Tibial Tubercle Transfer

I had PT that involved that tapingsix years ago and it did no good at all. TTT July 31 2001 and I'm feeling better now. Have full range of motion and not too much discomfort. OS told me I must do ankle wights for the rest of my life????? (I'm 52). I don't mind daily 30 minute biking or walking 30-60 minutes almost daily. But must I really continue with the ankle weights? Can anyone comment about that? TIA, Lili

Hi, I don't know what to do anymore. I had a Lateral Release on my left knee on July 17th. I am still on crutches, and i was told by my therapist that my surgery didnt work. my knee still lays toward the inside half of my leg. They said it could be the bones above and below my knee structure that causes it. My doctor said something about a tibial tubercle Osteotomy before my first surgery. I have 3 days of therapy next week and im back to the doctor on 0ct. 8th. i am 16 years old, and really into sports. if i have the option to get the other surgery or not, i dont know what to choose? Should i go through with it and just get it over with and hope it will help in the long run? I am looking for any advice i can get. I have actually been on crutches since the last week of May. It's extremely frustrating and after reading some of everyones posts already, i can other people go through similar things. Thank you, Hoping to hear from someone - Karen

hi this thread is full of so much good info on osteotomys that I had to revive it! It really helped me. I had a TTT on december 12 so I'll be 4 weeks post-op on friday. I am a 23 year old female 5'4", 120 lbs. I've had problems with my knees dislocating and subluxing since I was 13. For years I was able to control my knee probs really well with physical therepy and I could do most things just nothing really strenuous like running etc. So in april 2002 i was on my stationary bike when i felt my right knee(the worst of the two) give out on me again. But this time no matter what I did it wouldn't go back to normal like it always did in the past.And the worst part was

(continued) my surgeon said with as bad as my knee had become I needed an osteotomy(TTT), lateral release, and medial reefing all at the same time on my right knee. I did research at home and found www.proteamphysicians.com it explains the whole TTT surgery process step by step, every aspect is covered and other types of knee surgery as well. It's the best info I've found so far so check it out. So on the day of surgery they put me under and and gave me a nerve block in my right leg. When i woke up I was dizzy and my leg was totally numb for 24 hours. I was in a brace and on crutches and they did it as out patient so I was driven home the same day.Since I can't lift my leg I hooked a strap to my brace so I can easily pull my leg up and down. The first week was hell you guys!!I was crying nonstop the first several days after the nerve block wore off and I had to get stronger pain killers than the 5 mg vicodin's i was prescribed. I used a polar care cuff (circulates ice water) to keep down swelling and reduce pain.I asked about the CPM machine, but my Dr. said I shouldn't use it with this type of surgery since the bone needs time to rest and heal. He told me to start physical therepy right away- lots of calf pumps,extention stretches,attepted leg raises to try and regain my quad.Oh and I used baby wipes when I couldn't shower and baby powder in my hair. On my 2 week post-op appointment they took out my stitches and I had a few blood blisters from the bandages but they have since fallen off.My Dr. said I could only bend to 30 degrees until 6 wks. post-op and no hardcore therepy until then so my bone heals. I can bear weight as tolerated on that leg while still using crutches.It's been almost 4 wks. now and I still can't lift my leg yet. The therepist recommended I get an EMS-electric muscle stimulator- to help me regain my quad. I was off the pain killers after 2 weeks and I don't have much pain at all right now. I have numbness on the right side of my kneebut it's getting better from the 15 mins. a day of self massage I was told to do on my leg each day to reduce swelling and scar formation,etc. So right now I'm still doing a lot of resting since my left leg now has to bear most of my weight and it's not in the greatest shape either, don't want to overdo it.I hope this has helped someone!! Any questions or suggestions please e-mail me t2omorrows_child@yahoo.com. I will keep y'all updated on my progress as I go along. God bless you all! ~Leah Richmond

