Tibial Tubercle Transfer

I am 7 mos post-op from Fulkerson realignment and lateral release. For me it worked. I have absolutely NO kneecap pain or grinding. It is a long and hard difficult surgery and rehab but if you get results like mine worth it. I was non weight bearing for one week and partial weight bearing for 6 weeks all with a bledsoe knee immobilizer. I started PT 8 weeks post-op and I recently stopped since I had the 2 screws removed yesterday since they caused me brutal pain. I will resume motion and strength PT afterI see my Dr on 7/12/00. Any questions do not hesitate to post olr email me. Cari

Am facing the same choice...tibial tubercle transfer or tibial osteotomy? Any further info understanding the differences between the two procedures. I need to research them also.

A TTT stand for a tibial tubercle transfer which is a patella realignment procedure where a piece of bone with the patella tendon attached is cut and moved to a more medial and sometimes anterior ( outward ) position and reattached with 1 or 2 screws. I am a 38 yr old female and I am 1 YRT post-op from Fulkerson TTT which is the most severe or radical of the procedures ( I am attaching a few links..one from an ortho textbook and one written by another poster ) that explains in better detail. I have no kneecap pain or grinding at it was gone almost immediately post-op. This is major open surgery and I have a 7 inch scar. I was immobilized and on crutches for 7 weeks 24/7. I started formal PT 8 weeks post-op. It started with range of motion exercises and then strengthening gradually. I went to PT for 4 months. I ended pt working on balance and agility . As far as activities it varies by each individual depending on their procedures and the condition of the knee prior to the operation. What is most important is to listen to all of the do's and dont's instructed by the surgeon.. It is so important. I hope this helps...GOOD LUCK. http://www.kneeguru.co.uk/forum2/messages/3294.html http://medmedia.com/oo1/510.htm

Tammy = See my story under knee surgeries. dlbavido@aol.com They dated my story ahead of itself. It's dated for Dec 22 i believe. I had Tibial Tubercle Transfer on 11/29/2000 and it will be sucessful.

Ok, after reading what everyone else had to say, I am getting more nervous about my surgery (Fulkerson procedure) sceduled for January 31st. Could anyone tell me how long you were out of work? I was told I'd have a cast for 3 weeks and an immobilizer after that. I was hoping to only be out of work for 2 weeks, is that feasable? I just sit at a desk most of the time and will probably rent a wheel chair to get around at work (I hate crutches)! Any info anyone can give me is greatly appreciated!

I am now 3 weeks post TTT surgery. I just found out the name of the surgery. I was calling it knee reaignment. I came home with CPM machine from hospital. And started PT 10 days later. I cannot do agressive PT yet, since with TTT you are restricted from full weight bareing for the first 5-6 weeks completely. I will progress to wight baring and have the Walker removed and a different supportive brace ad retuen to work with a cane or crutch. Still might need additional PT, but I will retuen to ork Post Op 8 weeks. I expected to return after 6 weeks. Don't let people who had Knee replacement tr to tell their stories. Knee replacement receipents are allowed weight baring. TTT victims cannot, as we will ruin what the surgery was for. I felt great on the second day and am going stir crazy to get out, but Chicago has had so much snow making this recovery miserable. Luck to you Be possitive. My work is a tchnical PC sit down job, and I cannot return until 8 weeks.

What a find! So many people with the knee problem! I had a tibial tubercle osteotomy with the subcutaneous lateral release and I have just returned to work after being off for 2 months. The first week or so was painful, but I compared it to my shattered ankle bones five years ago and it was not as bad. I found my pain manageable with Vicadin and elevation. I was pain free by four weeks! My physical therapy was easy at first--they did all the work. At 4 weeks out the PT got more difficult, but not outrageously painful. Then, the last visit, just before returning to work, the PT was fairly aggressive and some scar tissue from a previous surgery was dislodged. Now walking has become painful--feels like torn cartilage. I'm using a cane right until the end of the year, then I should be one my own, assuming the recent PT injury goes away. Still can't climb stairs normally for another two months. All in all, I'm glad I had this done.

