Tibial Tubercleplasty

It looks like I am having one on 20 December and I was wondering if any of you had any advice – not medical – but general advice for what I might need after. I have never been on crutches for all that long and the idea of 8 weeks sounds daunting.
Any tips?

Well, I’d be really curious to know more about the procedure and the reasons for it - sounds awfully interesting.
I was on crutches for 6 weeks after breaking my ankle - most of the damage was to my fibula which was put back together with a plate and nine screws. In this new security-conscious age, I frequently set off metal detectors rolleyes.gif
so here’s my two cents on living with crutches
Crutches SUCK and are dangerous, is all I gotta say. You will learn to think ahead so that you greatly limit your trips up and down stairs - you’ll learn to limit time on your feet, period. Be sure to ask for a temporary handicapped tag so that you can park close to buildings.
You’ll be on crutches during the same time of year I was - and it’s a bad time because of ice and snow. You will learn to look ahead VERY carefully to choose where to place your crutch tip.
How long will you be hospitalized? Will you get your instructions in crutch walking post-op? I found that experience less than helpful, because I was still woozy and nauseated from surgery the night before - spent most of my morning in PT wondering if I was gonna puke on the therapist. I don’t know if such a thing is possible, but if you can be fitted for your crutches, and get an intro “lesson” prior to surgery, that would be great.
Fitting: a common misconception is that the top padded piece is supposed to be nestled in your armpit. Nope, that’s too high. And besides, you should not be putting a lot of weight onto that top pad. Most of your weight should go onto your hands. So making sure that the cross piece where your hand goes is properly positioned is really crucial.
GO SLOW. Crutch walking takes a lot of getting used to, but it can be done. I think one of the hardest things for me was to figure that walking anywhere was going to take about three times as long as I was used to. Good luck!

I would recomend getting a pair of “Canadian Crutches”. The type that secure on your forearms. As some one who has spent just short of a year on crutches (in 4-8 week increments), I swear by them. They are about a foot shorter than regular crutches so the get in the way less and additionally are lighter. Also, the sides of your ribs and inside of your arms do not get rubbed raw. Finally, there are no pads to get dirty and funky smelling.

I hope to be in for only a night – and I should admit that I had the same knee operated on about 1.25 years ago.
Am starting to just want to get it over with!

Can I ask what you had done to your knee last year? I know that when I had knee surgery to tighten my patellar tendon (to keep my kneecap from sliding around to the side of my leg. Ouch!), they fastened the tendon with two large stainless steel staples to the tibial tuberosity. 15 years later I went in to have the staples removed, and there was a great deal of bone growth over the staples, leaving about 1/4 to 1/2 inch of bone to be shaved away before they could remove the staples themselves.
Anyway, it is my understanding that a tibial tubercleplasty would be similar. Something with the tibial tuberosity is wrong, and they are going to resculpt it. (Please, doctors, tell me if I'm wrong with my assumption.). If that is the case, I would think the recovery would be similar to when I had the staples removed (By the way, I had it done to both knees the same day.) For me, it was a day surgery procedure. In in the morning, home in the afternoon. Crutches were an absolute necessity, although they tried to tell me I didn't need them. For about a week to ten days, the knees just didn't want to bend. (You can imagine with both knees like that how hard some absolutely necessary daily activities became!). I used the crutches, regular old-fashioned crutches (but like Mary said, don't lean on your armpits!), for about six weeks, but after about the first two, they were mostly just to reduce the pressure on my knees as I walked. The entire time I had to bear some weight on my knees, since both knees were done at the same time and I couldn't figure out how to swing myself along with nothing touching the ground!
But, looking back at it. . . . It passed relatively quickly. And now my knees feel much better.
So, don't worry too much about it all. You will find that the time passes quickly, and before you know it you will be doing things in the same manner you did before your surgery. I think you will find that the waiting is much more stressful than the surgery itself, or the recovery period.
Best of luck and keep us posted!

Have had arthoscopies on both – my understanding, for whatever it is worth, is that this will shift where pressure is placed on my knee to a less damaged spot.
My doctor has said 8 weeks on crutches and no bending for like t he first 6.
My big fear isn't the surgery itself but I was a little scared when I heard that I'd have to spend the night – something I haven't done before. I am sure it will be fine – am a lot less stressed about this now than I was.
THANKS for all the advice & everything else.

Oh this is sort of comical.
My doctor's office called to say they went to get my surgery ok'd by the insurance who told them I had been dropped – in April 2001 – a full month before I started at my current job!

Insurance companies can be so frustrating. . . . . but get used to it. We'll have to deal with this kind of problem a lot once we start practicien!
As to the surgery. . . you said no bending for 6 weeks. Is he going to put you in a straght leg cast or just a brace? I know when I had my first knee surgeries, my leg was in a cast for 6 weeks. If that's the case, be sure to do a lot of leg lifts and other exercises for your quads. It'll make it a lot easier when it comes out of the cast. And then the fun starts as you try to make the darn thing bend again! But you'll get through it all. And in the end, it will give you one more thing to help you understand your future patients' situations.

