Tuesday, June 25, 2013

Op report #7

Right Hip Open Removal of Hardware, Bursectomy and Gluteus Medius Repair Indications: the patient had a prior surgical dislocation, painful hardware and loose medius and adductor weakness. She had a failed non- operative management and indicated for removal of hardware and Bursectomy and gluteus medius repair. Procedure: The patient was correctly identified in the holding area, she was brought to the operating room. Spinal anesthesia was administered she was placed in the lateral decubitus position and the right leg was prepped and draped in the standard, sterile, fashion. Approximately 4cm incision was made over the previous lateral incision from the Gibson approach and taken down to the level of the iliotibial band. Scar tissue was debrided. The iliotibial band was split using modified anterior Gibson approach in line with the fibers of the gluteus Maximus. There was significant bursal inflammation on the undersurface of the iliotibial band which was excised and resected en mass. Three 2.5 mm screws were identified and extracted. The abductor tendons were intact although there was some attenuation of the posterior superior facet, insertion of the round fibers of the gluteus medius. Using drill tunnels through the posterior, superior facet, modified Mason- Allen sutures using #1 OrthoCord sutures were used to restore tension on the abductor in this region. The PRP was then injected at the site of the abductor repair. The wound was copiously irrigated. A light closure was performed with 0 vicryl for the iliotibial band and 0 vicryl 1 and 2.0 Vicryl for the deep layer and a 3.0 Monocryl sutures with Steri Strips. The wounds were cleaned, dried and sterile dressings were applied.

Sunday, June 23, 2013

I am unscrewed!

My unscrewing was 4 days ago. Leading up to the surgery I was pretty calm. My OS and I had discussed things and decided that while taking out the screws he would do whatever he could to help my gluteus medius. This including repairing any and all tears and injecting PRP. It turns out I didn't have a bad tear but I had a stretched out tendon. I am not 100% sure why it was stretched. My OS said it may have healed like that after the open dislocation or, since I hadn't been firing, it looked all loose. I guess it's one of those situations- what came first, the chicken or the egg. Surgery was on Thursday (6/20/12) and I was supposed to come home that day. Since I am usually not the star patient in the PACU, I had a lot of trouble recovering and was in a lot of pain so I ended up staying over. The next day things didn't go too well. I was in a lot of pain and very dizzy. The hospital won't discharge you until you "pass" PT. I was too dizzy for PT so I was stuck another night. Yesterday was almost a repeat of the day before. I failed PT twice bc I was too dizzy and in pain. Plus the PT said I was way too pale and was nervous I would pass out. Everyone gets PT 2x/day so I maxed out my opportunities. I REALLY didn't want to stay another night so I skipped a dosage of pain meds and made sure I drank a ton of juice and ate a little. I asked my nurse to beg the PT to give me one more chance. A really nice PT came back and cleared me to leave! Yippee!! So now I am home, I feel like I did after my open surgery, if I don't move I am fine, if I walk, roll in bed, sit, scoot etc I see stars. My OS took pics with his phone so I a waiting for him to send the to me, he showed me in the PACU but I was a little out of it!

Tuesday, June 4, 2013

Hardware Removal Pre-op Appointment

I decided to make an appointment with my OS to go over some last minute pre-op concerns. Primarily what the heck is going to happen with my glutes. He will fix whatever needs fixing and suture it back down. He will also put prp in while in the surgery to promote healing. Post op I will be on crutches for 2 weeks minimum and no active abduction for 2 weeks minimum. Since I've been on crutches this whole time I shouldn't expect to miraculously walk!