I was just told today about this procedure, and how my knee is the perfect candidate for it. 
Basically it is realigning the patella partially by breaking and realigning the tibia. :eek: Yike. Has anyone had any experience with this?
Hi. I was told about this procedure, known to me as tibial tubercle transfer, which I believe was developed by Dr. Fulkerson. However, this was back in the 90ās. I am a candidate for it in both knees, but after having a failed lateral release in '97 (it lasted a whole four months), my PT begged and begged me not to have the TTT done. He said I wouldnāt be happy w/ it. Yet he had a patient that had had both knees done and she seemed happy, however she was not a very active person (not into sports, riding, etcā¦) I met her during a PT session and she was happy. So Iāve been living crappy alignment and chondromalacia for 18 years now.
The down time also deteered (sp?) me. Then again I also have bad hip dysplasia in both hips and was a candidate (3 yrs ago) for a PAO (periacetabular osteotomy - NOT a fun one) and havenāt had that done either (not by choice.)
If you do have it, Iād be very interested to hear how to get along w/ it and if you think it was worth it.
Iād also be interested in hearing more about itā¦as long as I am active, I can keep going, I thinkā¦but I worry that the knee is just going to completely go one day.
DGā¦ Iāve lasted 18 years so far. How about you?
My biggest problem is referred pain. W/ back, neck, hip and knee problems, most days I canāt tell what part of me is really hurting as it seems to show in other places. So frustrating!
Thanks so much for the replies!
This dr. is a very sports minded guy, and knows what I do, so I know he took that into account. He stressed that it is a big deal and not to rush my decision. Does your kneecap slide off? Mine does not. But I can barely squat, if at all. In fact I havenāt tried in so long now, Iām not really sure what I CAN do, as my time is spent avoiding what hurts. :lol: I think I may really pay attention to how much I am compensating and just what exactly I am avoiding. The thought of the surgery is scary (Iāve never had any surgery), but he swears up and down it is better than the injections and other ālesserā surgeries and has references for me to call.
Yeah, 4-6 wks on crutches alone. 
My husband is a great guy, but my first thought was heād have to do the stalls, lol, and what time of year would be easiest. Summer I guess. Ugh.
I had not heard about that procedure. A sports medicine orthopedist said I should keep my natural knee as long as possible. Artifical kneecaps donāt last well and anything artificial would not work as well riding as my own do. I know there are knees that fit women better than unisex nes, and some rotate better. but riding is quite a stress. I have trouble squatting too. But I can bend the knees better now that 10 years ago when I had a meniscus problem. He said I wouldnāt be able to kneel and sit on my heels again but I can, barely. Riding doesnāt hurt but stairs do. Noit sure Iās break a tibia for my kneecap to though. Ouch!
DLee, please explain a bit more
Hi,
Would you mind explaining what the problem is that you want to solve? I need some education, thanks. Then I might be able to help you.
You do keep your knee with this surgery. From what I understand, there is ācleanupā involved as well.
Whicker, I have a badly tracking patella, actually two, that have been this way for years. In the last six months the right one has been the worst it ever has. Have done pt etc. Now Iām trying to decide just how bad it is, compared to a surgery. Also arthiritis in it now as well.
DLeeā¦ My kneecaps donāt slide off completely, but they slip and slide all over the place just while walking and bike riding is out (thatās gross to watch!!) Stairs are not fun either, nor going up or downhill.
For those that donāt understand what this surgery involves. Itās essentially breaking your leg, the top of the tibia, and tacking it down w/ one or two screws into the proper position for better alignment of the patella. Youāll be on crutches for awhile and a knee brace and the brace stays w/ you throughout PT and in the last stages of healing. The muscles and such have to be retrained to the patellaās new position. The underside of the patella will also be smoothed out for better tracking. All the same knee parts just a screw or two added to the top of the tibia. If you google it, thereās a lot of pics of the surgery online.
After the lateral release failed, I did PT forever and even tried taping, but the alignment was too bad to keep things in place. It was disappointing.
When/if I ever decide to get my joints fixed, I was going to pick fall/winter simply because thatās when Iām down the most. Chores arenāt really any harder for my SO that time of year than any other time. Then again, crutches in the winter might not be a wise idea. I had the lateral release in the spring and that worked out quite well. It takes a long time to get the atrophy back though.