Tammy - I was sent home with two of those cyro-cuffs as well since I had bilateral knee surgeries. My Dr will not let me have weight and that is illing me. He said he did too much work inside for me to break. I so want to walk on it, I know I will re-coop better/faster. Every Dr has their ways. An each patient may have a slightly different bit of repar work internally. Glad you did it fast. I am allowed to do my additional exercises for ROM at home along with the PT when I go each week multiple times. I noticed better strength in leg this week and feel I may aggressively (some) add what I can without causing any pain to recoop quicker. Thank you so much for your up date. Donna

Joshua - I knew you said a Patiet aided in your surgery. Don't know why I didn't think youwould be on workmans comp. I was at Dr again today, he sill insists I can not do full eight bearing until 6 weeks post op, and then still need a couple weeks PT for help in weight bearing before able to work at a desk, not your type of work. I would tend to believe your looking at 10 weeks maybe more due to yur size as you mentioned. If someone was to hurt you at work to cause this. I would gander for a minimum of 10 week recovery (possibly). And as many say different, DR, weight, size, and reason all make up how long we are off. Donna

Progress Update. January 2, 2001 I am post-op 35 days (5)weeks. I feel great. Haven't needed a pain pill since I came home from surgery. But as I say remember everyones pain levels are different). If your takig pain medicine and it helps you to keep moving the leg, use it. The main thing after TTT surgery is to move the leg often. Stay with the execise programs reccommended. All DR's do things differently as well I have found out since I had ths done. When I had the running external stitch on the 5 inch (approx) incision removed, it went well. The incision has heeled remarkably from my very first time seeing it the day they removed the running stitch. My PT progress is wonderful, I will advance to floor weight bearing execises next week. For all that had their surgery i past 6 weeks, we will be a little slower if you live in a cold climate area then others due to excessive snow and ice. I live in Ohare / Chicago area and have been blasted with snow and freexing temps since I had the surgery. I do tabl exercises, quad lifts. My TTT leg lifts higher then my scoped leg. I have developed strength and bending capabilities I did'nt know I had. I do side leg raises, on stomach leg raises, keee bends on stomach, heel slides to bed the knee and many others. I am advancing well in PT, yet still have full mobolizer and cruthces/walker. These aids will be removed on Monday to a movable brace with hindges and one crutch/cane. To go back and rethink this surgery. I definately would do this again. I was left with no choice when I chose to have this done as I was barely walking. I feel no pain what so ever even with the PT and exercises. I crutch up stairs and down stairs as long as there are railings and do that well, no pain. SOmething I was not able to do before surgery. My Range of Motion measured today is 112 degrees on my own, and with PT assistance I can bend it further. Swelling is gone. I even went to Target shopping alking in the store for three hours with a cart and crutches. I am so looking forward to next weeks aggressive PT I will update everyone at that time. The original CPM machine I used I fell in love with. Donna

Thanks for the message Joshua! Actually I am supposed to have a cast for the first 3 weeks post-op and then an immobilizer for 3 weeks after that.

I am four months out of a lateral release, but it looks as though that alone is not going to help knee pain. I didn't realize there were others enduring knee pain which is a real pain in the ass. Are any of you who had the TTT bowlegged? I am slightly bowlegged and played basketball growing up. I am curious if anyone with the TTT also had an osteotamy? Thanks for the support. Take care. Angelo

Liltoad and Joshua, Liltoad - Don't worry yourself so much you'll get ulcers over it. And I agree with Joshua, no 70 hours working for a while. Please remember were here for you. Everyone recovers differently and every Doctor does the surgery their way and has their patients using is/her techniques of recovery they have thus found work best for them. I am going back to work on the 29th this month, but I wll be sill attending PT for awhile. The knee/leg strength doesn't come back as quick as you hope. And I follow the PT words and exercises regularly. Strange how everyone/ almost everyone that is having this surgery seems to be workaholics. I a dying to return to work for sanity. I had my surgery a few days before the bad snow storms of Chicago area early December and I was going stir crazy. But I'm driving for some time now and shopping in the malls has been helping (I hope my recovery. Poor Joshua has had endless problems and my heart bleeds for my adopted son. I have been really fortunate with mine. Although the screws I am told stay there indefinately. Still wondering if I will ding at the airport. Take care all Donna

Liltoad - You are planning for the worse and will fnd relief that all the worrying wasn't worth it and it will be better then you think. We all will think of you. And the four letter words will be- HELP me get up, I LOVE the DR, I still HAVE my leg, and my KNEE feels great, LIFE is great now that it's over. Relax things always work out. Remember PAIN goes way. Staying over night in a hospital is scary ONLY if you are around the patients Joshua worked with, but you won't be. ICE is soothing, and the PC is'nt far away.

