NOT want my screws to come loose and have to explain to my surgeon (yet again) why I was non-compliant and doing more than I was told to do! I have a long history with him scolding me. The only way he would agree to do this surgery is if I promised to follow directions and not do ANYTHING extra and when in doubt I was to ask!

My other "exercise" is straight leg raises for VMO strengthening. MY PT is pleased that when I do the SLR that my foot/shin stay in a straight line which indicates that my muscles are working like they should be! And finally the ankle pumps of course which i find are getting more difficult as the bruising is coming out more.

So back to your mother in law... is everything looking better now? How is your husband doing with you laid up and his mom ill?

So a triathlete? Do you anticipate being able to return to competing?
Susan
07/12 - injury
03/13 - scoping, cleaning
09/13 - TTT

Offline twiggyholly

  • MICROgeek (<20 posts)
  • *
  • Posts: 10
  • Liked: 1
Re: Holly's Tibial tubercle osteotomy and lateral release
« Reply #4 on: October 07, 2013, 12:25:36 PM »
Its now 38 days since my operation and only a week until I can take my knee brace off. Yippee!

The other day my physio got me on an exercise bike. My ROM is only just enough to complete a rotation and even then I have to 'warm it up' and seriously hip-hike to get my leg all the way round. Did anyone else find it really hard the first time? It was also the first time I have really experienced any pain through the whole process so far. I get a feeling that once the brace is off and the really rehab begins I will start to get more sore.

I've also noticed that part of my scar has still not healed correctly and it is weeping a little and has gone a little red around the edges. I'm putting antiseptic cream on it but haven't decided whether to go and see a nurse about it yet. Any suggestions?!

I'm now finally doing some leg raises to try and build my muscle back up for when the brace comes off. I measured my surgery leg this week and it is at least an inch smaller than my other leg (and I have skinny little thighs anyway!) I'm actually a little scared of my knee dealing with the world all alone with out its brace comfort blanket but I'm sure it will be ok.

My mother in law is making a good recovery and the op went very well so we are all hopeful of a good outcome. Its a pretty stressful time for myself and my husband at the moment with my mother in law ill, me unable to do much for myself and the fact that we are in the middle of expanding our business. Bad timing! It is our first wedding anniversary next month so we are hoping to get away for a bit of a holiday.

As for getting back to triathlon - Ive never been good at tri (impossible when you cant run!), but I love the sport and as soon as I can run again I will be competing again. I'm going to enter a super short triathlon in April to give myself something to aim for :)




Offline chondro...huh?

  • Forum Faithful
  • ****
  • Posts: 194
  • Liked: 4
Re: Holly's Tibial tubercle osteotomy and lateral release
« Reply #5 on: October 08, 2013, 04:42:28 AM »
The little problem with the drainage and not healing could be related to your body trying to 'spit out' the internal stitches. I have had issues with this in the past on several other incisions/surgical sites. Do you by chance have something looking like a string sticking out of the wound? It is generally not a big deal, except be carefull with bending. I would let your Dr. know because if this is the case, the open area will not heal until the internal suture is taken outt. Sometimes the body will work the stich out over time and sometimes it will need to be removed. For me as soon as the stitch came out, the wound would heal out in a few days.

The other questions your Dr will want to know is the drainage; if it is yellow or green (especially green) you should let them know right away. Also if the drainage is odorous let him know right away.

Have a great day! Isnt the bike amazing that first time?!?!? I just got on the bike today myself!
Susan
07/12 - injury
03/13 - scoping, cleaning
09/13 - TTT

Offline twiggyholly

  • MICROgeek (<20 posts)
  • *
  • Posts: 10
  • Liked: 1
Re: Holly's Tibial tubercle osteotomy and lateral release
« Reply #6 on: October 09, 2013, 01:47:28 PM »
Thanks for the reply. There was a stitch poking out near the area that isn't healing. I cut it off in the hope my body would swallow it up and it would nicely disappear. I think that wasn't the best move because its made the area around it a bit angry. Its stopped seeping now but still look quite red. I'm hoping it will fix itself in the next few days!

The bike felt good, but being a keen cyclist I was slightly disappointed by how hard I found it. Its to be expected, but I cant help feeling frustrated!

Offline chondro...huh?

  • Forum Faithful
  • ****
  • Posts: 194
  • Liked: 4
Re: Holly's Tibial tubercle osteotomy and lateral release
« Reply #7 on: October 09, 2013, 08:13:29 PM »
If you see the stitch again... DO NOT cut it off! Instead go in and have the dr remove it. It will likely keep festering back up until it is removed completely and that is NOT SOMETHING YOU WANT TO do on your own. I might know this from experience! ::) hahaha
Susan
07/12 - injury
03/13 - scoping, cleaning
09/13 - TTT

Offline twiggyholly

  • MICROgeek (<20 posts)
  • *
  • Posts: 10
  • Liked: 1
Re: Holly's Tibial tubercle osteotomy and lateral release
« Reply #8 on: October 18, 2013, 11:25:52 AM »
47 days post op..

I've ditched the knee brace!!

Yesterday I saw my surgeon for the first time since the op and got an x-ray done. All is healing well and Ive been given the green light to start proper rehab. I was surprised to see that I have 3 screws in my tibia (I think I was expecting only 2), and I finally found out why I have 5 scars on my knee rather than the 4 I was supposed to have. My surgeon had to go in on the lateral side to release more tissue to allow my patella to  move over.

As soon as I had seen the surgeon in the morning I ditched my brace and started trying to walk around a little without it. Its hard. You forget how to walk and dont quite trust your knee.

In the evening I saw my physio who got me working on many exercises to help me build my muscle up again. This morning I am really feeling it in my hip flexors, glutes and quads. This is where the hard work begins!

Offline twiggyholly

  • MICROgeek (<20 posts)
  • *
  • Posts: 10
  • Liked: 1
Re: Holly's Tibial tubercle osteotomy and lateral release
« Reply #9 on: October 22, 2013, 06:20:49 PM »
51 days post op.

Best evening ever yesterday. I finally managed to do some exercise!! I went to the pool for the first time and did a few lengths with a pool buoy between my legs so that I could kick. It was bliss.

Work have said I can come back this week with a bit of office working and a bit of home working. Not sure if I'm happy about this or not at the moment - but it will be good to feel more independent. I've been practising walking around a bit but its very hard going and my knee feels like its going to collapse when I get tired. Hills are a nightmare!
















support