Week 1
First week went very well. I was in little or no pain. Rehab
exercises went well and I was able to do 20 reps of each exercise
three times a day. No pain medication was necessary. PT included
knee tightening, leg lift, toe pointing and return and let extensions.
I had good range in the knee, but not total range.
Week 2
This week saw a change in the pin sites. Pain increased in the
pin sites with the high back pin site most painful. I made a doctors
visit to see if "something had gotten screwed up" since
the change in pain was so dramatic over week 1. X-Ray showed no
problems and pin site pain was expected. I wasn't aware of this,
but was relieved in a way to learn this was normal. I needed pain
medication for the rest of the week and was able to do some PT
but the exercising was dramtically less than week 1. I started
distraction at this point(one half turn four times per day for
ten days) and was told to expect soreness.
Week 3
Soreness from distraction was apparent but not too painful. Pin
sites continued to very painful, some redness developed on lower
sites. I made slow progress with increasing PT reps during this
period and was also able to start to put more and more weight
on the leg.
Week 4
All the pin sites except one have settled down and I am now doing
PT without pain medication. Up to 50 reps on all excersises 3
times a day. The leg is getting stronger and I have noticed a
weight shift now that walking with some weight has begun. Outside
of leg along shin bone is sore. I am able to walk with cane for
short limited periods at this point.
Week 5
Pin sites are on and off with pain. Some days are better than
others. I am able to walk around with cane and even some without
the cane. If not for the pin sites soreness I think I would be
making better progress. Soreness in break area is gone. PT is
going better. Now up to almost 100 reps of excersises.
Week 6
Continued excellent progress now. Pin sites bleed a lot during
cleaning but most of the pain is gone in them. Some redness has
returned in the lower leg around the pin sites. During past office
visits there was concern over this, so I am keeping a close eye
on it. PT continues very well. Can spend long periods off the
cane at this point. Leg is getting stronger.
Week 7
Leg is feeling very good now. Can spend all day without cane
walking on it. Can now walk with only a hint of a limp. Knee and
ankle still have some swelling that I guess is from soft tissue
reaction to the pins. Very little pain in the leg. Spent all day
hiking on it with only soreness. Feel like I could start riding
a bike. PT going well. I can now do 125 plus reps of all my exercises
three times a day or more. I saw Dr. Elting again today and they
removed the part of the fixator I adjusted. He spoke to me about
watching the bone growth more carefully in this the 3rd month
and being prepared for some soreness since the fixator would now
allow the bone to contract and expand a little to help encourage
bone growth.
Week 8
This week has gone very well. PT is still going very well.
Somedays I have some swelling in the knee and ankle but nothing
serious. I can walk briskly now and take long walks of a mile
or more. I have been given the o.k. to use a stationary bike or
other running type machines and will start that this week. I am
sleeping well and feeling good about my leg. The original pain
in my knee is no longer there and I hope this is permanent. Pin
sites are still sore and I have come to realize they probably
will be for rest of rehab. I got the o.k. to clean them only once
a day now and in the shower with soap. Yea!! No more Q-tips and
peroxide.
Week 9
Leg feels almost normal now. Walking long distances with little pain. Only minor swelling in knee at times. Feel like I could jog but won't without doctors o.k. Riding an elliptical runner at low resistance with no problem. Visited Dr. Elting again today and was pleased with his reaction to my x-ray and gate. I am walking without a limp now and x-ray shows good bone growth. Dr. Elting explained that in two weeks he will remove the fixator and have me walk around for about an hour with just the pins in , then x-ray me and have a look. This was good news to me.
Dr. Elting also asked me to talk to another patient he had just done a scope on who was considering this same procedure I had. This seems to me to be a thing he likes to do - hook patients up with each other. I think this is an excellent idea so I was glad to help.
Week 10 and 11
Rehab continues to go very well. I continue to do my PT regularly and religiously. I also find some times to run on a stationary running machine or ride a stationary bike. These really help me leg strenght and my personal well being. It feels good to work out again. I have noticed the top pin sites starting to get "sloppy". The skin and tissue around the pins is rubbery and messy. The pins themselves seem to move a bit now instead of the very firm feeling they had previously. The lower two pin sites are very firm, all healed over and have almost no discomfort. The top two sites continue to be a bit sore, especially now that all the hair on my leg is grown back. The hair gets in the wrappings that I have to change daily and pull at the skin around the sites making it a bit sore. I wish there was some way to remove the hair from around the sites.
Week 12
Dr. Elting seemed so impressed with my progress that he decided to see if my fixator could be removed this week (a week early). When I arrived at his office I was VERY dissappointed to find out the standing x-ray system was down so I have to wait until the end of week 12 to have it removed.
