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Old 04-10-2009, 09:05 AM   #1
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Tendon Transfer and Heel Osteotomy

Hi. My name is Megan and I am 40 years old.

I have already had two ankle surgeries in 2003. But that was to remove a cyst and do a bone graft and then to replace the bone graft when I broke it.

I have managed to get this far with steroid shots but am at the end of the line with that. Currently I have an arthroscopy planned for the first week in May. This will basically be an exploration mission as there is so much fluid on my ankle the MRI is hard to read.

Ultimately, what I am looking at the first week in July is a tendon transfer for treatment of PTTD and a calceneus osteotomy. I have done lots of research and definitely am not going into this without a lot of trepidation. But it has to be done because I am really tired of being unable to walk 4-5 days a month because the pain and swelling are so bad.

My questions:

From a simple exploratory arthroscopy where they are just looking, what is the average recovery time back to full weight bearing? I have a vacation planned in the middle of June and really don't want to be on crutches or a walker.

And – for those that have had a tendon transfer and/or calceneus osteotomy,
1. How big and bad are the scars?

2. How bad is the pain? (I have a fairly high threshold for pain).

3. What is the average recovery time?

4. If you work, when did you return to work?

5. Is it an unreasonable expectation for me to go on a business trip 6 weeks post op? I have a trip scheduled to St Pete/Tampa.

6. Splint, then cast, then boot, then brace? What is the timeline I can expect from this?

7. Is physical therapy part of all this? The last surgeries I had did not involve physical therapy but they were not as extensive as this.



I am trying to figure out an approximate of time off work that I will need as I am going to have to apply for advanced sick leave to do all of this. What is the minimum anyone stayed home? And the maximum?

Any help you can give me would be greatly appreciated. THANKS!

 
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Old 04-10-2009, 12:34 PM   #2
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Re: Tendon Transfer and Heel Osteotomy

Anyone? Bueller? Bueller?

 
Old 04-11-2009, 05:28 AM   #3
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Re: Tendon Transfer and Heel Osteotomy

Megan,
I certainly hope you get your answers, there are many on these boards who've been through these procedures. Have you tried searching for other posts regarding this? I'm sure these questions have all been asked before by those trying to prepare themselves. I wish I had some answers for you but I've not had these surgeries. Good luck in getting your answers and keep asking the questions, someone's bound to answer soon.

 
Old 04-11-2009, 05:42 AM   #4
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Re: Tendon Transfer and Heel Osteotomy

HI Megan,
I'm guessing because of the holiday it is a bit quiet here. I have not had the same thing done so I cant answer any of the second group. I have had a scope done however they did some work not just explored. I think if they go in to just explore then it takes a few days of wound healing then you quickly go into regaining movement. the issue will lie if he does other things when he is in there. That may then take longer. I don't think you need formal therapy after an explore. I would say that a June vacation you should be fine with.
Maybe when everyone is back on after the weekend youll get better answers.

 
Old 04-11-2009, 10:24 AM   #5
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Re: Tendon Transfer and Heel Osteotomy

Thanks! I did search through the board and found several answers. I guess I just really really need reassurance at this point. I am tired of being in pain but nervous about going through surgery again - the last two I had were no cake walk but they were not as extensive as this either.

 
Old 04-11-2009, 01:58 PM   #6
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Re: Tendon Transfer and Heel Osteotomy

Hi Meg----I am going to try to answer a couple of questions----I am still in the middle of recovery so, I dont know that I can answer them all.....

As far as scars go-----I dont know what they will look like when its all over, but I had a tendon transfer, calcaneal osteotomy--and I have seen mine each time my cast has been changed----and i will say the one on the inside is large, probably 6 inches---the one on the outside of the foot is maybe 4 inches, and then a tiny one on the back of my heel. The 6 inch one is probably longer b/c I had anther surgery there last May that had created a lot of scar tissue----and the doctor had a hard time with that.
since i have been casted since surgery, which was March 6th---I have yet to see it as a "clean" foot----so its hard to say how "ugly" it is!!!

As far as pain---I also have a high threshold for pain----I have pain, yes, but i have not been in excruciating pain. So i am not going to answer that one too clearly probably----I think you will be okay----I did take my pain meds faithfully the first two weeks though, no matter how much they kept me knocked out! I didnt want to take the chance that the pain would get ahead of me..

Recovery time----Here is what i am currently anticipating---6 weeks NWB, in cast, possibly 2 extra weeks NWB in cast---I took a fall 3 weeks post op--so I may have to be casted a little longer. Then boot, 6-8 weeks working up to FWB----and beginning P/T.........

I am an auditor and I was/am scheduled off from work for 12 weeks---mainly b/c I have such a walk just to get into my office, that it was impossible to even contemplate me going back sooner. However, even once I go back, I am going to be working from home----so that will be nice too----if I am swelling and don't feel like sitting at a desk, I can stay propped up in bed, which is nice.

