Distal/Medial TTT, MPFL, and Distal Femoral Osteotomy 6/13/11

To let us know how you are getting on for the first days and first few weeks after your operation or injury. We would be interested in knowing about pain levels and meds, dressings, using the CPM machine, swelling, icing regimes, mobility, exercise regimes, bathing and travelling issues, etc.
JFVolleygirl27

Re: Distal/Medial TTT, MPFL, and Distal Femoral Osteotomy 6/13/11

Post by JFVolleygirl27 »

Post op day 12

Crankerchick - I know what you mean! I love to feel like I am being proactive in my recovery. I have been tending to just do the exercises twice a day, except doing double either the first or second go around. I much prefer that to just sitting in a straight leg brace -eww! I am so glad I am not in any brace. Okay! That reassures me about the drainage....yeah, the spot where I am still getting it a bit is on my femur. I hope photographing at the birthday party goes well! I can't wait till I am off crutches....almost four weeks left. Time flies!

The bike has been going good - I just get kind of bored with a stationary bike. I either do the full hour or split it in half. The first day I was really sore after doing the full hour, but now I am not having too much of a problem with it.

In the mean time, I have a lot of stuff this summer to do to get ready for college - lots of summer reading! So I have been juggling that with exercises for my knee. I am starting to get really excited for college! Although, slightly nervous too, as I haven't written a paper in over a year since I took the gap year to travel this past school year.

I have also gotten more adjusted to the cryo cuff - I guess it just takes so playing around with before you find what works best for you. I have also been putting it above my knee and making the straps tighter which helps control the amount of water that goes in it. Swelling has gone down a bit since the hospital!

JFVolleygirl27

Re: Distal/Medial TTT, MPFL, and Distal Femoral Osteotomy 6/13/11

Post by JFVolleygirl27 »

Post op Day 21

Can't believe it's already been three weeks since surgery! Everything has been going good - gets better every day. Swelling has decreased significantly, although, there is still quite a bit gathered in my knee and top of my thigh where I had the distal femoral osteotomy. My incision is still draining a bit, but it has definitely been healing. In some parts, the scabbing has already come off, just leaving a red line. Mostly just draining at the top of my incision where I got the distal femoral osteotomy.

I have also noticed quite a bit of atrophy these past few days. Once I noticed this, I began doing my exercises quite a bit more and am continuing some extras that I have been working on with my therapist. I normally do the therapy sets anywhere from 2 - 4 times a day. I have also been doing more on the bike. I feel like I have reached the point where I don't get much discomfort anymore doing any of the exercises - I just occasionally get some soreness while doing the bike on the lateral side of my knee and occasionally underneath my kneecap where I had the TTT. I still have a lot of tenderness in that area.

I also think that some scar tissue was starting to form on the medial lower side of my knee. It was either this or fluid build up I think, and it was causing increasing pain when doing canon balls or extending/bending my knee. So I got a tennis ball yesterday and literally rolled it around the painful area for a good half hour until it didn't really hurt to do anymore. This helped MAJORLY with the pain on the underside of my knee. Even when i did canon balls this afternoon, I have very little pain in that area anymore. So i think I will continue doing that every night for like 15 minutes or so. I am guessing that this was scar tissue beginning to form?

I am so tired of being on crutches. I can't wait until I can become full weight bearing again and start working on building up what I lost on the quad. I did up my protein intake significantly, and I am still doing between 1500 and 2000 mg of calcium.

All in all, everything has been going good! I am getting really excited to start college this fall. I just made a mock schedule with five potential classes that I wanna take at Brown my first semester. I am thinking about Principles in Economics, Chemistry 0330 (assuming I can place out of the intro class), Intro to Neuroscience, Fiction Writing, and Ghanaian Drumming and Dance Ensemble. Of course, the african dance class will semi depend on how far I progress by this fall with my knee - but it looks like so much fun! As for a major, I am totally undecided - I don't think I will do International Relations anymore, and I continuously am changing my mind about what classes I want to take (there are so many!). As of right now, I am considering the health sciences - I figure I will fulfill pre-med requirements in case I do decide to go on to med school after undergrad :)
JFVolleygirl27

Re: Distal/Medial TTT, MPFL, and Distal Femoral Osteotomy 6/13/11

Post by JFVolleygirl27 »

Post op Week 5

I get my 6 week xrays on July 25 at 10 AM - I have been counting down the days.

