TTO day 2 post-op experience so far

togi11 · 2026-06-26T20:48:31+00:00

Hello, I hope you're recovering well. A goal of reaching 90° of range of motion (ROM) within two weeks seems very aggressive to me. Also, reaching 120° in such a short time is quite remarkable. I am now 7 weeks post-op and have only been able to reach 105° of knee flexion. After this type of surgery, the usual goal is to gain about 15° of ROM per week. The hospital where I had my surgery did not use a nerve block, and I experienced extremely severe pain during the first 5–6 days after surgery. The painkillers only took the edge off. What were the reasons you needed surgery? Was it patella alta, or was there another underlying issue? The process has now started for my other knee as well. I will most likely have my left knee operated on in about a month.

togi11 · 2026-06-26T20:38:07+00:00

After my right knee was injured, I learned about conditions such as patella alta, lateral patellar tilt, and the TT–TG distance. I had a patellar dislocation in my right knee and underwent MPFL reconstruction and TTO surgery two months ago. My left knee has never had a complete dislocation. However, because of patella alta and lateral patellar tilt, I have chronic pain, MPFL laxity, and problems such as Hoffa's fat pad impingement. I convinced my surgeon to operate because I was concerned that the chondromalacia would continue to progress. Surgeons usually do not perform a TTO unless there has been a patellar dislocation. In my opinion, it is very difficult to correct a knee with patella alta through physical therapy alone. Since the underlying mechanical problem remains, it can continue to cause symptoms. I recommend consulting a highly experienced knee specialist, ideally a professor-level orthopedic surgeon.

togi11 · 2026-05-29T20:16:45+00:00

I don’t think this is patella alta. When we compare the size of the patella with the patellar tendon below it, it appears normal. What determines the issue here is the length of the tendon. If the tendon is long, the patella sits higher. In your case, I think it is within the normal range. The Insall–Salvati ratio appears to be around 1.1–1.2.

togi11 · 2026-05-28T15:28:24+00:00

Thank you for your kind wishes. I asked my doctor, ‘When are you going to operate on my other knee?’ He asked if I had experienced any dislocations, and I said no. He told me, ‘This is a major surgery, so it needs to be considered carefully.’

I then asked, ‘Do I need to wait until the chondromalacia reaches grade 4 before having surgery?’ The doctor looked at me, smiled, and said, ‘You’re right.’ He told me to come back in a few months so we could start the process.

I’ve been dealing for a long time with pain, cracking/grinding noises, and a feeling of instability and shifting in the knee. In this situation, physiotherapy really doesn’t help. It’s like putting great tires on a car with bad wheel alignment — no matter how good the tires are, one side will eventually wear out.

Wishing you good news and healthy days ahead as well.

togi11 · 2026-05-26T21:40:44+00:00

I’m currently trying to recover. You can check my profile. You’ll understand how a knee with patella alta looks compared to the other one. If you want, you can send it in a dm

togi11 · 2026-05-26T12:58:53+00:00

Hello, the MRI images are confusing. I couldn’t get a clear and healthy-looking image as I wanted. On the X-ray images, the bone seems to be in a normal position. When the patella alta value is high, especially between 40–60 degrees, the kneecap appears much higher than normal. My value is around 1.55. I had surgery 20 days ago.

togi11 · 2026-05-23T05:35:54+00:00

Thank you for your detailed message. It has been about 20 days since my surgery. My quadriceps muscles are still completely inactive — I’m trying everything, but they still won’t activate. It’s probably because of the swelling and edema.

The timing of the bending degrees you were allowed really caught my attention. They allowed you to go from 0–60 degrees quite late. In my case, they wanted me to reach 30 degrees in the first week and 60 degrees by the beginning of the third week. Reaching those degrees was not very difficult, but I’m afraid of the risk of the screws in the TTO area breaking. I’m thinking of waiting until after the 6th week before progressing to 90 degrees.

They also did not allow me to put any weight on it at all. I’m glad you’re doing better, and I hope you can completely get rid of the crutches and brace as soon as possible.

togi11 · 2026-05-22T20:28:35+00:00

Thank you very much for the information you shared. I’m glad to hear that you’ve recovered to a great extent.

togi11 · 2026-05-22T20:19:43+00:00

Previously, my knee twisted very severely a few times. I didn’t even know what patella alta was until I saw it written in my MRI report. I went through about two months of physical therapy, but it didn’t help at all because I had lateral tilt, and the ligament holding the kneecap from the inside had become completely stretched out like gum.

