Tibial Tubercle Transfer

Kim, yikes! Indeed, it seems you are trapped in a worker's compensation anti-treatment vortex. Not sure what you can do in Alaska to transfer your case to a doctor of your choice. Again, look into your legal worker's compensation rights. Meanwhile, ask your personal doctor to write a report regarding your condition and bring that report to your April 20th appointment. Alternatively to getting a report, get copies of your records from the doctors office. Sounds like your personal doctor feels you have an ongoing knee injury that needs further treatment. Hopefully, your personal doctor will be able to help you. Even though you returned to work at a desk job--- worker's compensation way of getting you back to work quickly --- it may be contributing to your symptoms. Too much, too soon. My last knee surgery, 1995 for pin removal, tendon repair, calcium deposit and scar tissue removal, clean up etc. etc., doctor wanted me at home for two months. Upon returning to work, I had the same symptoms you have. Doctor sent me home for another month. Even with a desk job, you are on your feet, going through your morning routine, getting to work, getting into the building, taking bathroom breaks, eatting lunch, etc. So yes, have heard of your symptoms. Seems like your symptoms could be caused from two things, ongoing injury and still healing from your surgery. Hope you can either switch doctors or get your personal doctor to become your health advocate. Good luck! -jj

Thanks jj. One more question, do my symptoms sound like the usual for ttt or just agrivation? My last scope was in November. My pt says that the chronic pain is a brick wall for me even though I continue to work hard. By the end of my 1hr. session my knee is swollen and painful. My Dr.. is very pro patient but w/c holds the purse strings, I had to write up my boss today for harrassment. I'm the only totally cross-trained nurse and he is bugged that he can't utilise me. He blew up at me twice in 2 weeks ( not the best manager ) but I figure that w/c may be interested in these events-maybe. I'm really curious about what the usual symptoms are that indicate a ttt-help & thanks!

Thanks jj, things will work out- I'm sure. Oh yeh, I didn't mention, my Q-angle is 30 bilaterally. I DO have VERY strong leg muscles but since the last injury, every step is a sublexation.( it's like the over-stretched balloon, it gets more sloppy with use, not tighter.

I've been reading the postings on this site, as I am considering doing a TTT on knee #2. I am so thankful to find someone who is over a year out of recovery. My first knee is still bothering me (14 mos. later), and I'm wondering if I too have a cyst or something that is causing the pain. How did you get the doc to do the bone scan?

For the mom who's daughter is having surgery May 7... can't Imagine having a lateral release and TTT as outpatient surgery. Probably has to do with insurance, not patients recovery. My stay for TTT was five days each and wore braces for 7 to 8 weeks. If outpatient or overnight stay are your only options, go with overnight stay. My knee update... finally had orthopedic appointment on Monday. Doctor ordered MRI and bone scans. Suspects patella cartilage worn to the bone. Fortunately, x-rays showed bones in reasonable condition.

JL Kendrick from the UK, glad to hear your recovery is so swift - what do you think the big difference was between the first and second operation in terms of recovery time? I had ttt 8 weeks ago now and can hobble around O.K. - never had a leg brace, but was on crutches for 6 weeks (and am still not brave enough to send them back to the hospital!). I found the bruising very painful - particularly around the ankle area which was a bit of a mystery to me! I am from the UK too originally - now in oz, so we both offer wider experiences outside the US system. I had a difficult surgeon who got pissed off when I asked him any questions about the procedure so this site has been blomming marvelous for me (although it took me a while to work out I had even had a ttt!). Well, I guess your knee procedure has happened at an opertune time when you wouldn't have been able to rome the countryside anyway! Liz

Thank you for the information. My insurance is not a problem. We are having her stay over night. My husband and I feel more comfortable with that. The doctor makes it seem so easy but after reading some of the post hear I got very nervous. He told us her leg will be in a brace for 3 weeks and pt after that. She will also need the same type of surgery on her left leg but was told she will have to wait about 6 months before it could be done.