Otherwise, as an update, I do have quite a bit of quad atrophy - my leg looks pretty thin. I can't wait till I can start adding more resistance during therapy sessions and at home to work on building the quad muscles back up. And the top part of the incision (where I had the distal femoral osteotomy) is still draining, as well as a small section on my knee cap. This has prevented starting on soft tissue work on this part of the incision. But the lower end, I have been doing some soft tissue work now at therapy to break up the scar tissue around the incision. Range of motion is around 135-140 degrees. I have been working on lowering the bicycle seat while pedaling which has been really helping my leg feel much more mobile. Swelling is also pretty much contained in my knee. My therapist said that breaking up all the scar tissue will help a lot with getting full range of motion.

I have been doing the fancy bikes at the therapy center whenever I get the chance because they work much better than the one I have at home - I normally put it on a resistance level that will at least enable me to feel like the quad is getting a bit of a workout. Mostly though, the bike has been amazing with gaining mobility and keeping range of motion in check. Last week, I spent four days in Chicago where I did not have access to a bike, and by the end of the trip, I could definitely tell the difference the bike makes during recovery. My knee felt really stiff by day 4.

I will also be starting aquatic therapy next week, so that should be fun. I was supposed to start it a bit earlier, but my therapist put it off a while longer since my leg is still draining. And even though it still is, she contacted the aquatic center and they have some sort of bandage that I can put on the incision to prevent it from getting wet.

Assuming I go off crutches on Monday (!!!), I will have a month before college starts to really work on the quads and start walking normally again. I feel like the bones are fully healed - I can comfortably put half of my body weight on my leg when standing and it feels much stronger when walking with more weight. Everything has been going fairly well....pain isn't bad really - the pain i am getting now is sporadic and mostly due to scar tissue I think. I just wish i could have preserved a bit more muscle. There is a dance class that I would love to take this semester in college, so I am hoping my knee will really improve over the next month and a half. I am hoping to get my right knee done over winter break! Overall though, the recovery is much better than I would have initially thought and very manageable.
JFVolleygirl27

Re: Distal/Medial TTT, MPFL, and Distal Femoral Osteotomy 6/13/11

Post by JFVolleygirl27 »

Week 6 Post op

I just got my 6 wk xrays this past Monday and am currently waiting to hear back about those. My radiologist had said that it was in their system and everything to have them sent to Texas, but I just called my hospital today to find out that they hadn't been sent yet. So, i am having them sent overnight to Texas. I am pretty sure the bone is healed - at least it doesn't hurt to walk on my knee unless I do it for quite a while.

I have been doing one crutch off and on a bit since getting the xrays to prepare for when I get the official okay to go off of them - it is weird to start walking again after being on crutches for 6 weeks. The knee is holding out pretty well though while walking with one crutch....it occasionally feels weak from vmo muscle atrophy if I bend it too much while putting weight on it, but overall, the smaller steps are going great.

I also started aquatic therapy this week which I absolutely love! I did walking in the pool and some other exercises. One of my friends here at home has a pool, so over the next 4 weeks before school, I plan to spend a lot of time swimming - its a more exciting way to work on the muscle atrophy. Its nice to be able to start being more active again. And I can't wait to take advantage of the athletic center and massive pool on campus when I go to college.

The main issue right now is just the scar tissue starting to form a lot along the incision, particularly at the lateral side of the knee....so this causes stiffness. Pain level is around 1....2 at the absolute most. There are occasional times when, after my leg is straight for a while, I will sit down a bit too quickly and the sudden bend kind of causes like a sharp pain at side of knee joint, but I am pretty sure this is just related to the scar tissue as it only happens at times when the knee is stiff from prolonged sitting or something.

