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Author Topic: Sarah's Open Wedge Distal Femoral Osteotomy  (Read 6890 times)

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Offline slightfield

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Re: Sarah's Open Wedge Distal Femoral Osteotomy
« Reply #15 on: May 21, 2017, 06:43:22 PM »
Gabriel,

Great to hear you don't have significant pain and the misalignment has not increased over the years. Also, I am hopeful that the recent arthro will help.  When are you back to weight bearing? I am non-weight bearing for 6 weeks. This week I will be halfway through the scrutiny of being confined to my walker, crutches and wheelchair. So, I am almost there!

I got a second opinion. That is a great idea. Also, confidence in your OS is crutial. I did some research and was fortunate to live somewhere that enabled me direct access to surgeons with experience doing this procedure. So, I completely understand your reservation. If you are willing to travel, that may expand your options but I don't know your specific situation. Indeed, weight management is one way to manage the symptoms. I was also taking Glucosamine and Chondroitin supplements daily. This helped the joint. I would wear an "unloader brace" when I would ski and this also helped significantly. But it is big and bulky.

Agree also that recovery is the main thing with this surgery. It is a very long process and one must be mentally prepared for that. I know I thought I was mentally ready, but this is going to be a true test. I find myself thinking about walking and watching others around can become depressing, but I quickly shift my thoughts back to "training" mode. I look at my status and situation as an opportunity to train for things to come. I tell myself that this is just my training regime and there is a reason it is the way it is right now. It will not last forever. Lots of people forget how much of the healing process is mental. I am trying to keep this in perspective everyday. I do a little more independently each day and those moments, no matter how small and insignificant are "triumphs" for me.

Best of luck to you as well and thank you for the positive thoughts!  They are always welcome!   

Offline Gabisv

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Re: Sarah's Open Wedge Distal Femoral Osteotomy
« Reply #16 on: May 23, 2017, 10:09:14 AM »
Hi Sarah,

Great to hear from you. I hope you are progressing well towards the 6 weeks milestone.
I'm now almost 4 weeks after surgery and the knee still has some amount of swelling around patella and on the inner part.

The doctor allowed me to go to a 30-50 % weight bearing on it, that means when I move around in both crutches I can rest the leg with entire sole against the floor and take pressure off my hands. Still, I am not allowed to walk in one crutch just yet.

This may look a bit unusual, as the artroscopy is a walk in the park compared to what you had as a surgery. But he said to take it slow, so I won't argue.

Around here is difficult to find good quality healthcare services. I live in Romania and the national programme is  quite unreliable when it comes to receiving quality treatment so the only option is to go to private hospitals where costs are quite high compared to average earnings of employees.

So,there are limited options for regular workers and it's also not very convenient to travel and receive treatment due to high costs and besides that you can only get home by car on discharge and the  roads are in less than average condition so you need to get ready for some bumps.

 I'll sure get a second opinion on the need for osteotomy as I am really reluctant about it.
 Also, mentally I'm not very good now as I spent a lot of time indoors. I live in a flat and now it's quite difficult for me to walk down and up the stairs to get out for some air.

Still trying to stay positive and I'm glad you do that as well.

Best wishes

P.S. Are you using a CPM machine for your  recovery?

Offline slightfield

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Re: Sarah's Open Wedge Distal Femoral Osteotomy
« Reply #17 on: May 26, 2017, 11:19:04 PM »
3 weeks and 2 days post op. I am happy to share that my progress toward the 6 week mark is going well. I am completely off pain meds. I have had two physical therapy appointments so far. I will come back to my thoughts about the physical therapy in a bit.

It was great to hear from you, Gabriel! Thanks for the well wishes from Romania. I'm also glad to hear that you are progressing well after your arthroscopy. Just keep doing what the doctors are telling you. They have your best interest in mind. As far as the surgery being a walk in the park, I'm sure you are having to endure just as much discipline and perseverance as I am, maybe just not for quite as long.  ;)  A friend of mine just had the arthroscopy surgery to her knee yesterday and she said she was "in and out". She is doing well, mainly just itching all over, which I told her could be a side-effect from the pain meds. I hope you can make a full recovery very soon and get out into the fresh air to enjoy your days more. Are you going to physical therapy to help your recovery or doing any exercises/home program? I am not familiar with a CPM devise. When I looked it up online it resembles the mechanical version of a manual exercise I am doing called "heel slides". Are you using a CPM machine? It looks interesting. 