Week 13
Fixator was removed. I then walked around for about 40 minutes or so an Dr. Elting had another x-ray taken. He then spoke with me about the new x-ray and that he was looking to see if the osteotomy had closed up any. He pointed out differences in the x-ray angle and scale which makes it more difficult to read, but he look pleased. My leg felt very good after walking. No pain at all so they removed the pins. See pin removal for more details on this process. I will now start a new PT program (which I look forward to). I am having very little pain in the leg... I even hit a bucket of golf balls today and will spend the weekend camping. Hopefully my holes won't bleed too much over the next few days.
Week 14-15
Pin sites healing nicely. Swimming now and walking pain free for long distances. Leg feeling very good. I have on occasion a sharp but very short pain at the pin locations in the leg, especially when I ride my stationary bike and EFX runner. I imagine this is just the pin holes in the bone healing. These pains are not terrible, nor do they last long and thus have not stopped me from rehab. As I have begun to be able to work out now for longer periods the strength in my leg is really coming back. My knee is starting to feel strong now. I can bounce up and down the stairs now. I still have pain in the knee if I try and flex it closed all the way (heel against my butt) and the joint still is creaky.
Week 16-20
My leg is getting very strong now. I have tried jogging a few times during this period. Cracking in the tendon and some joint stiffness make it difficult, but it starting to feel like it will just be a matter of time and I will be able to run again. Spending all day on my feet is easy now. I can carry my golf clubs and walk 18 holes now with no pain at all in my knee. The joint still has some creakiness in it and some sorness after long exercise periods, but certainly much less then prior to surgery. My quality of life is now much much better than before surgery. I can now say with certainty that this procedure was successful for me.
Week 21-29
Saw Dr. Elting today for one last visit. He told me I healed
up better than anyone he had ever seen have the procedure. He
said "I guess your made of the right stuff.". My leg
certainly feels good. It is not perfect, and still have some sorness
in it, but for the most part it is much better. I'm glad I went
through the procedure. I will continue doing rehab and over the
next 6 months make an occasional entry in this journal. My goal
is to be running 1 mile by the end of the year. I am already doing
6 miles on a stationary bike and 3 miles on a runner (EFX) three
times a week with no problems so I have hope. In any event, even
if I can't run alot again, my knee is much much better and I can
now at least stay in shape and spend the day on my feet.
Week 30
Week 30 finds me leg very good. I can now lightly jog distance with little or no pain. I can jump down from a wall, and even sprint short distances with no pain. I still have occasionally soreness in the bone at the pin sites. I also cannot do things like sit on me legs with my legs folded up under me any longer. Maybe with more time this will clear up. My ankle and knee are still adjusting to the new orientation and I have sorness in my ankle and knee when I first get up in the morning. A few steps and the sorness is gone. How well my knee is still truely amazes me. I can do much much more than I thought I would be able to and even after almost 7 months I still feel my knee is getting better everyday and it still maybe some time before I am completely recovered.
11 Months
I feel like I am beginning to know the final results of the procedure. My knee is pain free just about all the time. I do have some tendon cracking at times, but that is mostly gone now also. There still is some soreness in the knee but it rarely is painful enough to make me want to sit down or not do something. I continue to workout as I can - riding a bike and running on an eliptical runner along with lifting light weights doing high reps seems to help a lot. The pain in the bone at the pin sites is now mostly gone.
3 Years
It has been almost three years now since the procedure. My leg has continued to slowly improve over these three years. I am now much more active than I was before the procedure and seem to be still getting better. For example, I can now play ice hockey or ride a bike for hours and only have some knee sorness the next day. I imagine that some of this is just from my age (now 44). I have been very happy with the longer term results of this procedure and would recommend it to people with the same situation. I suspect there are many many factors that make up whether the procedure would be successful for someone else or not. Things like weight, life style and most of all expectations. If you expect this procedure to magically fix your leg you will be disappointed. If you expect to work hard and have less pain most of the time you will be happy with it. For example, I still do 100 leg lifts a day with my leg... everyday. You can normally squeeze them in just waiting for someone to get out of the bathroom!!
5 Years
Perhaps the best test of any procedure is time. I am now 5 years out from this procedure. My knee is still good. At times I would say very good, other times just good. I am still able to remain active. I hike, ride a bike, spend all day on my feet many times with very little or no knee pain. On the occasional time I play something a bit hard paced, like soccer my knee tends to be "cracky" the next few days, but not very painful. This normally goes away in a day or two. I am still very pleased with the outcome of this process. So far, still so good. One of the things that is hard to tell is how much of this maybe related to my age (now 46) and how much to my knee. Other joints are getting sore when I play now.. so you never really know. The bone where the pins were is still sore at times... very odd given all this time. It is usually the pin sites on the lower part of my leg. Nothing bad, but noticeable.
If you want to ask me specific questions about this send me an email.
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