I am 20 years old and I have had 2 surgeries on my right knee. I have chondromalacia and subluxation. I had a tendon realignment in june of 2002. I am 3 weeks post-op from a TTT. It was a combination Macquet/Fulkerson procedure. I also had a piece of bone taken from my hip that was screwed into my tibia with 3 screws. I had a drain put into my knee while I was in the hospital. I was in the hospital 2 days and on morphine for both of them. They sent me home on some other pain pills. I only took the MS Contin for 2 days, then I was taking the Tramadol only to sleep(the hardest thing so far, since I usually sleep on my stomach and I could only lay on my back!) I am getting around without crutches pretty well, and it doesn't hurt at all with weight bearing. I am in an immobilizer, but I am getting a brace with hinges in a day or so. I was suprised at the amount of pain that was involved, but so far it seems worthwhile. I felt 100 times better after I had all of the staples taken out(47 total). I can sleep on my side now so it seems to get better each day. I am a hairdresser so I was left with few options after finally getting frustrated with coming home from work unable to walk up my stairs because of the pain in my knee. I am getting married on May 8th of this year, so I am hoping to be fully recovered by then. PT is in a week or 2, so I should improve quickly from there. I am only worried that I am going to have to get the screws removed, since I have read so many people have. I do get a weird pain that shoots straight through my shin bone, and I assume that it is either the screws or that I am just healing. If anyone can give me information on what is involved with getting the screws taken out and how long the recovery is for that I would appreciate it. I know it would be a while, but it might require more time off work which I don't know that I can take. Thanks! Sandy

Hi again and thanks for your reply...I am actually allowed to bend my knee up to 45 degrees so far, but since I haven't gotten my hinged brace yet, I am not able to bend it too far as of right now. I know that PT is going to be hard and especially with bending the knee. I had a tendon reallignment 1 1/2 years ago and was immobilized for almost 8 weeks. I am assuming that the PT will work with the scar and loosening up the scar tissue. Now I just have to wait for the OK from my doc to go to PT. I will post back soon. Sandy

I had TTT and the lateral release a little over a year ago and it truly was a great decision. I suffered 3 patella dislocations in 10 months and so the surgery was a no-brainer in order to prevent further injuries. Regardless of your situation, if your doctor feels it would be best to go through with it, then do have it. I definitely made the mistake of underestimating the severity of the surgery though and recommend to anyone that is having the surgery to understand what you're getting yourself into. I'm no athlete, just a regular guy with a bad knee so surgery was a new thing for me and I had no prior experience in handling it. The pain is tremendous the first few days no matter the pain-killers you receive. You're then obviously on crutches and placed in a large leg brace or some sort of cast. I was on crutches for 4 weeks and had to wear my brace for 6 weeks. Getting back the range of motion and overcoming your fear is so hard once you start PT. I was unable to do much the first month and my leg muscles deteriorated into nothing because of this, despite starting PT 5 days after the surgery. But once you've healed and the true rehab starts, be prepared for a lot of work. I started by sitting on a stationary bike and having just to pedal, no resistance. It took over a week, but finally I was able to complete a full cycle. Once your ROM comes back, the swelling will fade away and your mobility will increase, but your lack of strength still will have you feeling very unstable and you'll lack confidence in your knee. When you begin the strength training to rebuild your quads and hamstrings primarily, that's when you'll start to get the true confidence back. This surgery is a major undertaking for anyone regardless of your occupation, income, or health status. Be prepared for lots of work and effort, but it really is worth it in the long run.

