Post-Surgery Concerns: Pain and Mobility After Tibia Surgery

Postoperative care for tibia and fibula fractures?

Hello Doctor! A few months ago, I underwent surgery to remove a tibial tumor, and artificial bone was used to fill the area.
Recently, I've been experiencing back pain, so I followed some rehabilitation exercises I found online, which included a kneeling position.
At the time, I didn't feel any pain, but two days later, my legs felt weak, and walking became quite difficult.
Upon closer inspection, it seems that the metal plate has shifted towards my knee.
Could my plate be fractured? Or has my knee sustained a fracture? Or is it simply that my muscles are weak due to insufficient rehabilitation? Will I need a joint replacement? Should I avoid kneeling? Thank you, Doctor, for taking the time to read my message.

Amber, 20~29 year old female. Ask Date: 2021/05/02

Dr. You Dianqi reply Orthopedics

From your response, I noticed that there are concerns about the possibility of the bone plate screws shifting.
This issue may require imaging to provide a more informed response.
As for your questions about whether you can kneel and similar inquiries, it largely depends on the condition of the newly formed bone after the tumor excision and whether it is intact and healthy.
Medicine is a highly individualized field.
Without seeing the patient and their preoperative and postoperative imaging, it would be risky to offer general advice.
I hope you understand.

Reply Date: 2021/05/02

More Info

After undergoing tibial tumor resection surgery and having artificial bone grafted, it is understandable to have concerns about pain, mobility, and the integrity of the surgical hardware. Your symptoms of back pain, weakness in the legs, and difficulty walking can be attributed to several factors, including the surgical procedure itself, the recovery process, and the rehabilitation efforts you have undertaken.

Firstly, regarding your concern about the plate appearing to shift towards the knee, it is essential to understand that surgical hardware, such as plates and screws, is designed to stabilize the bone during the healing process. If you notice any visible displacement or feel that the plate has moved, it is crucial to consult your orthopedic surgeon as soon as possible. They may recommend imaging studies, such as X-rays, to assess the position of the hardware and the integrity of the surrounding bone. A broken plate or a fracture in the knee area could lead to complications, so timely evaluation is necessary.

Your experience of feeling weak and having difficulty walking could be related to muscle atrophy or weakness due to reduced mobility during your recovery. After surgery, it is common for patients to experience a decrease in muscle strength, particularly if they have been less active. Engaging in rehabilitation exercises is vital to regain strength and improve mobility. However, it is crucial to perform these exercises under the guidance of a physical therapist who can tailor a program to your specific needs and ensure that you are not putting undue stress on your healing tibia.

Regarding your back pain, it could be a result of compensatory movements due to your altered gait or posture while walking. When recovering from lower limb surgery, patients often adjust their walking patterns to avoid pain, which can lead to strain in other areas, such as the back. It is essential to address this issue with your healthcare provider, as they may recommend specific exercises to strengthen your core and back muscles, which can help alleviate pain and improve your overall stability.

As for kneeling, it is generally advisable to avoid positions that place excessive stress on the knee joint, especially in the early stages of recovery. Kneeling can put pressure on the knee and may not be comfortable, particularly if you are still experiencing pain or if the surgical site is sensitive. It is best to discuss your activity levels with your surgeon or physical therapist, who can provide personalized recommendations based on your healing progress.

Lastly, the concern about needing a total knee replacement in the future is valid, especially if there are complications or if the joint does not heal properly. However, this decision is typically based on a combination of factors, including the extent of any damage, the success of rehabilitation, and your overall function. Regular follow-ups with your orthopedic surgeon will help monitor your recovery and address any concerns that arise.

In summary, it is crucial to maintain open communication with your healthcare team regarding your symptoms and concerns. They can provide the necessary evaluations and adjustments to your rehabilitation plan to ensure a successful recovery. Prioritize your physical therapy sessions, and do not hesitate to reach out to your surgeon if you notice any significant changes or if your symptoms worsen. Your recovery journey is important, and taking proactive steps will help you regain strength and mobility.

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