Joshua I have just read your response to Amber which is quite frightening. I have a 3 inch scar on my right leg which is difficult to see even though I had the screws removed opening the same wound. My left leg has a 2 inch scar. I am now coming up to week 5 and it is disappearing very quickly. I do understand that you have had quite an ordeal, mine was straightforward -modified Fulkerson and lateral release. I am walking around the house without crutches, just the brace and I do not have to wear the brace at night.

Liz - The difference between my first/right leg and second/left leg is that I had chrondoplasty and drilling 6 months before the TTT which was not successful so my system had to recover from 2 operations. This leg/left seems a doddle in comparison to the right. You say you did not have a leg brace, were you able to weight bear for the whole of the 6 weeks? I am really stable with the leg brace doing away with the crutches at 3 weeks. It is good (well not for you) to hear that you too had problems with your ankle. I found that to be worse than my leg especially at night. The physio said that bruising causes acid which is the same as gout so no wonder it is painful. I found that pain killers did not touch it but anti-inflamaty pills did the trick. Also, I used some "magic" cream that dispersed the bruise really quickly called Lasonil which contains heparinoid - brilliant stuff - too late for you now though. I am really pleased to read your note - worldwide coverage eh! It is also good to know that we are keeping up with the "rest". I now have a really good relationship with my surgeon - lucky old me. Perhaps it is because I have been seeing him every few weeks for 18 months. As your recovery is now 8 weeks and I am 5 it will be good to compare notes. Well that's it for today. I have had my say. Looking forward to reading your next posting. Jean

Jean, No I wasn't offered a leg brace, although this seems to be unusual. I could weight-bear after 3-4 weeks with a little help from crutches outside of the house. I saw my surgeon for the first time in 4 weeks yesterday, for all of 20 seconds (after the usual hour wait). He just seemed disgusted that I couldn't straighten my leg from a seated position (I get a lot of pain in my knee cap that prevents me from doing this) and told me to come back when I could! Your weekly visits to your surgeon are very impressive in comparison. My surgeon does a lot of the high profile knee cases on australian-rules footy players and so I have the feeling he thinks my case is rather mundane in comparison! I have very weak muscle strength in general and as with your 'first leg' have had 2 incidents to recover from - first a bad dislocation on new years eve, then the surgery in Feb. My quods are hopeless and I feel very vulnerable walking, especially outside of the house (I feel like an old woman, and I'm 30!). I walk very cautiously and stop if anyone runs towards me. I am now quite scared of dogs, and I love dogs! I am doing lots of excercises but the progress is slow. I was interested to hear that Joshua has a numb knee - I have that too, although I have regained a small amount of feeling. I had assumed that was normal, but maybe not? Liz

I got the OK from the workman's comp. dr. to get my fulkerson done!!!!!! Now it's just be a matter of time, infact, he said it's the only procedure for my knee and if I were his patient he would do it now. The end is starting-next stop rehab!!!!!! Hey Amber, I don't have surgical experience but I do the pain. I have very semilar sensations. When I finally got it together into words my/both dr.s heard me. You have described it pretty well. How's everybody else......

Liz, sorry to hear about your bad knees "down under". Your pre-TTT symptoms, dislocating knees, DO have much in common with me. I too had/have weak leg muscles. Those fortunate to have strong legs generally do better. Doctors and therapists always recommend strengthening your thighs. Easier said than done when you are built like Tinkerbell or Thumbelina. Your surgery was not too long ago, and it's not unusual for weak-legged people to take longer regaining strength. After five surgeries within two years, my tiny legs were extremely weak. Post surgeries (no. 4 and 5), I was unable to even raise my leg. My physical therapists attached electrical muscle-stimulating equipment legs to encourage and speed muscle building. Took some time but it worked. Good physical therapy is important for your recovery. And yes, being around playful dogs is scary. They are right at knee level!! Take care-jj

I am having the surgery on June 26th. Could someone prepare me for what I am going to feel like when I wake up and after that????? Do the drugs help? Any ones work better that others? I would love to hear some stuff about this surgery before I have it! I am a teacher too! I chose to do the surgery duringn summer break just to have enough time to recover. I would appreciate any suggestions or advice. Thanks Kelly

I'm responding to those who want to know what this surgery (ttt) and recovery is like. I had the surgery 14 months ago and am mostly recovered, although I still have some pain..the doctors say it may or may not go away. I don't want to scare you, because some heal faster than others, but prepare for a long recovery. I was on crutches for two months, then one crutch for another month, then walking short distances only for another month. It took six months to regain normal function and a full year to get the strength back that I had before surgery. And, no I didn't slack off. I probably pushed a bit too hard and had a few setbacks. I'm getting ready for the same surgery on my other leg. At least this time I will have others to share my aches and pains with. I'm glad I found this site. Anyone else over a year post TTT?