I am doing a lot of actual quad exercises now that I am at 6 weeks...I really increased the resistance level on the bikes that I do at the therapy center now. I did a lot of exercises and bike at therapy on Monday and was pretty sore for the next two days.

I can't wait to officially go off crutches!
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Re: Distal/Medial TTT, MPFL, and Distal Femoral Osteotomy 6/13/11

Post by crankerchick »

Hey you! Just popping in to see how things are going for you. Sorry I haven't replied in a while! Glad to read that things are moving along. You are doing so well with this and once you get the OK to go full weight bearing, things will move along even faster for you.

How exciting to be starting college and with a leg all fixed up and on the road to full function!

I'm super proud of you for all that you have done between last summer and this one. I remember your earliest posts; it's great to see you where you are now compared to where you were then.

As for the things you mention, I'm no doctor, but based on my experience, it's all pretty normal. Just keep doing your exercises and riding the bike. Consider picking up a heart rate monitor or using the monitor on the bikes at your gym and PT place so that you pedal with enough resistance to get your heart rate up to the target for your age for your entire hour on the bike. I've said on here a hundred times that I never really enjoyed the stationary bike but I can tell you this: it really does do wonders for the recovery when combined with the rest of the strengthening activities.

Things are going to feel so weak and awkward as you start walking, but just keep it in your mind that your leg is fixed and nothing is going to happen and push through your exercises and the rewards will come. Some things take longer than others, but the progress will always come if you put the work in.

Best wishes to you for continued awesome recovery.
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
JFVolleygirl27

Re: Distal/Medial TTT, MPFL, and Distal Femoral Osteotomy 6/13/11

Post by JFVolleygirl27 »

Week 7 Post Op

Thanks crankerchick!! It will be nice getting both knees out of the way my freshman year! thanks for the encouragement Hermanaluver1!!

I just got the official okay today to gradually work my way up to full weight bearing. So far, its been going great. I have been mostly just using one crutch this past week since getting the 6 wk xrays with virtually no pain. This weekend, however, I did do a ton of walking around the mall and in town on Sat and Sun - I should have probably brought both crutches for all the walking. It went pretty good, but by Sunday night, my knee was pretty sore and swollen. So last night, i iced it for a good 5 hours with the cryo cuff and put the white stocking back on....it felt much better this morning and was fine during aquatic therapy.

i am doing aquatic therapy twice a week and land therapy twice a week until August 24 when I leave for school. I doubt I will continue traditional therapy while in college....probably just work on strengthening my knee on my own.

So, all in all, weening myself off of crutches has been going fantastic! My knee no longer feels at all like its going to give out when walking on it with one crutch. I am hoping to be completely done with the crutch by the end of this week or early next week....but that may be too optimistic?

Other than that, nothing too new!
Last edited by JFVolleygirl27 on Mon Aug 01, 2011 11:54 pm, edited 1 time in total.
JFVolleygirl27

Re: Distal/Medial TTT, MPFL, and Distal Femoral Osteotomy 6/13/11

Post by JFVolleygirl27 »

Day 54 (Week 7) Post Op

Everything has been going good! I have been doing aquatic therapy and regular therapy each twice a week. I have been walking without a crutch lately, except for when I go into town, etc. and it feels fine on the leg. Main issues at this stage is still just scar tissue and stiffness. The past two days, I did a lot of strength building leg exercises in my own time at the athletic center - I am now doing the elliptical, bike with resistance, practicing walking, and balancing stuff. It's amazing to be full weight bearing again!!!

I have been doing a lot of scar tissue work too to try and break it up - I have a massive build up particularly right underneath my knee along the incision so if I haven't stretched or bended my knee for a bit (usually in the mornings), it hurts a bit when I walk and sometimes makes a "pop" sound. I have also been massaging the IT band (mostly at therapy) and this part is really painful as its pretty sore.