I actually had a business trip scheduled for the end of April----there is no way I could go on that, and I would be 8 weeks post op. I am having to miss the trip entirely---the rest of my team from work will attend without me--which is a bummer, as I work with auditors from all over the country and this was an annual meeting, but nothing I can do. The doctor will not approved this trip for me.

I am being told altogether, recovery is about a year before you are completely back 100%------6 weeks cast, NWB, 6-8 weeks working up to FWB, along with P/T------------then 6-9 months before everything is completely healed and we are back to our normal selves.

I hope this is somewhat helpful. Let me know if you have other questions---I will be glad to answer.

I wish you MUCH luck with everything!!! These boards are great help---and yes, my guess is no one is answering due to the Easter holiday, and people may be out of town. I will be around all weekend---I will check back later.

Take care,
Tracie

 
Old 04-11-2009, 09:38 PM   #7
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Re: Tendon Transfer and Heel Osteotomy

Thanks Tracie - I noticed in another thread that you mentioned the waterproof cast cover - I had one 6 years ago when I had my initial surgeries but can't remember where I got it. Did you get yours online? If so, what website did you use?

 
Old 04-11-2009, 09:42 PM   #8
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Re: Tendon Transfer and Heel Osteotomy

I actually found mine at a local "mom and pop's" type pharmacy----I was going to purchase mine off the internet but the orthopedic surgeon I was seeing at the time, knew about this pharmacy, and I was put in the cast at that time on an emergency basis, so it just worked out for me that I found one in town.

Maybe you could try a couple of your local" pharmacies and see if they have one----they tend to carrier more DME than a chain pharmacy.

i hope you have some luck!!!

 
Old 04-12-2009, 07:07 PM   #9
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Re: Tendon Transfer and Heel Osteotomy

Meg
Just so ya know we can't give web sites on this forum. I did once and got a spanking but it was done to help not in a mallicious manor so they let me slide (I think). But they edit and change the post. I never like surgery I had 3 in a year plus another hospital stay cause I have trashed my stomach with advil. I also had a fall like Tracie. Down the wood basement stairs. I still don't know how I survived that one. When I hear of people getting elective cosmetic surgery I just don't get it. IN the long run for us we want to stop pain. It will be worth it. A long journey but worth it.
Diane

 
Old 04-12-2009, 07:51 PM   #10
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Re: Tendon Transfer and Heel Osteotomy

Quote:
Originally Posted by justmeg View Post
Hi. My name is Megan and I am 40 years old.

I have already had two ankle surgeries in 2003. But that was to remove a cyst and do a bone graft and then to replace the bone graft when I broke it.

I have managed to get this far with steroid shots but am at the end of the line with that. Currently I have an arthroscopy planned for the first week in May. This will basically be an exploration mission as there is so much fluid on my ankle the MRI is hard to read.

Ultimately, what I am looking at the first week in July is a tendon transfer for treatment of PTTD and a calceneus osteotomy. I have done lots of research and definitely am not going into this without a lot of trepidation. But it has to be done because I am really tired of being unable to walk 4-5 days a month because the pain and swelling are so bad.

My questions:

From a simple exploratory arthroscopy where they are just looking, what is the average recovery time back to full weight bearing? I have a vacation planned in the middle of June and really don't want to be on crutches or a walker.

And – for those that have had a tendon transfer and/or calceneus osteotomy,
1. How big and bad are the scars?

2. How bad is the pain? (I have a fairly high threshold for pain).

3. What is the average recovery time?

4. If you work, when did you return to work?

5. Is it an unreasonable expectation for me to go on a business trip 6 weeks post op? I have a trip scheduled to St Pete/Tampa.

6. Splint, then cast, then boot, then brace? What is the timeline I can expect from this?

7. Is physical therapy part of all this? The last surgeries I had did not involve physical therapy but they were not as extensive as this.



I am trying to figure out an approximate of time off work that I will need as I am going to have to apply for advanced sick leave to do all of this. What is the minimum anyone stayed home? And the maximum?

Any help you can give me would be greatly appreciated. THANKS!
Hi, Meg. Welcome to the board! I have had PTTD surgery and an arthroscopy. Tracie pretty much answered your PTTD questions although I will say that I worked up to FWB over a couple of weeks, not 6-8, but everyone is different. I was also 6 weeks NWB- had PT for 3-4 months (and it was needed). 8-12 weeks is a pretty good estimate of time off work although there have been people on here who have gone back in 2-3 weeks but I would say that is exceptional.

Re: arthroscopy. I was in a post-op sandal and told to move my ankle ASAP. I was on crutches for about a week. It was sore for 4-6 weeks. I had PT for a couple of weeks. It's not unreasonable to expect to be able to go on a business trip at 6 weeks as long as they have not done additional work while in there "exploring". I had a lot of scar tissue removed but no other work done. Also, I would say you wouldn't want to do a lot of walking on that trip, but it would be "do-able" otherwise.

