On November 29, 2021, I went in for my fourth (and hopefully final) knee surgery. This time I was taking care of the left leg. If you have been here awhile, you may recall I had a MACI with MPFL Reconstruction done on my right leg. This time around I needed a much bigger procedure done for my left knee. I got the MACI procedure with a Tibial Tubercle Osteotomy.
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What is the Tibial Tubercle Osteotomy?
Very simply put, the Tibial Tubercle Osteotomy (TTO) surgery is a procedure to improve the alignment of the patella. In my case, because the point where my tibia bone attaches to the knee joint was over to one side so far, it caused my patella to be pretty tilted. This tilt caused the patella to damage some of the cartilage beneath it, which in turn caused me pain. With the TTO procedure, the surgeon cuts through the tibia bone and moves it over to better align with the patella. In my particular surgery, my surgeon moved the tibia over one whole centimeter.
What is the MACI Procedure?
A lot of times (not always, of course), when someone needs to have a Tibial Tubercle Osteotomy, they also need to fix the underlying cartilage. If you remember, back in 2018 and 2019 I had knee surgery on my right knee. The MACI was performed at that time. With a MACI procedure, a patient will have a scope done where the surgeon will go in and clean up the underside of the patella and take a biopsy of the cartilage. This biopsy is then sent to a lab to grow more of your own cartilage. Pretty neat! On the day of surgery, the damaged cartilage is removed and the new cartilage is put in its place. You then will be in a full brace and doing PT, while that new cartilage thickens and hardens to match the rest of the cartilage in your joint.
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Knee Surgery Day
On the day of surgery, I have to admit, I was pretty nervous. This surgical plan was a little more serious than the previous surgery for the right leg. However, I trusted my surgeon. I mean, I had to…this was, after all, my fourth surgery with him! The surgery took about two and a half hours. When I woke up, I was in a tremendous amount of pain. The nursing staff were excellent and gave me medication to help with the pain. I also received a nerve block. When I was discharged, I wasn’t feeling any pain at all. One of the last things they told me at discharge was, “you are on some heavy duty narcotics. Absolutely no signing any legal documents”. In my stoned brain I heard, “when you get in the car, pull up Amazon and order some stuff”. So I did. The funny thing is, I have no memory of ordering these leopard disposable face mask, but I did! And boy did we get a laugh out of it when they arrived a few days later!
Recovery from Surgery So Far
I am only a couple weeks out from surgery, but so far everything is going fairly well. The nerve block ended up wearing off quicker than it was supposed to and I was hit with a ton of pain. However, a chat with the nurse helped and we were able to get my pain under control eventually. In chatting with my surgeon about it at my one week follow up, I think that if I had it to do over again, I would opt to not have the nerve block. Instead, I would have had the nurses give me whatever pain medication they could before discharging me. This way, once that starts to wear off, I can stay on top of the pain. With a nerve block, it just wears off and usually without warning. If you are having this surgery done, definitely discuss after surgery pain control with your surgeon.
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All in All, Everything is Good
While the recovery started out with a lot more pain than I was anticipating, in the end it all worked out. I don’t have nearly as much swelling as I did with my previous knee surgeries. I’m also not dealing with a tight IT band like I did when I had surgery on my right leg. The best thing I did leading up to this major knee surgery was hit the gym and get as strong as possible. Trust me, you want to do that. The stronger you can go into knee surgery, the better you come out of it. I will be sure to keep you updated periodically as things change with my recovery. Right now I am on crutches with about 20% weight bearing. Basically I walk with crutches and use my left leg to sort of balance myself, but not really put much weight on it at all.