Thats about it right now!!
JFVolleygirl27

Re: Distal/Medial TTT, MPFL, and Distal Femoral Osteotomy 6/13/11

Post by JFVolleygirl27 »

Week 8 Post Op

I can't believe its been nearly 9 weeks since my surgery. The recovery period has been very manageable....the main issues at the moment remain scar tissue and stiffness. Although, the stiffness seems to get better and better every week. I recently decided this week to cancel my next three weeks of aquatic therapy. I don't feel like I ever really got a significant workout with it...and its all exercises that I can do on my own at my friends pool. I have been doing a lot of swimming lately....this week, I began doing legitimate swimming again using my leg. Its really been helping with motion and stiffness I think. Feels so nice to be active!!

I still got two weeks left of regular PT at the therapy center....then, I think I will just continue strengthening on my own when I move into college on August 27. And especially appreciate that I won't have to really worry about my knee. I have four classes planned at the moment for this fall: Introduction to Computer Programming & Graphics, Principles in Economics, Intro to Acting and Directing, and Visual Arts. And I have a double major as of right now - Entrepreneurship and Film. No longer pre-med. I can't wait to start school again after being out for a year!!!!

But yeah - I feel very optimistic with the recovery!! I have been working on getting all range of motion back as well...I am nearly there! Oh - and I have been entirely off crutches this week and it feels great. My walk is pretty even...occasionally the weak vmo muscle makes my knee wanna give out at random times, normally after a bunch of walking, but its fine. I have been working on stairs this week, too.

Going great!!
JFVolleygirl27

Re: Distal/Medial TTT, MPFL, and Distal Femoral Osteotomy 6/13/11

Post by JFVolleygirl27 »

Week 10

All is good and about the same. Stiffness seems to be going down a bit. However, the more I am on my leg (which has been A LOT lately), I have noticed that swelling will increase and it will be pretty sore for quite a few hours after. I have still been working on scar tissue quite a bit, and I think there has been a bit of improvement - it no longer "clicks" as often if I bend it quickly....so I think the tissue is stretching. I have been doing a lot of pilates to break it up and it used to "pop" and cause a sharp pain when doing them, but its been improving drastically! My therapist just recommended that I buy "The Stick" to massage the scar, IT band, and hamstrings (these are still pretty sore) since I don't plan on paying to see a massage therapist. I just got it today and used it for a bit while watching a documentary earlier - seemed to help a bit.

I have been doing a lot more strength training, too which is nice! I have been doing the elliptical, baby lunges, squats, treadmill with incline....and stairs are going great - I now feel pretty confident going up and down! The muscle is definitely starting to come back. I have noticed that I do get some sort of pressure and pain at the top of my kneecap when I began using it to bend and push my weight back up....such as squats and lunges.

I move into college this weekend! I have no doubt that swelling is going to start increasing again when I have a bunch of walking around campus to do and all the freshman orientation activities. And I ordered a small ice pack that fits nicely solely around the knee cap. My brother had one that I used when I visited him earlier this summer and it worked great....only qualm is it doesn't stay cold for much longer than an hour. Either way, as I hate using the cryo cuff, I can't wait to exchange it for the ice pack!

Thats about it!
JFVolleygirl27

Re: Distal/Medial TTT, MPFL, and Distal Femoral Osteotomy 6/13/11

Post by JFVolleygirl27 »

Week 11

A quick update...

I moved into college yesterday....I can tell that its gonna be kind of hard on my knee with all the walking. I was on it pretty much all of yesterday and by last night, swelling was definitely up there, and it was pretty sore. But...only makes it stronger right? I iced it for about 15 minutes before bed - i just have an ice pack here and it wasn't quite frozen yet so it didn't last too long. And its pretty stiff after the long car trip to Rhode Island. But on a side note - I love college!!!

