I thought I was over the hump and my pain would be much more controlled from here on out. And then we adjusted my brace. Preparing for Surgical Kneecap Alignment. I was reading about it, and a physical therapist said that after having a major knee surgery like this, the quad muscles shut down in order to protect the knee joint. Everytime I stand up, I feel this big rush of blood running to my knee making it feel so heavy. I only have a couple doses of my prescribed narcotics left, so instead of taking two every four hours, Im taking one with another 550 mg of Tylenol. I was life flighted to MCR in Loveland, CO. My orthopedic injuries were severe, but totally missesd by the orthopedic team at Poudre. What to expect: 1. @article{Lundeen2022HighIO, title={High Incidence of Complication Following Tibial Tubercle Surgery". Patellar Instability (Kneecap Dislocation). I was told by one of the orthopedic surgeons that I worked with that I would never run again and would be lucky if I could ever hike again. I couldnt lift my leg so we brought my little stroller and crutches. I still cant even pick up my leg by myself. The osteotomy should be 8 to 10 cm long. The surgical procedure of triplanar osteotomy and transverse distraction. Usually, this involved moving the tibial tubercle distally or distally and medially. 2006; 13(6 . It is important to ensure that a proper workup has been determined as to how far distally (down the tibia) or medially (towards the inside of the tibia) the tibial tubercle must be moved in order to obtain the best surgical outcomes. Complications are not infrequent, even if performing the correct surgical steps. What to expect: 1. I was feeling well enough to sit in my wheel chair for a little while. Previous attempts to make it better provided only temporary relief. Tibial Plateau Leveling Osteotomy (TPLO) . The goal of the surgery is to improve patellar tracking and stability, alleviate pain, and take pressure off of the cartilage. The success rate for a tibial tubercle osteotomy depends upon its underlying reason for the tibial tubercle transfer. With the help of an oscillating saw, a cut is made medial to the tuberosity and a distal cut is also made. After discharge from the hospital most patients return to normal activity in three to six weeks. You will have a leg brace which may be removed only while sitting with your leg elevated. Tibial tubercle osteotomy requires a comprehensive evaluation of the entire lower extremity, since all of the imbalances associated with the patello-femoral joint cannot be assigned solely to You can schedule an office consultation with Dr. LaPrade. In patients with patellar instability and patella alta, who also have a tibial tubercle-trochlear groove (TT-TG) distance of 2 cm or greater, a tibial tubercle osteotomy may be indicated. My right knee was totally destroyed; ACL, MCL, PCL all severely torn; the patella was the only thing intact in my right knee. My surgeon wouldve judged me a lot for coming in in a wheelchair. Eagan, MN 55121, I struggled with my knee for 18 months - having gone from 10,000 steps a day to only walking as needed. 23. But then around noon today, I finished my last narcotic pill. The leg twitches are definitely not fun because they make my knee tense up. Today was the first day that I actually felt good enough to be out of bed for a little while. Fax: 435-655-2388 The segment from the tibia is then levered using osteotome so as to provide access to the medullary canal of the tibia. High tibial osteotomy. I am so glad I did! Im actually kind of excited to have those scars. Patients who have patellofemoral instability or patellofemoral arthritis that is localized to certain portions of the patellofemoral joint (kneecap), may be candidates for a tibial tubercle osteotomy. Knee. While many dogs are able to walk as soon as 24 hours after surgery, a full recovery and a return to normal activities will take 12 - 16 weeks or more. In some cases, there may be a longer period of nonweightbearing required, such as after a revision tibial tubercle osteotomy, or in cases where a thinner shell of tibial tubercle was transferred. Then an osteotomy through the bone cortex is performed without cutting off the lateral periosteum. Today was the first time since before surgery that I sat at the dinner table to eat! I was feeling well enough to sit in my wheel chair . Tibial tubercle osteotomy is a surgical procedure which is performed along with other procedures to treat patellar instability, patellofemoral pain, and osteoarthritis. Throughout my own experience with the tibial tubercle osteotomy I had earlier this year, I went through many ups and downs, both mentally and physically. In osteotomy procedure, a periosteal incision of 8-10 cm length is made at a distance of 1cm medial