I likely will be trying out a different physical therapist this week. The reason being that I don't think the one I am currently going to is doing enough. Let me explain, when I arrive at the physical therapists office I am greeted by the receptionist who usually greets me and lets me know which room is ready for me. Then that same receptionist will bring in a heating pad and set a timer for 10 minutes. Once the timer goes off, the same receptionist will come in, remove the heating pads and give me 2 exercises to do. She usually says, ankle pumps and straight leg raises 3 sets of 15. Then she will leave. About 10 minutes later she will show up and give me another 2 exercises to do usually being the heel-slides and side-ways leg raises, again, 3 sets of 15. Then after that she might give me one more exercise depending and then let me know that the actual PT will be in shortly. Which is never short. I usually end up waiting about another 10 to 15 minutes for him to come in.  Once he comes in (and I have timed this) only works on me for approximately 8 minutes. Then tells me that I'm going to get some ice and leaves. The receptionist comes back in with the ice packs and sets the timer for 10 minutes. Once the timer goes off, she tells me that I am "free to go, my dear". That's really it. Does anyone else think I have a right to be wanting more from my PT appointments?  It just feels wrong. I really would like to see more progress and work with the physical therapist, not taking orders from a receptionist and doing exercises on my own without any form of supervision. Hmmmm.
« Last Edit: May 26, 2017, 11:34:01 PM by slightfield »

Offline Gabisv

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Re: Sarah's Open Wedge Distal Femoral Osteotomy
« Reply #18 on: May 27, 2017, 04:30:33 PM »
Hey Sarah, great to hear from you
I'm glad that you are progressing well, now past the half way milestone.

I am still at home but will have a follow up with the doctor next week to check the knee and why it's still quite swollen.  As for PT, I am not doing any and I think I should. The doctor din not recommend it, just gave some plain advice not to keep the leg in extension too long . I am going to ask it again as I don't want to loose flexion,  I need to go from  90 to 130 degrees

 I followed the advice to go with  50% weight bearing and boy, it sure feels good standing on both feet, putting minimum pressure on crutches. I am able to stand for a while without pain but I still feel stiffness around the knee, more to the back side when bending it.

As for your PT appointment, honestly I would feel frustrated too about the 8 minutes. But have you thought that it may get better as you close on the 6 week moment? Maybe the time he works on you will increase progressively. It's just a thought really :)

 Around here,  they advertise a appointment takes around 50 minutes,   but you're just being given the exercises and then the physio nurse would check on you every 10 minutes or so. As for the time with the therapist, I wouldn't know exactly how much is it as I didn't try it.

I'd say you should look for another PT if things stay like this, to get better value from the money you're paying.

I'd like to hear from you soon. Where did you say you live in The States?

Best wishes and speedy recovery!

Offline slightfield

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Re: Sarah's Open Wedge Distal Femoral Osteotomy
« Reply #19 on: June 01, 2017, 12:42:06 AM »
Today was 4 weeks post op and my third physical therapy appointment, this time at a new office (which I was very pleased with by the way). He stayed with me the entire duration of the appointment, which was 90 minutes! WOW! ;D

I am excited to share my progress is continuing to go very well with overall pain, healing and ROM. I am keeping up doing my exercises at least three times a day everyday, no matter what. The new PT gave me additional exercises to start along with the ones I am already doing at home. Excited to start them! I believe it is more of a mental challenge at this point to be completely non weight bearing. The more I think about it, 6-8 weeks is a long time, so I try not to think at all. During the PT appointment today, I said I was hopeful to be released to partial weight bearing status after my 6 week doctor appointment on June 13th. My new PT said he would be hopeful for me also, but also added that it wouldn't be a complete setback if that wasn't the case since I am making such good progress as is. So we'll see.

It was pleasing to hear his measurements and assessments (whereas my previous PT never did any assessments). He told me I look better than 90% of his patients. He also said I am "leaps and bounds" ahead of where he would expect me to be right now. I was all smiles as you can probably guess since I have worked SO hard. His assessment concluded my flexion 113* degrees right now and he would like to get me to 130* degrees. My surgical leg extension he measured at 2* degrees, wow! He said he would like to get me at -2* degrees extension due the amount I like to hike and my needing that amount of extension. I am convinced the wedge I used the first 2-3 weeks post surgery to elevate my leg while in bed made that possible for me so quickly. It kept my leg completely straight while elevating, unlike using pillows that allow your leg to bend and for scar tissue to develop while in that position. Overall, he also noted I have a 4 cm difference in my thigh circumference because of muscle atrophy which I can really see.  It kinda looks funny! All the more reason to work harder when doing my exercises to get back to "normal". He asked if I had a stationary bike at home. Nope. So, I will probably go online to see if I can find a relatively inexpensive stationary bike somewhere nearby where I live this week sometime. I am very pleased with the way things are going thus far, considering the long road still ahead of me. Thank you all for the well wishes they mean more than you know! 
« Last Edit: June 05, 2017, 05:50:47 PM by slightfield »

Offline slightfield

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Re: Sarah's Open Wedge Distal Femoral Osteotomy
« Reply #20 on: June 02, 2017, 05:55:44 PM »
Last night after showering, I noticed the incision site looked odd at my hip where they took the bone for the wedge. There was a white-ish, what looked like a bubble in the middle, but no pain or additional swelling or redness. I simply applied minimal pressure around the bubble and it oozed a tiny bit of thick milky white liquid. Uh-oh...   :-\

Offline Gabisv

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Re: Sarah's Open Wedge Distal Femoral Osteotomy
« Reply #21 on: June 03, 2017, 04:22:52 PM »
Sarah, great to hear you're doing such good progress.

