Post-Op Trochleoplasty

[HR1994]

Thank you, I'll give it a try!

 

[EalingGran]

I have never tried shaking but certainly 'sinking' into a stretch and gently holding it is good.
I think for extension you will need to work vastus medialis ( the medial quad)- it only comes into play in the the last 15 degrees of extension and is often the weakest quad. I learned about it from my pilates teacher as I had residual pain in my medial knee on stairs ( due to a stretched MCL from lateral collapse of the joint).
The exercises for vastus are turning the foot out in straight leg raising and then lowering and raising the foot a few inches. It is quite a tough exercise and just do a few. You can also support the leg with a bolster.

 

[HR1994]

8 month update:

I continue to progress. Walking well, slowly getting faster. Knee strength is coming along, I can walk up the stairs normally without the railings. Going downstairs, still one step at a time! But that'll come as I continue to build knee strength.

My ROM is still at 125° but I'm pretty much functional in anything I do. I can gain probs 5° degrees according to my consultant, who said it'll probs max at 130° following knee surgery.

My knee extension without contracting quads is -3°. Once I contract quads, it's 3°. So it has improved over last couple of months, just need to keep working on it.

I was struggling to do SLRs a couple months ago but about 5 weeks ago, I was able to do them with no quad lag.

I still have knee stiffness pretty much everyday and I can feel it. I'm still 8 months into a 12 month recovery but how long did it take for that feeling of stiffness in the knee to go away for others?

 

[Jaycey]

still have knee stiffness pretty much everyday and I can feel it. I'm still 8 months into a 12 month recovery but how long did it take for that feeling of stiffness in the knee to go away for others?

Unfortunately stiffness can persist for many months. Continue to ice and elevate if this is limiting your mobility. But it sounds like you are doing very well!

 

[mendogal]

Hang in there! My L TKA one day older than your procedure and it's functional but yeah it's stiff. It should keep improving!

 

[HR1994]

11 month (nearly!) update:

I can comfortably walk up stairs without railings and can go down stairs pretty much normally too (although I need to hold railings!). Stiffness in my knee is slowly going away.

My ROM is at around 127°, which has increased by 2° in last few months. As mentioned previously, this will probably max out at 130°

My passive knee extension is 3° from being straight and hasn't changed much over last few months. It does still go to 0°/-1° after performing stretches but after half hour goes back to 3°.

My active knee extension goes into -6° hyperextension now though, which is good (probably due to the quad getting stronger!)

A couple of questions I had:

- Should I speak to my PT about my passive knee extension and the fact I can't get it to 0° (I see him in a couple of weeks)? Just a bit concerned, even though my active knee extension has improved, my passive knee extension hasn't improved despite performing daily stretches. Will this improve? It's slightly affecting my gait at the moment.

- My stiffness is going but I can feel the screws in my knee when I walk or perform activities (and it's been like that since day 1). It doesn't bother me much or cause pain, just a sensation of feeling something in my knee. Does this go away or is it worth speaking to my consultant about it? I have my next appointment in 6 months, so I can see how it feels then I guess.

 

[MSuki]

I’m confused, I thought you would typically do better on passive extension than active? (Don’t worry, I am not an expert, just that this sounds different than I thought. I have actually never been told an extension number.) Isn’t passive where you put your foot on something then maybe add a small weight? And active where you use your muscle? Either way if you are able to hyperextend to -6 I don’t think you have anything to worry about.

 

[mendogal]

Your range of motion is fine and should be fully functional!

I can't speak to the non-painful feeling of something in your knee. As long as there's no pain, swelling, instability, or fevers it's likely ok but you might call or email your ortho practice just to put your mind at ease.

 

[HR1994]

I’m confused, I thought you would typically do better on passive extension than active? (Don’t worry, I am not an expert, just that this sounds different than I thought. I have actually never been told an extension number.) Isn’t passive where you put your foot on something then maybe add a small weight? And active where you use your muscle? Either way if you are able to hyperextend to -6 I don’t think you have anything to worry about.

Hey. By passive, I meant letting my heel hang off a rolled up towel and measuring extension from that (with no external pressure or contraction of quads). I can just feel my gait off slightly.

Active, as you noted, is when I contracted the muscle and it hyperextends.

 

[HR1994]

Your range of motion is fine and should be fully functional!

I can't speak to the non-painful feeling of something in your knee. As long as there's no pain, swelling, instability, or fevers it's likely ok but you might call or email your ortho practice just to put your mind at ease.

Thanks. I think I'll wait to see how it feels over the next few months and if that feelings still there, I'll speak to consultant. I'm most certain it's the screws as my legs are small in general.

 

[mendogal]

Hey. By passive, I meant letting my heel hang off a rolled up towel and measuring extension from that (with no external pressure or contraction of quads). I can just feel my gait off slightly.

Active, as you noted, is when I contracted the muscle and it hyperextends.

Aha! Ok... I'm more into function than numbers (no idea what either knee measures now) but if you experience a wonky gait then Yes! Check in with PT. The gait problem may not even originate with range of motion.

 

[sistersinhim]

My extension was slower coming back than my bend. How I helped it along was by walking with a longer stride and with a heel to toe gait. Walking this way helps to stretch out those large muscles and tendons in the back of the knee. It worked well for me, but not overnight! Those large soft tissues take time to stretch out. Oh, and as you're taking that longer than normal stride, be sure to have something you can grab hold to in case you lose your balance! You don't want to fall!

 

[HR1994]

Thank you both!

 

[HR1994]

Hey guys - it's been a couple of years now since I had my left knee trochleoplasty and TTO and I remembered this community today and how much it helped.

I thought I'd post a two year update. My quality of of life has much improved - I no longer worry about my knee popping out or anything like that and the surgery was a game changer.

My knee flexion has eventually increased to 135°-140°, just depending on how much I've stretched that day. I had a slow recovery in terms of flexion but it eventually came back! In fact I was told by my consultant and PT that my ROM would be limited to 130° (which is the norm after a trochleoplasty) but I've exceeded that. In terms of my extension, I managed to achieve 0°. Some days, my knee is stiffer than others but a good stretch and some quad exercises, helps loosen it up massively.

I did have a second surgery on the knee in April 2024 but it was to remove the screws from my knee as it was causing pain whenever I went to the gym and I had a lot of sensitivity around that area. Once the screws were removed, a lot of that pain went.

I did suffer with massive quad atrophy after the surgery. A couple years later, my quads have grown, not to the size of my good leg but I have a good amount of strength and balance in my operated leg now.

The only thing I find difficult is walking down hills still. I am slow walking down hills but it was a problem before I had the surgery anyway. It just puts more pressure on the knee.

Thank you to this community for all the help and guidance.

 

[Layla]

Thanks for stopping by to post an update and for your kind words in regard to the forum. It is appreciated.
It's wonderful to read how well you're doing. It is always inspiring to see progress over time. Wishing you continued success and happiness on your journey, HR. Take good care!
@HR1994

 

[Jamie]

It's great to read your report and see that you're doing well. That's something we always love to hear. I also appreciate that you hold BoneSmart in high regard. It means the world to us. You're always part of the BoneSmart family. Please come back and check in whenever you can.

 

[EalingGran]

That's a great report. Thanks for updating. It's good to hear how things continue to improve

 

[sistersinhim]

It is wonderful to read how well you are doing! You're an inspiration to others on here, reading how it does get better.