Helena, You're my inspiration! What's your secret to a successful TTT? I have to assume you were in GREAT physical shape when you had it done. Would that be accurate? I'm 33, 5'2"/110 with dislocating/sublux kneecaps. I had a lateral release in '88. Failed. I'm planning my TTT for just after summer. I'm hoping to use the next few months to try to strengthen my legs even more. If you -- or anyone else -- have any tips, please let me know. Oh, I'm planning to have Dr. Keith Schroeder in Hoffman Estates (Chicago, Illinois area) do the surgery (I live in Iowa). If anyone has comments on him, please let me know. Helena, may I ask who your surgeon was? Thanks! Here's to great knees, Dee

G'day, I had what I now know is a TTT in June 2001 and I could not be happier with the result. I developed weak knees as I grew older, which are very skinny, hypermobile, patella alta and maltracking patellas. What's more, I have flat feet. This, as I'm sure you'll agree, is very unfortunate when you live an active life like me. It prevents you from playing sport, etc, which is a very big part of Australian life. Everything m23james@holly.colostate.edu said about the pain and difficulties involved in recovering from this sort of operation is true. But, after I regained the full range of movement and the residual pain went away, I found myself with with a stronger and more stable knee than I had ever had before. I am now a law student and volunteer firefighter. In a couple of weeks I will go n to have my other knee corrected in the same procedure. This is something I've been putting off for some time, but since I know the benefits in the long term, I've decided to take the plunge while I'm still young (22).

Hi everyone! Wow, I am really SHOCKED to see how many of you are actually still getting Maquet's done, even if it is in combination with a Fulkerson. I am 3 months post op from a full Fulkerson (March 1 04 - including lateral release, 2 arthos for patellar resurface and recircumference since I had ground down the lateral patellar edge) and very happily, it was done by the man, the myth, and the legend himself, Dr. John Fulkerson. http://www.oahct.com/4udr2/web...665147484&chk=9765 I really would advise anyone whose doctor says that Maquet is the only way to go to get a 2nd or 3rd opinion!!! Maquet is mostly obsolete(--MOSTLY, but of course in extreme cases it might really be needed!) That is why Dr. Fulkerson fixed the whole process! Obviously, he did a pretty dang good job about it, considering that it is now globally named for him. The knee brace he uses is great, and yes, he designed that too! http://www.djortho.com/product...df/trupulladvanced.pdf What I completely agree with is THE PAIN... It really is amazing, isn't it? When I was maxing out on Percoset in the first week post-op, I knew I was dealing with something that I wasn't fully prepared for. It was truly an incredible, life-altering experience. Happily, the teeth-chattering pain quickly got much better within a few weeks. In those first 2 weeks on my back, and then in a wheelchair for a month at work, I experienced an enlightenment and appreciation of walking and functionality that still makes me deeply grateful to be bipedal and healthy. At an early post-op visit, my Husband and I were chatting with a very nice lady who had come up from NYC to see Dr. Fulkerson. She asked us if we had any kids, we said not yet, and she smiled. She told me that now that I had been through a TTT, I would have NO PROBLEM with labor! She had 2 TTT's and FOUR kids. On the slightly-down side, I still have a great deal of chondromalacia, mega quad atrophy/pain and IT band pain, but I'm not grinding away my kneecap anymore, so I'm declaring victory! The hardest thing is the "no running, jogging, skiing, hopping, jumping, etc. for a year." Don't get me wrong, I'm no fragile flower, but I did play 3 varsity sports and then 2 in college, and no question that helped me with muscle strength. As my condition worsened, my 5'10" frame began to pack on some pounds, slowly but surely. I DID wait to get this TTT done, and all I can say is DON'T WAIT. It DOES get better, so everyone hang in there! If your PT says it's ok, strengthen your hips and everything else by getting one of those big inflatable balls. They're about 12 bucks at wall mart, and help your hip flexors, etc. A LOT!!!

Hi all, I'm scheduled for a TTT surgery on 7/12 and after reading all of your postings, I'm more scared then ever! This will be my seventh knee surgery. I've had several lateral releases (didn't help) and then knee cap "clean up" surgeries - knee caps keep shreading away to nothing. Please tell me what I'm really in for this time - the LR surgeries were pretty bad but not something you couldn't make it through with a little help from percocet! Has someone out there who has had LR and then TTT please compare the two for me so I can be better prepared for recovery? Also, I was not prepared to stay in the hospital overnight... Dr. never said anything about that! Were any of you allowed to go home after you got out of recovery? Thanks for your guidance!