Well, I'm going in tomorrow for my Fulkerson procedure! Wish me luck! I'll keep you guys posted!

Ok, I'm 2 days post-op and as warned I feel like hell! My leg is a swollen down to my foot and the painkillers are not working nearly as well as the morphine I was getting in the hospital (although that made me puke). Hope it will get better, as it is I have cried everytime I have been out of bed to go to the bathroom! Please tell me it gets better!

It does get better !!! The first 2 weeks are the worst it is going to get and for me they were horendous.. If you cannot tolerate the pain pills ask your os for something different you shouldn't suffer like that !!! Feel Better Cari

Sharon - My heart bleeds for you not being able to sleep and having pain. I had the full leg immobolizer from almost hip joint to ankle for 6 weeks with no weight bearing AT ALL. Similar to you 6 weeks is normal, then you may go down to a knee brace/sleeve with side hindges for support during the harder physical therapy. The only difference is, you have the cast now for the first three weeks which restricts leg movement completely and muscle or knee bending of any type until you get the immobolizer on. No it's not easy and I sure hope your mom can help you clean up, that will hep you feel better. Physical therapy will start as soon as you get rid of the cast. First you will feel like your leg is dead, and rubbery since you haven't had the opportuity to even move/bend the knee slightly as you will when you get the cast off. In the end when your all done with physical therapy perhaps you can look back at what you went through and feel good with your progress and be able to share all this with others. You will watch others first coming to physical therapy and remember when you did that. Keep your head up, and I'll pray your pain lessons quickly. I have been very fortunate not to have had any pain after the surgery. Keep us updated and we will offer all the support we can. It will get better, the pain part anyways.

Update - I am 9 1/2 weeks post op from TTT, I have been back to work 2 1/2 weeks full time. I am having no problems and can even actual run down the stairs to the sub way in Chicago which if you know is about 4 flights of stairs down under ground. I can do that well, although just to be safe I hold the railing in my run down. I stopped PT when I graduated 3 days after returning to work. I dont even wear my Patella Pro-stabolizer during the day only wear it back and forth to work, although the surgeon suggest to continue wearing as the bones do not completely heal for the work sustained in a TTT in under 4 months. For some of us we have extremely good luck in the recovery process. I have been fortunate that way. I wish everyone the luck I have had in recovery. I will keep an eye on all of you. (hugs to anyone in pain) especially my son Joshua.

Hi Tammy, I had a Tibial Tubercle Transfer on January 30th. I had the Elmslie Trillat procedure done. It's pretty similar to the Fulkerson, except they don't cut away as much bone. It will be 3 weeks since I had the surgery this coming Tuesday, and so far I am doing fine. I didn't have much pain before I had the surgery, but I had severe and grinding in my right leg if I were to bend my knee or squat. My alternatives were to try physical therapy to try to strengthen the quads to get my knee cap back into alignment, and I found leg lifts were quite painful. I tried PT for about 6 weeks, and my 1st OS said he saw some improvement, but I was concerned about the "catching" and "Crunching" noises not going away. I then proceeded to get a 2nd opinion from a sports Medicine Ortho, and that's when he recommended the surgery. It was a tough decision for me because I was not in much pain with the knees before the surgery, but it was a matter of correcting it before it would worsen. As for the experience of the surgery, I don't have really any pain, and I didn't have to take any pain meds. But each one experience varies. The decision of having the surgery is soley up to you. I know it's tough!! I almost post poned mine twice because I was frightened. I still don't know what my outcome will be, but I have a good feeling that it shouldn't be too bad. If there is not pain, I must be recovering pretty well. If you have any more ???'s feel free to e-mail me anytime. Take good care of those knees!! :-) Jessica