to the tibial tubercle. <> Complications after tibial tuberosity osteotomy: association with screw size and concomitant distalization. A tibial tubercle osteotomy involves moving the tibial tubercle to a different location, almost always due to some underlying kneecap problem. . This is called a High Tibial Osteotomy or H.T.O. Murray, Utah 84107 In these circumstances, a workup to include a long leg alignment x-ray to see if a patient is malaligned in a significant amount of valgus (knock kneed), as well as plain x-rays to ensure that there is no significant arthritis, supplemented with an MRI scan to determine the amount of arthritis and shape of the trochlea, as well as a CT scan to determine the patients tibial tubercle to trochlear groove distance (TT-TG) would be indicated. so this video is just about my experience with knee surgeries, specifically my latest one & some advice I have for people going through the same thi. Ive been feeling a little bit discouraged because of it. Surgical kneecap realignment (also called tibial tubercle osteotomy and elevation) is performed when your kneecap has moved out of position and all other efforts to put it back into the natural kneecap track have failed. Often, it involves a complete detachment of the tibial tubercle, along with the patellar tendon that is attached to it, and moving it either further down the tibia (due to patella alta or a high-riding kneecap) or moving it more to the inside (medially) because of an increased tibial tubercle to trochlear groove distance (TT-TG) or some treatable lateral patellofemoral compartment arthritis. The osteotomy can be combined with soft tissue realignment procedures or . I cant even get out of bed without someone lifting up my leg by my ankle and setting it in that little stroller to wheel it around. There is still pain, but Im finding that I can go five or six hours between taking my medicine. The physical therapist also said that hooking the leg up to a machine that sends electrical impulses to the muscles will stimulate them, and then you can relearn how to use the muscles after a little while. In a tibial tubercle osteotomy, the tibial tubercle and the patellar tendon are detached and moved to a pre-calculated new position on the anterior tibia. Thank you, Dr. LaPrade, for treating me with the care, focus, and expertise as if I was an Olympic athlete!- From your 63 year old very appreciative patent ~. 7,9,14,16,24,28,40,44 The ultimate goal of a TTO is to . It seems to be working pretty well. TTA surgery can be done safely and effectively to provide your dog with the best comfort and outcome . Then, I had my post-op appointment. Tibial tubercle transfer (TTT), also known as tibial tubercle osteotomy (TTO), or Fulkerson osteotomy, is a surgical procedure that is performed to correct lateral displacement of the tibial tubercle. The goals of this operation are to: wedge Improve knee alignment graft Shift weight from the arthritic part of the knee onto a healthier part of the knee Tibial tubercle osteotomy and transfer is done through an incision made in the front of your leg just below the patella. 2018;6(10):2325967118803614. I sat up in the wheelchair and it made me so happy to finally be able to move around. Not much has changed. I was hit by a car on my bicycle near Horsetooth Reservoir in CO. Tibial tubercle transfer technique involves realignment of the tibial tubercle (a bump in the front of the shin bone) such that the kneecap (patella) traverses in the centre of the femoral groove. Tibial tubercle osteotomy and transfer is done through an incision made in the front of your leg just below the patella. Once it wore off, I started taking liquid Tylenol and much smaller doses than I had been with the pills. Eighty-eight knees, opening-wedge osteotomy with Puddu plate (group A . The first thing we did was get x-rays. 3 0 obj Then we got the stitches out. I still can only lie on my back which makes the back of my head ache after a little while. Tibial Tubercle Osteotomy and MPFL reconstruction journal Just a blog following the journey of my Tibial Tubercle Osteotomy and MPFL reconstruction surgery :) Posts. I am 5-months post surgery, and am doing great, stationary biking and exercising every day, no pain.You know you are seeing the best when you find out he has written over 500 medical journal articles - among many other accomplishments. Methods: Forty-two TTOs were performed in revision knee arthroplasties between 2009 and 2015. Dog Recovery from Knee Surgery. The osteotomy segment is then moved under direct vision into a position that assures proper tracking of the patella. Usually, patients have a secure fixation . TIBIAL TUBERCLE OSTEOTOMY PHASE I: ~0-2 Weeks Postoperative GOALS: WBAT with crutches/brace Monitor wound healing Full extension