I feel like the muscle is definitely getting stronger. There is like a clump of scar tissue along the scar just below my knee joint - this where I normally get the most pain. It feels like the tissue is like connected to the bone or something....it just doesn't want to move. But I tried working on it a lot during the car trip. Other than this, I am just getting random aches that come and go. And stairs are going really well....although somewhat awkward still.

Thats about it.
JFVolleygirl27

Re: Distal/Medial TTT, MPFL, and Distal Femoral Osteotomy 6/13/11

Post by JFVolleygirl27 »

Week 12

My knee has been pretty sore from all the walking, but the muscles are definitely getting stronger! I have not had any time like at all to go to the gym to work on therapy this past week and half because of how busy pre-orientation and regular orientation have been. But, I think the miles and miles of walking, hiking up and down the massive hill to the city, playing frisbee, and bumping the volleyball have been good for it. I still don't think I would be comfortable with running yet. I have however, been doing a lot of yoga, so I think that is working a bit to strengthen the muscles and help with the hamstrings. Its actually my hamstrings that are more sore than my knee many times. I have been using my massage stick occasionally to work on the muscles a bit. And from all the activity, I think the scar tissue has gone down significantly!! I still have a pretty large clumb at the top of my scar along the IT band where I had my DFO, but the scar tissue around the knee and right under it where I was having problems have gone down quite a bit. I used to have a massive clump like right under my knee along the scar, and its a lot better. I start classes on Wednesday - I can't wait!! I still am having a horrible time narrowing down my schedule (my university has an open curriculum...so no gen ed requirements!!), but I am thinking about taking a computer science object-oriented programming course, Visual arts, acting and directing, and economics....possibly intro. to sleep - sounds really interesting! and i also really want to take calculus and spanish....narrowing it down to 4 courses is so difficult with so many options!

I have been trying to ice my knee at least 15 minutes per day. And it still gets pretty stiff from excessive walking....or excessive sitting.

I need to go to the gym next week...maybe do some swimming, hamstring exercises with the exercise ball, and a few other things to strengthen my knee muscles.

I also plan on going to the beach with some friends either this weekend or next. We are going to rent some surf boards, so I am gonna give surfing a try. I think it would be a good way to work on balance and strengthening.

And I also want to continue yoga this year...its every sunday at the jewish center on campus and its free. I think it would be a good way to measure improvement.

Anyone else do yoga? Has it helped your recovery at all?

Thats it I think!
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Re: Distal/Medial TTT, MPFL, and Distal Femoral Osteotomy 6/13/11

Post by crankerchick »

Hey I just wanted to check in and see how you are getting on. Glad to read college is going well and the knee seems to be holding up to the increased demands.

I actually have "The Stick" too on recommendation from my PT. While I did find it helpful at first for "massage," I found that the foam roller is much more effected once I could tolerate it. I used the stick around the same time as you are now after warming up and again after a workout, plus 1-2 more times a day. Then I swapped it out for the foam roller and a slew of curse words around I guess about 18 weeks post op.

Keep up the great work and just remember to try and take time out for stretching at the least along with the stationary bike. Hope you continue to enjoy your semester.
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
JFVolleygirl27

Re: Distal/Medial TTT, MPFL, and Distal Femoral Osteotomy 6/13/11

Post by JFVolleygirl27 »

Week 13

Crankerchick - Thanks!!! I haven't really had the opportunity to use the stick too much yet like consistently, but it seems to help with immediate relief when my hamstrings were really sore. i did the foam roller at therapy a bit.....I didn't want to buy one though. They may have one here at the athletic center, I am not sure. But yeah, my therapist said the foam roll is better.

Everything has been going amazing! When I first got to college about two weeks ago, I was a bit worried that I was losing some of my range of motion. The first week, my leg was just consistently sore, and it hurt a lot to try bending it. But I think the first week and a half just totally loosened up my hamstring muscles with all the walking and physical activity because it is feeling much better now. I no longer have to stretch my leg that much to loosen my knee up.....and I range of motion has been coming back really nice. I haven't really had any aches or pains during the last few days, except for a few sporadic times when the medial side of my knee joint kind of hurts. I went to a party last night and it didn't bother me dancing at all, whereas a week before, I went to dance parties three nights in a row and it was so sore.

