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Author Topic: Fulkerson, LR and Microfractures  (Read 208 times)

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Offline bcerella

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Fulkerson, LR and Microfractures
« on: July 24, 2020, 12:22:50 PM »
After getting opinions from 4 different surgeons, I finally had surgery on my right knee on 21 July at the Ospedale San Raffaele near Milan, Italy. Dr. Vincenzo Salini (Head of Orthopedic Surgery) and Dr. Daniele Tradati (patella surgeon) performed a Fulkerson osteotomy, lateral release and several microfractures.

20 July: COVID19 swab

Thanks goodness it was negative! I had COVID earlier this year, but I'm not convinced that I can't get it again.

21 July: Surgery

I had spinal anesthesia, but kept telling the anesthesiologist I wanted to sleep during the surgery because I didn't want to remember anything! She gave me something and I fell asleep as they started cleaning my toes with iodine.

I woke up about an hour later. Anesthesia wore off in about an hour and was wheeled to my room. After a couple hours of dozing I wondered why my leg was hurting so much - not like I expected it to - and looked under the blankets. Blood had soaked through my dressing and into the sheets. The nurse said, "Oh Dio!"; Dr. Tradati added more dressing; Dr. Salini came to check on me about 6 hours post-op. He took the dressing off, found the spot that was still bleeding and closed it with a butterfly bandage. It was A LOT of blood. The ward nurse almost fainted! I got my first look at my incision - 22 staples! It's going to be a gnarly scar.

In visiting me, both surgeons mentioned that my cartilage was in really bad shape, apparently far worse than what they could see in my MRI.

In the middle of the night I asked for stronger pain meds. Apparently I was getting only paracetemol! Over the next couple days I learned that opioids can be prescribed by the anesthesiologist, so I wouldn't be getting any of those anytime soon. I don't know if that's specific to Italy or this hospital.

22 July: Post-op Day 1 & First Physiotherapy Session

Dr. Tradati changed my dressing and removed the elastic bandages. I'm do ankle flexion / extension to move my calf and prevent DVT. For a few hours, I enjoyed the illusion of freedom and comfort. Then the physiotherapist came... he put a compression stocking on me, strapped me into the brace, locked it at full extension and made me bear weight while walking with a walker. It was excrutiating. Not sure why that was necessary, but I won't be doing that again anytime soon. I spent an hour on the CPM at 30 degrees and was exhausted. I'm to do isometric quad contractions every hour.

23 July: Post-op Day 2 & Heading home

Dr. Tradati changed my dressing again, gave me my discharge instructions and explained in detail what to avoid (mainly resisted extension). He's very pleased that I have 45 degrees range of motion just 48 hours after surgery.

I spent an hour on the CPM before my family picked me up. On the way home we acquired crutches, a wheelchair that allows me to keep my leg extended / straight (a lot more comfortable than the hospital wheelchair) and a CPM machine. As advised by the physio and surgeons, cryotherapy machines are hard to find in Italy - even online! We did eventually find a place that can order one, but it won't be here til next week. Two more hours of CPM and I was asleep by 2030.

I have restless leg syndrome, and the surgeons were concerned that I might inadvertently kick against my brace (that resisted extension that I'm to avoid). But if at all possible, I'm to wear my brace all night, locked in full extension and sleep on my back. My meds control the RLS very well, so I was able to do this. I slept surprisingly well!

24 July:  Post-op Day 3

There are a lot of stairs in our building and apartment. Since I'm not confident with the crutches and terrified of falling, I've been bum scooting up and down the stairs while my husband holds my leg up. I'm doing find on just paracetemol. I'm doing hourly physio and 4 - 6 hours of CPM at 50 degrees.

A large patch under my knee is completely numb. Strange feeling.
« Last Edit: July 28, 2020, 09:38:40 AM by bcerella »

Offline bcerella

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Re: Fulkerson, LR and Microfractures
« Reply #1 on: July 28, 2020, 09:26:27 AM »
28 July: 1 week Post-op

I've been using the CPM 4 - 6 hours a day, icing after each session and doing isometric quad contractions hourly. Feeling my kneecap pull in a different place is the strangest feeling! I'm still at just 50 degrees on the CPM, but I've got another week to get to 70 degrees.

My pain was been mostly well-managed until the hematoma moved to the sides of my knees. Also, day before yesterday my husband bumped my wheelchair pretty hard while we were out for a walk. It hurt a lot! Yesterday my pain started increasing, especially while standing / on crutches, and paracetamol wasn't cutting it. At bedtime I took palexia (Italian brand opioid) for the first time. I hate taking opioids, but it had been years - apparently I had forgotten exactly how awful they make me feel. I fell asleep quickly but woke after a few hours to go to the toilet. I was dizzy, pouring sweat, nauseated, muscle cramps, tingling extremities and the medicine hadn't helped my pain at all. I was miserable. Now, 14 hours after the palexia, I'm still drowsy. The paracetamol is kicking in and I'm feeling a little better.

I changed my dressing at home for the first time today. The incision looks lumpy, like scar tissue is forming under it; I think that's a good sign.

Offline kneegeek2020

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Re: Fulkerson, LR and Microfractures
« Reply #2 on: July 28, 2020, 03:09:39 PM »
Gl with recovery, would recomend one of those ice machines you could get on amazon
« Last Edit: August 03, 2020, 06:37:47 PM by kneegeek2020 »

Offline Brandon123

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Re: Fulkerson, LR and Microfractures
« Reply #3 on: August 03, 2020, 05:15:06 PM »
Thanks for the updates, a lot of valuable post-op information!
RK sharp pain while running, diagnosis chondromalacia patellae 6/09
RK arthroscopic chondroplasty 9/09
RK rehab, recovery, 90% normal, started running again -> back to square one 5/15
RK diagnosis patellofemoral arthritis + LK diagnosis chondromalacia patellae 8/15 -> conservative treatment