DRESSING: - POD 1: Debulk dressing, TED Hose in place - POD 2: Change dressing, keep wound covered, continue TED Hose - POD 7-10: Sutures out, D/C TED Hose when effusion resolved After anesthesia is administered, the surgeon makes a four- to six-inch incision over the tibial . With this procedure, patients need to be non-weight-bearing for 6 weeks and the osteotomy itself can take up to 4 months to heal before significant stress can be placed across the quadriceps mechanism in order to make sure that they do not go on to have a full fracture of their tibia. But, using a muscle roller helps loosen the mu. The tibial tubercle is then secured back to the tibia, most commonly using cannulated screws and washers, to provide a solid fixation of the tibial tubercle until there is appropriate time for it to heal. It wasnt nearly as bloody as I thought it would be. In this circumstance, the tibial tubercle is either elevated or moved distally (away from the center) and elevated to try to restore a more normal position of the patella, or to unload the patella from an area of arthritis on the trochlea or distal pole of the patella. In general, it is felt that the success rate can be between 70-80% for up to 5 years. I had one very bad one this morning that felt like it ripped some of the stitches out. I still cannot physically lift my leg and its been driving me crazy! Phone: (770) 363-8770. Depending upon whether it is treating concurrent kneecap instability or osteoarthritis, the tibial tubercle will be moved a set amount distally down the tibia and/or medially on the tibia to best position the tibial tubercle to address these pathologies. February 1, 2018 - Day 8. Recovery after knee surgery entails controlling swelling and discomfort, healing, return of range-of-motion of the knee joint, regaining strength in the muscles around the knee joint, and a gradual return to activities. I could not bear weight on my right side though I tried repeatedly, but finally I went and got an MRI and one of the orthopedic surgeons that I worked with was shocked when he saw the MRI result. . The procedure usually requires hospitalization and general anesthesia. Tibial tubercle osteotomies are used to treat patients who suffer from patellofemoral instability (PFI) or painful patellar maltracking. Oral pain medications will be prescribed that helps control your pain. 900 Round Valley Drive, Suite 100 The moved tubercle is held in place by two screws and washers. Tips: How I washed my hair- I sat on the toilet next to the, I am so uncomfortable! But then I realized, I cant hold my leg out infront of me, but I can hold it out behind me! References. It was so nice not eating in bed like I have been! Osteotomy literally means "cutting the bone." That means, in the surgical procedure known as tibial osteotomy, the tibia is incised and it's reshaped as a way to reduce the force on the knee joints. Keep the operated leg elevated and apply ice packs (Click to buy from "The Kit Room") or your AIRCAST CryoCuff(Click to buy from "The Kit Room") over the area for 20 minutes. In addition, patients with a high-riding patella (called patella alta) also need a workup with varying measurement techniques when they do undergo kneecap instability surgery to determine how far distal the tibial tubercle should be moved to have it better seated within the trochlear groove. How long will it take to be able to walk or run again? You may have minimal to moderate knee discomfort for several days or weeks after the surgery. A total of 187 patients (195 knees) who underwent HTO between 1990 and 2010 were retrospectively evaluated. . Tibial tubercle transfer on a medial periosteal pediclea report of a new technique. Some patients will be able to be discharged . In osteotomy procedure, a periosteal incision of 8-10 cm length is made at a distance of 1cm medial to the tibial tubercle. <> Are you a candidate for a tibial tubrical osteotomy? Eat healthy food and drink plenty of water. Ive only gotten out of bed 2-3 times all day to use the bathroom. Its the best Ive felt since before surgery. The purpose of this study is to report and analyze the long-term outcomes of the patients who underwent high tibial osteotomy (HTO) with three different techniques for the treatment of medial compartment arthrosis. This procedure, also called bone realignment, is designed to improve the movement of the patella (the kneecap) to correct patellar tracking disorder. My pain level today was about the same as yesterday. This surgery is used to attach the tibia and the patella back together. Most commonly, osteotomies about the knee are cuts in the top of the shin or "tibia" bone. The surgery may be combined with other procedures such as knee arthroscopy or MPFL reconstruction. Although, this morning we got to take