Iām glad you found a sport orthopod that understands. My new one is like that. Heās a team orthopod for our local college basketball and football teams.
Keep us posted!!
Stem cell alternative possibility (no surgery!)
Is this a ligament or connective tissue issue? Please explain it in more detail. I am seeing 2 of the major gurus in autonomous stem cell work. They can do amazing things now in many different types of tissue. I have done PRP for SI and pelvic ligaments, my daughter is in process of a complete shoulder joint regeneration and my husband is having his back degenerative disc worked on. Please pm me if you want more info. I have posted about Dr.Friedlis and PRP, so you can read that. The shoulder and back are a different dr. Hips and knees can be done. There is going to be a discovery channel special about autonomous stem cell work that will be showing sometime this Fall. I will post when I get the dates. My Drs are in it.
I would not dismiss anything too quickly.
I had a wrist that was stiff as a board and hurting all the time.
The Dr took a look at the x-rays and said I needed a āpositive ulnar reductionā and rebuilding two of the eight little wrist bones.
The condition is called āgymnast wristā and I was a gymnast as a kid.
Happens when, as a kid, you have an injury to your wrist and one bone of those two in our forearm keeps growing, while the other is repairing itself and so one ends up a little longer than the other, changing the mechanics of wrist function.
That operation meant cutting the perfectly good ulna in two, shortening it with a plate and screws and using that little piece to rebuild the two little bones the too long projection of the ulna had damaged over the years.
It sounded barbaric, so I went for a second opinion and yes, that was indicated.
They did that and now my wrist works as new, better than the healthy but older other wrist, that has some arthritis changes.
I am very happy with it and no more pain.
Soooo, I would check into whatever a specialist recommends, then get a second opinion.
If they are similar, go for it, if you are too impaired to do well as you are.
I now can clean horseās hooves and saddle without pain or having to ask for help.
Wow, thanks Bluey. That is really good to know. amdfarm, how about you go first!? :lol:
That is great Whicker, Iād love to have any info you have.
Dlee,
I sent you an email. Let me know what you think.
Gee thanks, DLee, but I canāt find an insurance company that will take me and I certainly canāt afford any surgeries out of pocketā¦ uh NO!! So you or DG will have to go first!! :lol:
whickerā¦ Iām pretty sure itās a mechanical issue and how weāre built or things we did prior in life that leads to this problem. All I know is that my Q-angles are WAAAAY off so they donāt track normally and cause pain. First orthopod didnāt realize how bad it was until he actually got in there. I also had the plica excised. I have very little cartilage left in that knee. The second orthopod (sports one) was shocked at what he did and how he did it saying it wouldnāt fix the problem. But I was a little out of it and itās not like he could discuss other options w/ me at that time.
The stem cell stuff sounds interesting, but also $$$. :eek:
Stem cell is much less $ than surgery. PRP is even covered by insurance. You have no down time, so no loss of income. I am riding again about 3 days-week after a procedure. (I experimented with how soon after treatment) the pain gets dramatically less very quickly. I went from painkillers to tylenol after the first procedure. It lasts many years. Check it out.
Less than surgery wonāt help either unless they take payments or itās freeā¦ I have NO insurance, as they keep rejecting me for too many pre-existing conditions. I make payments to my PCP and then pay the whole shebang for the chiro upfront after treatment. It stinks, but Iād like to feel better so I can do more.
Send me the info, please. Iāll check it out. Iām in Iowa if that matters. Donāt know how that works or if anyone does it around here. Iāve got several problem areas.
Thanks!
For a first look at PRP or Prolotherapy, Look at Dr. Mayo Firedlisās website
www.treatingpain.com
There are many articles and links to more information. The spine/shoulder joint guru is in the St.Louis, Mo area. I donāt have his website info, so I will have to search and get back to you. I spent many hours researching before I decided to call Dr.Friedlis. He is great at referals of who might be closer to you.
Thanks, whicker, Iāll check it out.
amdfarm,
Well, Iām getting it done. Just waiting for the date. Scary, Iāve never had a surgery. Hoping itās worth it.
Awesome, DLee!! Do let me know the date, Iād love to follow along w/ you through the process and recovery if thatās okay w/ you.
Iāve had several surgeries and lived to tell about them, so Iām sure youāll be fine.
It MUST be worth it!! My knees are rooting you on!!