I  wouldn't worry about the side incision. As long as it is not reddish/painful you're safe from infection. To be on the safe side ask your doctor. Maybe give him a call?

My knee is better now, I am able to apply full pressure and walk on it. Though still dependent on both crutches.
It's still swollen but I'll get to PT next week. Hopefully I'll be down to one crutch after one more week of PT

What kind of wedge did you use to keep the leg elevated? It is something you bought? I saw something on Amazon tbh.

Did your doctor tell you that you may encounter increased pattelar pressure after the surgery/recovery?  Mine raised this issue at last appointment, so the osteotomy is kind of on hold for me as I have some cartilage damage on the back of the patella as well :( Turns out the deviation is 15 degrees as he said.

Best wishes and speedy recovery!

Offline slightfield

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Re: Sarah's Open Wedge Distal Femoral Osteotomy
« Reply #22 on: June 05, 2017, 06:26:42 PM »
Just shy of 5 weeks post op! The incision site at the hip is fine now but I went ahead and called the doc anyway to let them know. Most likely it was a "spitting" stitch/suture. It's gross, look it up. I was told keep an eye on it. But really, after it oozed, it was gone! No issues after that so that was a big relief.

In case some of you are wondering what I mean when I refer to the "wedge" I propped my leg on for elevation the first 3 weeks after surgery... I am not referring to the bone wedge they took from my hip. I am referring to a large physical therapy tool, see below. Hopefully, the hyperlink I inserted works so you guys can see what I mean.
https://www.amazon.com/dp/B00QSGBS8S?th=1

Update: At my most recent PT appointment last Friday, I did different exercises this time. One where I roll over to my right side while laying on the table. Then, bend my left leg and place my foot on the table in front of my right leg (still extended straight out on the table). Next, I lift my right leg off the table while keeping it completely straight. What a workout! Then I did some additional exercises with the EMS (Electronic Muscle Stimulator) which was fun. I can describe all of my exercises thus far for anyone who would like to know, just send me a message and ask, I would be happy to do that for you.

After the exercises, my PT asked me to come over to the stationary bike. I was both excited and a little bit nervous. He helped me onto it, then asked me to SLOWLY try a rotation. At a slow but sure pace, I went around to feel a good stretch the first try. While he stood beside the bike, I attempted the next rotation and went completely around no problem! No pain! I was the hit of the room, which made me feel great! I went around and around both frontward and backward for about 10-15 rotations each way before he had me return to my room.  Once back to my room, he took measurements to compare to my previous visit (which was my 1st visit there). First measurement, I fully extended my leg that I was at 0* degrees! Woot, Woot! The second measurement, I flexed/bent my leg and held while he measured. While he was measuring he told me, if I could guess the number I was at I could release my flexion. I smiled and... I began to guess the degree of flexion. I remembered I was 113* degrees the time before so I started my guess at 118* and worked up slowly only skipping 1 or 2* since I was confident it was right around there (I mean, how much could it really change in a couple days, right??) WRONG. I was getting tired and achy once I reached 126* degrees! When I finally guessed that number, he chuckled and allowed me to lower my leg to the table. Wheww! Tired, achy, but very pleased, I was given some ice, which felt really good.  My next PT appointment is tomorrow morning! We'll see what he has in store for me then! Keep you all posted. P.S. It is SO worth it to find a really good PT. Thank you for your thoughts Gabriel, it helped a lot as I was making my decision whether to find another PT. You rock!!

Offline slightfield

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Re: Sarah's Open Wedge Distal Femoral Osteotomy
« Reply #23 on: June 07, 2017, 06:25:29 PM »
At 5 weeks post op. Went to PT appointment yesterday. He said my incision looks good and is healing well. After more exercises and some stationary bike time, I was measured.  My ROM is 0* extended to 130* flexed! My PT has officially qualified me as FULL ROM!!!! I am super happy!

Now to keep up with the exercise program at home to maintain ROM for my 6 week follow up doc appointment...I hope my bone healing is progressing as well!

Offline slightfield

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Re: Sarah's Open Wedge Distal Femoral Osteotomy
« Reply #24 on: June 09, 2017, 11:35:06 PM »
Three days until my 6 week follow up appointment with the OS...