Thanks so much Cari and Kim for responding! Can you tell me what your first few weeks post-op were like? How long til you went back to work? Were you given a CPM machine? Have most people had their screws taken out (and after how long)?

First of all I meant I am 16 ( not 160 ) months post-op !!!! I did not have a CPM machine. I have a desk job so I stayed home from work 3 weeks. I went back at 4 weeks psot-op and worked half dxays for 2 weeks. For ME the firstg 2 weeks were miserable...the pain was bad !!!! As long as I laid down and elevated it was controllable with the pain meds. When I woul d get up for a bite to eat or to go to the bathroom the pain rushing to the screw/fracture site was the worst pain I ever felt !!! After about 2 weeks the pain got much more manageable even moving around. My doctor never wanted to remove my screws and when I questioned it he said 12 months psot-op. Since I had such severe pain from them he removed them at 8 months post-op. I basically had a typical reaction ( inflamatory ) to the screws..basically they were being rejected. I do not regret having the surgery..it saved my knee !! Please feel free to ask more via post or email. Cari

Cari, and others post op: It sounds as if no one else has lingering pain under the patella - that makes me hopeful that mine will go away. Cari - I'm so sorry for you having to go through that screw rejection. It sounds awful. I hope things improve now that that is over with. I'm also experiencing some twinges on the inside of my knee - near the transfer site - anyone else? Everyone's scars are different it seems. Mine is 2.5 inches horizontal - I feel fortunate it is so small.

I don't have anay lingering patella pain,. I get pain in my quads occasionally near my patella from not enough strengthening. I have decided hat if anyone could have complications it would be me I really thought when he took the screws out it would inprove greatly but it was minimal.. The last surgery was really nasty I think the pain was up there with the TTT pain Though I still get significnt pain I do now have many GOOD days so the improvement is soo slow but it is there. Are the twinges like electrical type..if it is I have been told it is from the nerves regenerating. My os used a 7 inch scar because he did an open lateral release also ( no scope ). He siad the incision probably would have only been 4 inches if he didnt do the lateral release. Today was my first time working out in a gym since my last surgery 2/13..I met with a personal trainer ( new gym ) It felt good to be exercising. Take care Cari

Cari, This surgery sounds absolutely awful! Seriously, do you think that it is worth it? My doctor has mentioned performing a TTT on my knee. I have had a lateral release and scraping done with no real success. Of course my knee is not getting any better and I have been having problems with my "good" knee dislocating. I guess that I have decided to just live with my bad knees. I asked my doc if he would perform TTT on his own child and he said that he wouldn't. I guess the thing that I am worried about is my knee getting worse. It can't be doing it any good with all that grinding going on. Do you think that the TTT will prolong the life of your knee? Sorry you had to go through all of that pain-not fun. Hang in there!

Well, The surgery is awful!! My Dr. did not sugar coat it for me. He was brutally honest as to how painfull this was and how long the recuperation could be. Although I still am dealing with the shin problem..I have NO kneecap PAIN or grinding anymore !!!! The kneecap was positioned so well during surgery that it stopped hurting almost immedialely. There are different versions of the TTT...the one I had was the fulkerson which is the hardest to recover from and the most serious of them. It involves a larger and steepper cut into the tibia versus a small sliver from others. My Dr feels I should no longer need a TKR or if I do it maybe not be before 10 -15 years.. I am not one to quit or give up so I will give it 6 more months before I decide how permanant the pain is. I DO NOT regret having this done. My knee is no longer degenerating !! PLease feel free to post or email me. Cari