I also tried the women's crew team this week. I had a lot of practice drills and training to do for that such as jumping, push ups, etc, and my knee held out really well. If anything, the actual rowing part was really good for my knee because you constantly have to bend your knees and push back when you row. However, I do not think I am going to stay on the crew team - it is much too large of a time commitment and I wouldn't be able to have my work-study job or any other extracurricular I want to do if I did crew all year. But I really feel like I will eventually work myself back to wear I was before the surgery - that was my main concern when getting this surgery. Because, aside from the fear of my knee dislocating, I did not really have too much pain yet (probably would have increased as I got older) and was not really limited by my knee. So I was worried about not being able to get to that level again, particularly after the DFO. But so far, the recovery has been going great. And my muscles have really been coming back the past two weeks - I can now jump (although with not too much power yet in my left leg) and I feel like I am at the beginning stages of running again. I will give that a try tonight when I go to the gym. One thing that I haven't really been doing is the usual therapy because of time constraints - but I have been doing the bike, tons of walking, dancing, stairs, and other activities that I feel are doing a great job at getting my knee back in shape. I want to start swimming again soon....I will try and go to the athletic center this week during free swim to do that. I still try to ice every now and then, particularly if my knee is sore or I can feel it swelling.

The scar tissue is also loads better too....the massive clump underneath my knee that I had about three weeks ago has gone down a lot - I feel like the tissue is stretching. I still do Pilates occasionally to break up the tissue which has been helping.

JFVolleygirl27

Re: Distal/Medial TTT, MPFL, and Distal Femoral Osteotomy 6/13/11

Post by JFVolleygirl27 »

Week 14 (almost!)

My knee has been holding out really well, especially with sports and other activities lately. Stiffness has been improving quite a bit...swelling is still pretty prominent, along with scar tissue, however I can tell that is improving too. Or at least, it feels like the skin is starting to stretch to allow movement. It is taking forever to get full range of motion back, at least like the last 10 degrees or so just seem to be coming very slowly. But I can now sit cross-legged comfortably for a good amount of time before my knee starts aching from being bent for so long.

And....I just tried sailing two days ago!!! And I am still really sore from it, but in a good way. The practice was about 3 hours long - I think it was probably still a bit too much on my knee at this point. I didn't realize how rigorous sailing was! It was windy enough that we came kind of close to capsizing a few times, particularly since I was learning and a bit slow at tacking. But it was a lot of fun...I am still extremely sore from it. I could barely lift my arms yesterday, and surprisingly, my left leg was my good leg for the past two days as my right quad muscles were so sore that it hurt going down stairs. I think I unconsciously babied my left leg a bit when it came to moving around in the sail and such, otherwise, I can't understand how my left leg wasn't as sore. The sailing team is pretty cool at my school - they allow people to come and sail recreationally without the commitment of joining to compete.

An hour after I got back from the sailing club, I also went to the Salsa dancing club! This was a lot of fun and something I plan on sticking with this semester! Some moves were a bit awkward still with my knee, but overall, it went great! My knee held out through sailing and salsa for nearly 5 consecutive hours. It was definitely a bit sore afterwards so i iced it...but its so nice to be getting to the point in recovery where I can do stuff like this again!
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Re: Distal/Medial TTT, MPFL, and Distal Femoral Osteotomy 6/13/11

Post by Fathead_D »

Thanks for keeping this journal. I am seeing Dr Sanders on Tuesday and will likely be having surgery at the end of the Oct.
11/29/2010 Lateral Release left knee
1/2011 Cortizone injection left knee
4/1/2011 Lateral Release right knee
5-6/2011 Supartz injection series (5)
12/12/2011 TTT and Lateral Release repair left knee
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