Hope this helps! ask any other questions and I'll be happy to help if I can.

emmie

 
Old 04-13-2009, 09:20 AM   #11
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Re: Tendon Transfer and Heel Osteotomy

Thanks for the responses everyone.

I plan on taking two days off for the arthroscopy and then back at work.

I plan on taking about 2 weeks after the TT and osteotomy - I will - more then likely - return to work when I get a hard cast after stitches come out. Luckily - I work at a desk in my own office all day - so I can always put my foot up and keyboard in my lap and keep going.

I think I may cancel out on the trip to St. Pete/Tamp (which is a shame because my BFF was going with me). I'll talk to the surgeon about it.

I really appreciate the information I have found here!

 
Old 05-03-2009, 08:20 AM   #12
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Re: Tendon Transfer and Heel Osteotomy

Hey Meg,

I just saw this post, otherwise I certainly would have answered sooner! I think because I type in 'pttd' in the search, it didn't come up until Emmie's post where she had 'pttd' in there. Dunno.

Anyway, I'm three days shy of 9 weeks post off for pttd, bone thing, tendon transfer, etc. It always amazes me that people remember the long medical terms for what they had done! I just know they cut my heel, put in a few screws, broke a few bones on the top of my foot, put in a few screws, took a tendon from my baby toe and replaced the posterial tendon with it. If those sound like the surgery you're having, whoohoo! I can help!

As for the scars - they are long, they are ugly and I can send you pictures of my foot if you'd like a visual. I consider them badges of honor, so I don't know if I'll try to hard too make them go away. I'm strange, I know.

I was NWB for 6 weeks, then told I could start bearing weight 'as the pain dictated'. I know some people are told - 10 lbs to start, then 25, then 50, etc. My doc just said 'if it hurts, stop'. I've not had much in the way of pain from weight bearing, which scares and excites me. I can walk around a few steps without crutches, but that usually ends up in foot zaps (there's a post on here about those, check it out). Back to scars - I have a 2 inch incision on the top of my foot, a 4 inch incision on the inside of my foot, and I think two more incisions on my heel, one on the outside by the ankle and the other right in the back for the achilles lenghtening. Oh, yeah, I forgot to mention that - I had my achilles lengthened too. The two on the heel have been real buggaboos for me. The scabs rub and rub and rub. Really, the pain was manageable, but those scabs are driving me crazy.

I go in on Wednesday to get my final cast off - hopefully! And then I will be put into a boot. I'm not sure how long that will be for. But I do know that at the beginning of all this I was supposed to be casted for 3 months and if I get my cast off Wednesday, then it will only have been 9 weeks instead of 12. Yay! I'll update on Wednesday for you.

I'll also know then about PT. I know I'll have to do it, but not sure how long, etc. You mentioned going to Florida - one of the things my doctor told me was that sand is out. I live at the beach, so it's an issue here. I just thought I'd throw that out in case you do go on your trip. Which, I don't know if I'd be up for a trip at 6 weeks post op, but everyone is different. When I was 6 weeks, I went to the grocery store and was exhausted. Sweating, shaking from the exertion, etc. But if you go back to work at 2 weeks, you'll be more conditioned for it than I was. I, literally, was in a recliner chair the first two weeks. That's about all I could handle. I'm 44, a little chubby, but otherwise in good health/shape and very active before the surgery so it was a shock how little energy I had. Oh, and getting off meds as soon as you can will help. I stayed on them for a month and that was too long for me. I got physically addicted to them and coming off the meds was a nightmare. Why people like taking drugs is beyond me. I never liked the woozy feeling I'd get. I find now that a few advil every day works just fine. I wish I'd trusted that earlier, but I was afraid of the pain (which probably wasn't there, but I didn't know because I kept taking the drugs). Go figure.

And finally, I was never told of a brace. It was always, splint, then cast, then boot. Some people on here went straight from surgery to hard cast, or air cast, and some lucky ones straight to a boot. All the docs seem to work in their own way and no two stories are the same. Tracie and I had surgery 2 days apart and she's still NWB (could be because she fell) and I'm already PWB, so it all depends on you and your doctor.

Good luck with your exploratory surgery and please do keep us posted! Now that I've found you, I'll make sure to check up on your progress.

Last edited by SoCalGal09; 05-03-2009 at 08:25 AM.

 
Old 05-03-2009, 11:59 AM   #13
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Re: Tendon Transfer and Heel Osteotomy

Thank you so much - I have the arthroscopy scheduled for the 13th - definately not looking forward to it - BUT at least then I will know what I am up against. And - it will be a quick recovery.

I am re-thinking my trip to Florida - even though it is for business and not pleasure - IF I have to have the whole pttd and heel thing - I am not sure I will be able to handle it. With 3 kids, I stay pretty active, but it is MAJOR surgery and am not sure I can handle the whole airport thing with connecting flights in Atlanta and all.

 
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