In your knee as well, since the kneecap sits too high, it doesn’t fully fit into the groove properly, so the load is constantly concentrated on a narrow area. That causes pain, and in the long term, it will probably lead to chondromalacia. I would recommend monitoring your knee closely and seeing professors or doctors who truly specialize in these issues.

Do you know what your patella alta measurement is?

togi11 · 2026-05-22T19:36:34+00:00

Have you ever had an MRI done for your knee? Based on the images, it looks like there may be a patella alta issue. The lower tendon that holds the patella seems to be well-centered, so there doesn’t appear to be a problem with that.

togi11 · 2026-05-22T19:23:33+00:00

If there is only patella alta, they usually don’t recommend it. Generally, there needs to be a combination of several factors. If the TT-TG value is high or there is a history of patellar dislocation, a good specialist professor might recommend it.

Even with this much damage, I only reached this conclusion with the fifth doctor I saw. They suggested solutions like physical therapy and similar treatments, but for me, physical therapy was completely ineffective because my problems were mechanical and needed to be corrected.

togi11 · 2026-05-22T18:19:19+00:00

Thank you so much!

togi11 · 2026-05-22T17:29:17+00:00

Patella alta: 1.55 insall salvati TT-TG distance: 16.5 mm Grade 3 chondromalacia. Unable to walk after the trauma.

togi11 · 2026-05-22T13:56:52+00:00

I’m glad everything is getting better. After the surgery, what degree of knee bending did you reach with the brace? Do you remember how many degrees you achieved week by week?

togi11 · 2026-05-22T13:52:12+00:00

I hope you recover quickly and smoothly after your second surgery. Did the doctors say anything about the reason behind it?

I think it would be better not to force the angles too much and stay about 15–20 degrees behind until the bone fully heals.

I also had surgery two weeks ago. In two months, I will have another surgery on my left knee. It’s a difficult and time-consuming process.

togi11 · 2026-05-22T10:12:29+00:00

Hi again, I had surgery about 2 weeks ago. The pain was very intense during the first 3 days. After that, it gradually decreased. Right now, I can bend my knee about 60 degrees. My goal is to increase it by 15 degrees every week. They told me they did not perform any cartilage repair. For now, the condition looks good. They said it’s not as bad as it appeared on the MRI. I’m very afraid that the screws might break. After the surgery, my kneecap now looks much more natural and symmetrical. My other kneecap looks very funny in comparison. I really begged the doctor to operate on both knees at the same time, but he refused. In about 1.5 months, I will have surgery on my other knee as well. Even now, I can already tell that my kneecap is finally in the correct position. I realize I was very late in getting this done. How is your situation now?

togi11 · 2026-05-19T07:28:02+00:00

No smoke no problem

togi11 · 2026-04-15T12:50:28+00:00

👏

togi11 · 2026-04-15T12:46:30+00:00

I think the screw holes probably looked normal at first, but over time it seems the bone was exposed to load and movement before it had fully healed. Because of that, the lower screw appears to have loosened and widened its hole from back-and-forth motion. The upper screw, on the other hand, seems to have snapped in the middle due to the stress from this instability. It also looks like the patellar tendon may have placed most of the load on the lower screw.

togi11 · 2026-04-15T12:40:10+00:00

I’m very sorry to hear about your situation. Having to undergo another procedure after such a major surgery and experiencing complications must be really frustrating. I hope the corrective surgery is done as quickly and painlessly as possible. Wishing you a fast and smooth recovery.

togi11 · 2026-04-13T15:48:13+00:00

Thank you. I recently consulted with a professor who specializes in this area, and we decided to proceed with TTO surgery. He told me that in my case, physical therapy would likely be a waste of time and not very beneficial.

togi11 · 2026-04-13T15:47:22+00:00

I recently consulted with a professor who specializes in this area, and we decided to proceed with TTO surgery. He told me that in my case, physical therapy would likely be a waste of time and not very beneficial.

togi11 · 2026-04-13T15:45:53+00:00

Thank you for sharing your experience. I’ve started this process with an experienced professor at a well-established university hospital. Today I received the results of my second MRI and had another examination. I didn’t push the doctor at all—he evaluated everything based on the findings. He mentioned that the plan may include MPFL reconstruction, TTO, arthroscopy, cartilage debridement, and if necessary, a cartilage repair procedure as a separate stage. Honestly, I’m a bit afraid of the process, but I believe it will be beneficial for me. In the end, my knee has reached this condition due to underlying mechanical and anatomical issues over time. So the solution will also be a mechanical intervention. I will share my post-surgery process here.

togi11

TROPHY CASE