Thanks for all the advice and you’re right about perspective. My advisor was telling me that I should shadow a doc to see what it’s like to have frustrating problem that’s hard to treat – and my knees seem to be just that kind of problem! tongue.gif
The insurance people just crack me up. They called today to tell me not to be worried about the scary letter I am about to get in the mail…

I’ve had two arthroscopies on my left knee plus many minor injuries to it so I’m pretty experienced in the land of crutches and recovery!!! Several suggestions:
1. Make sure you have plenty of stuff to do beforehand. I’m assuming you’ll be spending plenty of time on the couch so get lots of good books, videos, games, whatever you like. Believe me, daytime TV is only interesting for about the first hour (excepting Jerry Springer for comic value-you’ll probably get so frustrated having to be down that you’ll need some laughs laugh.gif )
2. To deal with the straight-leg brace thing, I bought a light collapsible camping footstool (one of those canvas things with the metal frame) and carried it with me to the dining table, the computer desk, anywhere I had to sit on a chair. It will be really handy to keep your leg up without having to slide your butt to the edge of the chair. Also keep extra pillows around to grab when you need to prop up your leg or reposition yourself.
3. If you can beforehand, try to do plenty of arm and shoulder exercises to strengthen your arm muscles. This will make using the crutches much easier and less painful. I also second Linda in that you should be doing leg exercises as soon as possible. My doc had me doing gentle range of motion after 4 weeks and started me with the leg lifts and bending, etc. after 6 wks, but my left leg was very noticeably smaller after I got out of the brace and it took me another 4 months to return to normal (I do ballet, pointe, and jazz dancing so my “normal” leg muscles are at a pretty high level, but I was shocked at how fast they deteriorated mad.gif ) One thing I wish I’d thought of was just to tense and release my muscles as my leg was lying there to give it at least a little exercise.
Edited to add: One more thing I forgot-you may want to rearrange furniture and such to give you wider pathways and maneuvering. We had to relegate our coffee table and a hallway table to the basement. Also, make sure you have something to lean your crutches up against in the bathroom, next to the dining table, couch, whatever. It really sucks having to lay them down on the floor and then having to bend down, grab them, and try and maneuver them into place. Ok, that’s all I can think of.
Hope this helps-good luck with your surgery and I hope things will be finally resolved for you! biggrin.gif

Thank you all for all your advice. I think I am going to stay in the downstairs part of my house on the couch for at least a while (our stairs are way steep).
I have one final and that's Wed and then the surgery is Fri.
Looking forward to a week off work!

Thank you again to everyone here. I think in the future I am not going to schedule anything this far in advance – all this has done is give me more time to worry about it. Though I am sure the experience will help me in the future.
Wish me luck tomorrow!

Good luck tomorrow. Here's to a speedy recovery.
Susan - Chicago

Surgery was last Friday. Was home last Saturday and just moved back to my bedroom on the second floor. Kicked my butt a little but I am a lot better now. Was awake and watched most of it. Am happy it's over and am looking forward to getting off crutches.

I feel very whiny today.
Anyone have any advice for the back issues that seem to accompany crutch use? I cannot wait to not have to use them. <!–emo&<_dry.gif
And while I am complaining, though this isn’t too big of a deal because I think what they did was cool and generally like talking about it, does EVERYONE on the street need to know what happened?
Sorry for that. This is just more painful than I anticipated it being.

get a PT referral to work on your back! I am a huge fan of physical therapy for this sort of thing. (also, are you sure your crutches have the arm rests at the right height?) A consultation with a PT can show you the exercises to do.
and yeah, some days the curious questions are fine - especially if you enjoy story-telling and even more if you like to be dramatic! When I’d broken my ankle, I did not simply say, “I broke my ankle,” I said, “I have a plate and nine screws in my leg.” laugh.gif I still offer to let people see/touch the heads of the screws on my lateral malleolus, just because I get such a kick out of the looks of horror.
But there were definitely some tiring times when I was recovering. Sounds like you need some sort of luxury item - a movie? dinner out? ice cream in? whatever, something to just cheer you up a bit and help you regain your equilibrium

this will sound a little silly - but try a higher heel on your good foot -
since your immobilizer/brace is keeping your knee straight (or relatively so) - the only way for you to keep your foot off the ground is to tilt slightly to the other side - or use glut. medius to raise that side's hip up- or flex at the hip - all of which gets old really fast.
at least when you do an ankle or foot you can bend the knee to keep it off the ground.
you've probably been wearing flats or running shoes on the good foot for stability - and so don't have much of a height advantage on that side and still tilt - so if you have one - try a higher heel on a stable shoe and see if you can then stand straight with the other leg still off the ground. it might help.
otherwise - yes, go see a PT about what you might be able to do to improve your technique -

Thanks for the suggestions – I will try the higher heal and will talk to a therapist. I think part of the problem is the way I’ve been using the crutches – and I’ve been keeping my leg up all day and that puts me into a strange position that bothers my lower back.
And Mary, I think you’re right, I actually went out and had ice cream tonight, have been a tiny bit depressed. Came on so gradually I don’t think I noticed it but since the surgery my stamina has been so low that I think it just has gotten to me a bit. I am going to get my hair cut and my eye lashes dyed, that always perks me up. tongue.gif
Funny thing happened tonight. Ran into my neighbnor and one of her friends. The friend wanted to know what happened and where I had the surgery done and who did it. When I told him who my surgeon is he said that he sees him, too and he said, “He’s brilliant!” Cracked me up because I say that all the time.
(my doc is Craig Faulks at GW)

so - nearly 2 weeks later - how's the leg?

Thanks for asking…
I saw the doctor this week – at about six weeks post and he wanted me to keep the brace and crutches but start to ease off them over the next four weeks. I am sorry to say that I think I might have done something rather stupid today and am going to go in and see him again on Monday. I was out w/o the crutches but with the brace and ended up walking about 3.5 miles. It didn’t seem to like that and I don’t really think I did it any harm, I am going to go in to make sure the screws are in the same place and the allograh is doing what it should be doing.
Oh well. When I was a teen, my mother would say “Someday I hope you have a child who is just like you are now!” I feel like he should say, " I hope you have a patient just like you are!" It’s so hard to stay still! I miss working out! (though I do some, I lift and am trying to get a pool membership).