T Nation

Doubts About Surgery


#1

I was diagnosed with 3-4 degrees of varus in both of my tibia. And in my right tibia about 8 degrees of a rotational deformity.

It has taken me literally 10 years and 20 doctors and as many PT's to get that diagnosis.

I think it's at the very least on the right track, since I've been pleading with doctors to consider that something they hadn't noticed was wrong, because nothing they said made sense of how my legs felt. But a body deformity did.

Unfortunately, I got a second opinion by sending all the imaging and reports to another doctor I had previously seen. He acknowledged the deformities, but could neither endorse surgery to fix it nor would he say surgery was wrong. He said he has never corrected less than 5 degrees of varus.

I'm working on getting another opinion, and I'm still leaning towards surgery, which would be an open wedge high tibial osteotomy.

However, I wonder about one thing. My legs felt fine until about 20 years old. Not just fine, but perfect. There was no malalignment at 20 years old. I've been told once you stop growing you wouldn't acquire a malignment. I don't think I grew much if at after 20 years old. But I only noticed problems after that. And they got progressively worse after that.

Any idea how I explain that? I have a hypothesis that the bones changed shape due to prolonged pressure applied to them due to how I sat in desks at college and at work. Slight pressure for hours at a time. Almost every day. It might be ridiculous. All the doctors say it can't happen. But all the doctors also told me there was basically nothing wrong with my legs, and they were all wrong, except for the last two.

However a misdiagnosis is different than being wrong about basic physiology, IE bones changing shape due to pressure applied for long periods of time. So I'm somewhat less inclined to trust my own instinct despite the fact that I have a better track record than the doctors I've seen.

Also my muscles have changed shape. Only my quads really. I only really noticed this some time after 20 years old. I attribute this to changing shape of bones, which would alter the position of the connection points of the muscle relative to each other, changing the overall shape. I didn't notice this until well after I stopped growing.

I'm somewhat worried about surgery because due to the nature of how my problems have developed since I was supposed to have stopped growing, I have no idea whatsoever if it will improve my symptoms at all.

I can't seem to find a single person who has ever had symptoms similar to time due to a malalignment.

Any idea why my symptoms would get worse over a period of 10 or so years AFTER I stopped growing, if the problem was due to a bony deformity which supposedly was established and fixed when I stopped growing?

And how do I figure this out so I don't get my tibia's sawn in half only to come out no better, or even worse?

Is there soft tissue work that needs to be done too? What kind of soft tissue work would address problems that a bony deformity would cause? Are the progressions of symptoms due to soft tissue response to the deformity? What's the mechanism for these changes?

Basically, I need guidance, and it's hard to get this level of guidance from a doctor, because they are so constrained by time, and seem to want to gi


#2

You sat cross-legged, on top of your feet, all day, every day, and it warped your shins? And now you walk around on the outsides of your feet instead of the bottoms of your feet? Because your lower legs curve in? Because you sat on them all day? I would 100% get a second opinion.

What are your symptoms?

Have you tried some clam-shells, 1 leg extenions/1leg curls, and single leg calf raises to attempt to straighten things out?


#3

I didn’t sit cross legged. But I sat in a way that would have put lateral pressure on my tibia.

But that that could have altered my bones is not a doctor’s opinion. It’s a possibility I have considered.

I’ve done all sorts of PT exercises, none of which has done the slightest thing.

McConnel taping did help, but just barely.