off the brace and ace bandage to change the gauze. Other than that, these past two days have been pretty similar. Tibial tubercle osteotomy (TTO) is one of the many procedures utilized in the treatment of recurrent patellar instability, painful extensor mechanism maltracking, and patellofemoral chondrosis, alongside a concomitant cartilage procedure in patients who fail nonoperative treatment options. EDINA- CROSSTOWN OFFICE Osteotomized tibial tubercle bone block being trans-lated in the appropriate direction to address patellofemoral A Tibial Tubercle Osteotomy (TTO) is surgery to move the insertion point of the patella tendon and fix it in a new position with screws. The apex of the chevron should allow a fragment thickness of 1.5 to 2.0 cm at the level of the tibial tubercle. Ill explain how I was able to wash up a little bit under the tips section! Its like my quadriceps just arent there anymore. This was devastating news after being a top triathlete (3rd in the world in my age group in 1989 & 1st nationally in my age group) and a big marathon runner. Get link; Facebook; Twitter; Pinterest; Email; Other Apps; February 01, 2018 SO MUCH HAPPENED TODAY!!! Figure 7. in cases where there are difficulties gaining adequate surgical . Johnson AA, Wolfe EL, Mintz DN, et al. Recovery from a revision knee replacement mirrors the recovery from the initial total knee replacement. This decreases swelling as well as pain. A tibial tubercle osteotomy involves detaching the tibial tubercle from its attachment on the tibia (shinbone) concurrent with its patellar tendon attachment. In osteotomy procedure, a periosteal incision of 8-10 cm length is made at 1cm medial to the tibial tubercle. With the help of an oscillating saw, a cut is made medial to the tuberosity and a distal cut is also . For a tibial tubercle osteotomy that is performed with a cartilage resurfacing procedure, or with the treatment of lateral patellofemoraljoint arthritis, the success rate is dependent upon the cartilage resurfacing technique and the amount of arthritis that is present. By moving the bone (tibial tubercle), it can correct the malalignment of the patella in the groove (trochlea) of the femur (thigh bone) and eliminate . This answers all my questions! In a tibial tubercle osteotomy, the tibial tubercle and the patellar tendon are detached and moved to a pre-calculated new position on the anterior tibia. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Patients who have a high tibial tubercle to trochlear groove (TTTG) distance of 20 millimeters or more that do need to have a medial patellofemoral ligament reconstruction (MPFL) are generally felt to need a tibial tubercle osteotomy. Office Hours It corrects the maltracking of the patella (kneecap). Background and Objectives: Studies have shown that centrally sensitized patients have worse clinical outcomes following total knee arthroplasty (TKA) than non-centrally sensitized patients. Its going to take so long to just be able to pick up my leg without physically grabbing it with my hands and moving it. Patients who need a tibial tubercle osteotomy surgery usually have underlying kneecap instability or lateral patellofemoral compartment arthritis. Fulkerson osteotomy. It is unclear whether central sensitization (CS) affects patient-reported outcomes (PROs) and/or level of osteotomy site pain in patients undergoing medial opening-wedge high tibial osteotomy (MOWHTO). Tel: 435-655-6600 Right Knee Surgery After Auto Bicycle Accident, Medical Second Opinion Service MRI/X-ray Review. Risks following tibial tubercle osteotomy surgery are rare but may include compartment syndrome, deep vein thrombosis, infections and delayed bone healing. Tibial tubercle osteotomy and transfer is done through an incision made in the front of your leg just below the patella. The lateral periosteum serves as a point of attachment for the osteotomy segment. A thorough work-up is necessary to determine which patients may be candidates for a tibial tubercle osteotomy. This removes the load off the painful portions of the kneecap and reduces the pain. What t, Last night was pretty interesting. omy cut for tibial tubercle osteotomy within appropriately placed cutting jig. Initiate open kinetic chain progressing to closed kinetic chain multi-plane hip strengthening, Progress open and closed kinetic chain program from bilateral to unilateral, Aggressive terminal quadriceps stretching, Advance unilateral open and closed kinetic chain strengthening, Advance open and closed kinetic chain strengthening, Increase intensity on bike, treadmill, and elliptical trainer, Increase difficulty and intensity on proprioception drills, Begin gym strengthening: leg press, hamstring curls, ab/adduction; avoid lunges and knee extensions, Begin multi-directional