Offline slightfield

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Re: Sarah's Open Wedge Distal Femoral Osteotomy
« Reply #25 on: June 12, 2017, 11:43:36 PM »
I had a good day at PT today. He measured me and I am at 134* flexion! Tomorrow I go in for my 6 week follow up. I hope after the Xrays, I will be released to partial weight bearing or as tolerated. My PT says that is when I can start the "fun" exercises.

I am very happy with the way PT has been progressing. I no longer take pain pills, even before bed. Sometimes, in the middle of the night I will wake up and the knee is stiff and there is some pain when bending or moving it around to get to a comfortable position. I am not sleeping with the brace on, which is nice since that means I can sleep in any position without restriction. I am still doing my exercises everyday, not as much as I was before at three times daily, but once or twice to maintain the range of motion.  My PT did mention that he was liking how my quad muscle is firing. He mentioned he would be writing a brief letter for the OS tomorrow stating the progress and current functioning. I was very impressed that he offered to do that. Do they normally offer to write letters regarding patient progress like that? Anyway, it impressed me, coming from the other PT office that didn't even take measurements!  Guess it doesn't take much to impress me. 

I managed to make it in to the local home improvement store today. Granted I had to resort to riding those fun little "granny skooters" around. Still it was nice to get into an actual store. We are rebuilding our deck and went to look at materials. It'll be nice once the rebuild is done so I can go out and enjoy the outdoors. Speaking of outdoors, I will be going to Yellowstone next week. I've never been and am excited to see the animals! Looking forward to getting out a bit more and enjoying my summer before it's over. 

Offline slightfield

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Re: Sarah's Open Wedge Distal Femoral Osteotomy
« Reply #26 on: June 23, 2017, 06:45:40 PM »
I am now 7 weeks post op. At my 6 week follow up appointment, i was given weight bearing as tolerated so I am now walking, tolerating a good amount of weight using only one crutch. I can take a few steps without crutch assistance, but very slowly. I even managed to walk into the grocery store and get milk and curry seasoning without my crutch! There is still some swelling and soreness, which I was told to "listen to", so when I feel it, I will rest and ice. Still going well at PT. He added mini squat sets to my exercise program. I will go back for a follow up at 12 weeks, which is around the end of July. So glad I will be able to enjoy some of my summer now!

Offline Gabisv

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Re: Sarah's Open Wedge Distal Femoral Osteotomy
« Reply #27 on: June 25, 2017, 02:19:40 PM »
Sarah,

It's been a while since I posted here. I've replaced my phone and didn't get my bookmarks right. I hope you are allright.

Great to hear you are now down to one crutch. Hopefully in not too many days from now,  you will be able to put it away and walk freely :) 


Myself, I need to keep doing PT as my quads are pretty weak.
I started to walk now, but as time goes, I need to get to do that DFO in order to be active again.

I have that cartilage badly  damaged still on top of tibia (about 2 square centimeters)  and no doctor will attempt reconstruction surgery as long as the leg bones are not correctly aligned. I have a lot of restrictions, basically everything but walking short distances (must avoid hills) . Standing more than 15-20 minutes starts to give me some sharp pain in that area where cartilage is damaged and I need to take weight off the leg as soon as possible to wean off the pain. 

Best wishes and I hope you had a great time at Yellowstone!
« Last Edit: June 25, 2017, 02:24:45 PM by Gabisv »

Offline slightfield

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Re: Sarah's Open Wedge Distal Femoral Osteotomy
« Reply #28 on: June 25, 2017, 06:46:11 PM »
Hi Sara my name is Jake,  and I'm currently on active duty in the Marine Corps. I'm scheduled for the same procedure JUN 27th and trying wrap my head around everything and i hope your surgery went well if you could keep me posted on how everything goes I would greatly appreciate it. any thoughts, experiences or just anything at all that you would share with me might help alleviate some of my concerns thank you for your time and hope all is well

Hi Jake! I am eager to know how you are doing so close to your DFO surgery. I know it will go very well and you will have many moments of triumph and despair. Just know that I am here for you along with several others to help in your time of need. Good luck and the worst part will be over very soon!! Keep in touch please.

Offline slightfield

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Re: Sarah's Open Wedge Distal Femoral Osteotomy
« Reply #29 on: June 25, 2017, 06:53:45 PM »
Gabriel,

It is great to hear from you and glad you are doing well. Yellowstone was wonderful, got to see several animals in their natural habitat which was an experience! Even though other parts of my life are neglected, I am in good spirits about my recovery and have been focusing my time and energy there. Thank you so much for the well wishes as they come at the perfect time. I am sorry to hear that you are limited right now. It must be hard to consider the effects if you were to remain in the state you are in now. The pain is no fun to live with. I say do all you can to fix it now while you are young and can be active. I know it is an extremely huge decision to make.

Keep going with the PT, it will make all the difference in the short and long term. Stay positive! It will get better!
« Last Edit: June 28, 2017, 09:09:51 PM by slightfield »