Hi, I've had 2 TTT w/LR in the past 2 years. My most recent one was the end of Jan '04 and I'm still in PT. I was 6 weeks NWB for this surgery and 6 weeks for the last one so that was tough. I actually spent 2 nights in the hospital both times and was happy about that. The surgeries have been a success but they aren't fun. My right knee was done due to severe arthritis under my kneecap after I had my first surgery when I was 13 years old. I haven't dislocated since that first surgery but they modified the TTT for me, since I'm not old enough for knee replacement. I have 1 screw in my right leg and 2 in my left. My sister also had both her knees done at the same time 8 years ago, also TTT w/LR. We both feel that as painful as the surgery is, it's well worth it. Good luck.

One other question... you mentioned your sister had both knees done at the same time. Which way would you recommend? One at a time or both at once, as you compare your experiences? I'm 34 with a 1 yr old. Thanks, Dee

Thanks a ton for the info. I may have to seriously consider both at one time. Heck, I won't be able to keep up with him anyway... might as well just do it once??? ;-) Do you know how long until she could drive? I'll have it done out of state, but then will be back home to recover and do PT. There just aren't as good of options for surgeons that I've found in Iowa. Thanks again! Dee

Hello everyone - I need some information please. I am due to have numerous procedures done on my knee next month. I am to have a lateral release, quad muscle transfer, tibial tubercle transfer, knee cap clean up, and cartilage transplant. I had cartilage clean up done in 2001. Can someone please give me information on recovery times and what I am to expect? All I know is I will be on crutches for 6 weeks and no driving for 4 weeks. I know what the procedures are but I would like first hand accounts on what to expect. Please feel free to email me also! Thank you

Hi Liz, I know it is a long time since we had our operations, 2000, I am wondering how you are, well not so much you but your knees. My shins have been giving me some trouble and my knees are not very comfortable, how about you?
Jean

hi
i just had my TTT surgery done on 29/1/08 on my left knee and i have symtoms of alot of brusing and swelling around carf and ankle the bruising is from my thigh to my ankle i was told i am weight barron wich is no weight down on my leg so the use of crutches and a frame is what i use for the next 6-8 weeks i have a screw in my knee too with numbness around the wound and down my carf and pain around the back on my knee is this normal ? cause i going to have the right knee done next afterwards

i tell you folks not been able to walk is a pain tho and not be able to stand up in the shower and to use a chair to sit on while having a shower is fun ..laughs!!!


how long does the it take to recover from this surgery and leaving the screw in for years cause any future damage ? what can and cant you do after the healing is finshed
is there any little tricks out there that can help me with the pain and swelling that may help me

thanks fellow TTT's

regards
Tina from aussieland

Hi Everyone!
This is the first time I am writing. I am 24F, I have an upcoming Tibial Tubercle Osteotomy coming up on January 25th. Along with that they are doing MPFL reconstruction with hamstring allograft. I previously had both my knees done when I was 13 and 14 years old. My knees were dislocating numberous times a day. My mom and brother both had the same problem and had surgery when they were around that age too. They both do not have further problems with their knees. The problem i am having right now is my knee is malaligned (I have a hard time going down stairs because my knee doesnt run on track) Its impossible to wear a high heel and go down steps. It also dislocates too but not as much as it did before my surgery when i was 13. My other knee runs on track a little better but still can dislocate whenevever i move a certain way and am not careful.
I also have severe arthitis and take 2 50mg tramadol daily. Can anyone tell me if they have gotten this surgery, what it was like for recovery and mainly about the screws. My doctor said i would not need to get them removed. But ive been reading this website and everyone talks about not being able to kneel because of them? Please let me know how the screws effect you. Thank you very much