functional cord program, Continue pool running program advancing to land as tolerated, Begin multi-directional field/court drills, Begin bilateral progressing to unilateral plyometric drills. The moved tubercle is held in place by two screws and washers. I didnt feel like it would be a good idea to take a shower because all we have are tubs. X-rays are usually obtained at the 6-week point after surgery to ensure that there has been an appropriate amount of healing of the tibial tubercle to judge whether further advancement in their weightbearing program can be performed. My pain level was low and since Ive only been taking one pill of narcotics, I didnt feel groggy and dizzy. osteotomy site Osteotomy means cutting the bone. We tried using a wheelchair, but we cant get it into the bathroom very well. Tibial Tubercle Osteotomy Preparing for Surgery Getting healthy before surgery, eating a balanced diet, adequate hydration and rest. What to ex, I cant believe its been a week since surgery! Follow-up period ranged from 3 to 24 months. I cant wait until Im able to move around by myself and do basic things for myself. Now Im allowed to bend my knee up to 40. Use tab to navigate through the menu items. Dr. La Prade had just moved to Vail and I was his 2nd patient @ The Steadman Clinic. Usually, patients have a secure fixation which allows for early knee motion of up to 90 degrees of knee flexion. Tucker Office Location: 1462 Montreal Rd WEST Suite 101, Tucker, GA 30084. I never knew how much work this surgery costed!! My knee is still so swollen that I cant even see my knee cap. This surgery is used to help dogs who are unable to extend their knee. Tonight I was able to wash my hair for the first time since before surgery and it felt so nice! I cant tell if its internal or the incision itself. TTA surgery for dogs is a surgery that is used to treat a condition called tibial tuberosity avulsion. It essentially forgets how to work and lift the leg until it is restimulated. It was exactly 101F and being the worrier I am, I was freaking out. To get to the bathroom, weve been using one of my old baby doll strollers. A thorough workup is necessary to determine the underlying pathology and determine where the tibial tubercle will need to be transferred. Leg twitches. Those are the little things I used to take for granted- being able to do things for myself. I just, This morning I was feeling great. I also knew that the incision for the tibial tubercle osteotomy would be large, but I didnt realize that that incision for the MPFL reconstruction would be so big, too! 900 Round Valley Drive, Suite 100 Park City, Utah 84060 Tel: 435-655-6600 801-743-4500 Fax: 435-655-2388 Office Hours Monday-Friday: 8-5 By doing this, a tibial tubercle segment which is more than 2 cm in width, more than 1 cm in thickness and 8-10 cm length can be obtained. It should include all portions of insertion of the patellar tendon. While the use of a long, tibial tubercle osteotomy (TTO) is an established method to improve exposure, controversy still exists concerning complication rates and sequential use. %PDF-1.7 Osteotomy means "cutting of the bone." Tibial tubercle osteotomy is the most common type of knee osteotomy performed. At first, knee arthroscopy will be performed to inspect the inside portions of the knee joint. Just a blog following the journey of my Tibial Tubercle Osteotomy and MPFL reconstruction surgery :), SO MUCH HAPPENED TODAY!!! But once I got inside, they ended up giving me a wheelchair anyway! The tracking pattern can be confirmed arthroscopically. Ive been thinking about this a lot while lying in my one position. The procedure usually requires hospitalization and general anesthesia. When surgery is complete you will be cared for in the recovery room for 1-3 hours before being transferred to the orthopaedic ward for your overnight stay. But after getting cleaned up yesterday and moving around today, I started to feel more human again! endobj endobj Tibial tubercle bone block being drilled and fixated in translated position with two 4.5-mm countersunk cortical screws. Similarly, a proximal cut is made using appropriate instruments such as curved osteotome or reciprocating saw. DOI: 10.1016/j.jisako.2022.11.005 Corpus ID: 253899986; High Incidence of Complication Following Tibial Tubercle Surgery". endobj 4 0 obj For cases that are performed concurrent with a medial patellofemoral ligament reconstruction (MPFL), the success rate for the surgery is felt to be greater than 80%. Talk to your orthopedic specialists about knee replacement with tibial tubercle . Begin multi-plane straight leg raising and closed kinetic chain strengthening program focusing on quality VMO function. This surgery can prevent or delay the need for partial or total knee replacement. Tibial Tuberosity Advancement (TTA) . Heber, Utah 84032, 5848 S Fashion Blvd (300 E) Honestly there havent really been any changes from yesterday to today. This open surgery has the longest recovery time of all patellofemoral pain syndrome . The procedure was first performed in Europe during the 50's and was brought to the US in the 60's. Thank you for choosing Dr. LaPrade as your healthcare provider. % Tel: 801-743-4500435-655-6600 I went to the fridge and got myself a glass of water for the first time in a while! The procedure is performed under general anaesthesia and you will be completely unaware of the surgery until you wake up in the recovery room. But after the doctor had us look at the incisions (which looked fine) and to squeeze my calf and make sure there was no pain, she wasnt too concerned about the fever. The time for recovery and rehabilitation and the intensity of physical therapy treatment . The tibial tubercle is cut at an angle and slid into a different position to transfer load to the healthier part of the patellofemoral joint. My mom put a couple blankets in it. The following instructions are intended as a guide to help you . Despite this, TTO is a challenging technique with a long learning curve and potential pitfalls. (including injections and arthroscopic surgery), I heard Dr. La Prade was going to practice in the Twin Cities - where I live, & waited for him, based on his renown reputation. I was in a lot of pain and had a fever so we ended up calling the doctor. This surgery realigns the knee joint in people who have knee arthritis. The truth is that healing completely from knee surgery is a long process. Tomorrow is the day I get to take off the brace and change the gauze! Risks following tibial tubercle osteotomy surgery are rare but may include compartment syndrome, deep vein thrombosis, infections, delayed bone healing (non-union) and fracture. But at the same time, the past week has felt so long!! And I still cant pick up my leg!!! My knee hurts and the incisions itch. Tibial tubercle osteotomy cannot be considered an entirely safe procedure in primary TKA as it is associated with local complications, particularly skin necrosis and fracture of the tibial tubercle. 2700 Vikings Circle I feel much better than I did the first and second day for sure. Im a pretty independent person so this has been interesting relying on other people for everything. x][o7~GenEQ"SEva"jrG89DJG[nG>UU18f^-~?09|WLgE5[?TOzR~=;>=a|dK4|v?fyBELXG13vug>(eB6gY/~/_6_?w>mXu>p)JV$fcX*rv`/dO;|t;?9;eQ =&=RXi[zx@f&rV ("c1L`r=. The mobilised bone is then fixed into its new place using screws, which can be removed later if they cause irritation. }, author={Anna Lundeen and Jeffrey A Macalena and Julie Agel and Elizabeth A. Arendt}, journal={Journal of ISAKOS : joint disorders \& orthopaedic sports medicine}, year . Usually, this involved moving the tibial tubercle distally or distally and medially. This is a quite safe procedure and provides excellent access and surgical exposure during a difficult primary or revision total knee arthroplasty. Theres the, Today was a pretty good day pain-wise. Physiotherapy exercises should be done as it helps in regaining mobility. 1 0 obj Most commonly, tuberosity transfer is employed for the treatment of patellar instability or symptomatic overload of the patella. 2 0 obj Surgical treatment is indicated when physical therapy and other nonsurgical methods have failed and there is history of multiple knee dislocations. I have looked many times for answers on my tibial tubercle osteotomy and never found any as detailed as i needed. Edina, MN 55435, EAGAN-VIKING LAKES OFFICE Then I rest my leg in it while using crutches and my mom walks backwards pulling the stroller. By moving the bone (tibial tubercle), it can correct the malalignment of the patella in the groove (trochlea) of the femur (thigh bone) and eliminate symptoms of instability and decrease the symptoms of . Recovery from a revision knee with tibial tubercle osteotomy. I can just barely get my leg off the ground holding it out behind me. Kanamiya T, Naito M, Hara M, et al. The distal osteotomy cut should taper from the apex of the chevron to the distal-anterior tibial cortex in a straight line. Tibial Tubercle Osteotomy. Request Case Review or Office Consultation, Lateral Patellotibial Ligament Reconstruction. stream Im feeling better in terms of my dizziness, but my pain level is back up there again. But it does hurt a lot less to touch it. Therefore, tibial tubercle osteotomy should be performed only when necessary, i.e. Tibial tubercle osteotomies are used to treat patients who suffer from patellofemoral instability (PFI) or painful patellar maltracking. Robert LaPrade, MD, PhD Tues. & Wed: 85, Brace locked in full extension for 6 weeks, Non-weight bearing for 4-6 weeks per physicians instructions, Ice and modalities to reduce pain and inflammation, Continue with aggressive patellar mobility, Continue with submaximal quadriceps setting, isometric hamstring/groin and global lower leg strengthening, Progressive weight bearing per physicians instructions, Continue with ice and aggressive patellar mobility, Increase intensity with quadriceps setting, Open brace to 45- 60 of flexion week 6, 90 at week 7, Continue with swelling control and patellar mobility, Gradually progress to full range of motion. All I can say is Dr. La Prade did an amazing job and I am not limited in any of my activites. I can run, bike, & climb mountains. (Please keep reading below for more information on this treatment.). I can definitely tell when the pain medicine starts, I still am in a ton of pain just like yesterday, but its a tiny bit better. Id say that while I still have to make sure I stay on track with the pain medicine, the pain is becoming more tolerable and manageable. <>/Metadata 254 0 R/ViewerPreferences 255 0 R>> In addition, for patients who have an articular cartilage resurfacing procedure of the distal half of their patella, or the medial or lateral portions of the trochlear groove, may also be candidates for tibial tubercle osteotomy. The tubercle is commonly moved distally or medially depending on the indication for surgery. Its pretty painful but its so much better than any other alternative. After we got home, I was really frustrated about still not being able to move my leg. In fact 2 years ago I finished climbing the top 100 peaks in CO. 801-743-4500 A A triplanar osteotomy (6.5 cm in height with a width of 1.5 cm) was created on the medial cortex of the proximal tibia along the 3 sides (proximal, distal, and lateral) of the rectangle; the medial margin of the tibia was used as the medial side of the rectangle.B-D 2 curved skin incisions were made. Figure 8. Osteotomy of the tibial tubercle is a versatile procedure that can be utilized for several common pathologies about the patellofemoral joint. Office Hours My recovery process took about 12 weeks, and as you'll see throughout this series, the journey really is what you make of it along the way. hi guys! I look like the most ungraceful thing you ever saw, but at least I can hobble around and get to the bathroom by myself. Introduction: Tibial tubercle osteotomy (TTO) is a well-established extensile approach to improve joint visualization and implant removal. Dr LaPrade performed a deep root repair to my meniscus, which saved me from a knee replacement at this time. A Tibial tubercle osteotomy is generally considered a higher level/ salvage type procedure. Im kind of excited to see the incisions. Either that or Im just getting used to it by now. This complication is rare, a sudden fall or stress to the knee could put the area of the tibial tubercle osteotomy under significant stress, which could lead to a fracture. Im supposed to be doing straight leg lift exercises but I cant. It feels numb almost, but I can still feel myself touching it. This is a specific technique that involves removing a part of your tibial tubercle (a specific area on your tibia). They told us to call if my fever was 101F or higher. Tibial Tubercle Osteotomy. The patellar maltracking is corrected by moving the tibial tubercle medially, towards the inside portion of the leg. Dr. Robert F. LaPrade operated on my right knee in May of 2010. 24. This procedure, also called bone realignment, is designed to improve the movement of the patella (the kneecap) to correct patellar tracking disorder. MondayFriday: 85, 380 E. 1500 S. Suite 103 With the help of an oscillating saw, a cut is made medial to the tuberosity and a distal cut is also made. Most patients who have a tibial tubercle osteotomy require 6 weeks of nonweightbearing to ensure that the tibial tubercle heals appropriately. I took off the brace again today to change the gauze. Hey - if he is good enough for Olympic and professional athletes..he's good enough for me! Park City, Utah 84060 It involves small incisions or portals through which small instruments are passed and a video camera is used to visualize the anatomy of the knee joint, evaluate patella cartilage and assess patella tracking. It is our goal to provide the highest level of care and service to our patients. Tibial Tubercle Osteotomy & Arthroscopic Lateral Release. Every once in a while I get these extremely sharp pains near my MPFL incision. Who is a candidate for a Tibial Tubercle Osteotomy? There are two ways to initiate a consultation with Dr. LaPrade: You can providecurrentX-rays and/or MRIs for a clinical case review with Dr. LaPrade. Orthop J Sports Med. 4010 W. 65th St. Knee Topics Conditions. The . 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