amaya at lake

amaya at lake

Friday, March 3, 2017

Eight Plate surgery

Sweet Amaya at her appointment 

Today we saw Dr. Nelson for our yearly check-up. When he came into the room he laughed saying that if he saw Amaya somewhere else he wouldn't have recognized her since she's so big. After looking at x-rays from two years ago and comparing them to this years x-rays, watching her walk & run and manipulating her knee he said that he needed to correct the alignment in her left knee. He said her left knee is turning in more than the right one. You can see it when you look at her legs, but "more so" when you look at the x-ray. He said that its important to align the leg before she's done growing and before she begins her next lengthening surgery (also about 14 years old). He said that ideally the eight-plate is completed a year before kids are done growing. Girls typically finish growing at about 14 years old. So the eight-plate should be started at age 11 & 1/2 to 12 to be complete by age 13. He said the latest we could wait to do the surgery is six months from now (Amaya is 11 & 1/2 now), but since we're moving to Northern California this summer he said we should do it ASAP. That way he can monitor her as much as possible while she's still here. The soonest date was March 30th. We did our pre-op paperwork today, so we are officially scheduled for surgery. The week of the surgery we'll have a consultation with the anesthesia department and then do the pre-op appointment the same day as the surgery.

Dr. Nelson also said that her left leg is now 7 mm (about a quarter inch) shorter than her right leg. Last year the difference wasn't noticeable. We will keep monitoring it to see how she continues to grow and when to schedule her next lengthening. He thinks it'll be around age fourteen or once she's done growing.

About the surgery...
Using a small incision (about an inch to two and a half inches) Dr. Nelson will place an eight plate on her left knee. The plate is held in place by two screws. The plate helps by guiding the growth of her bone to naturally correct the alignment. The surgery is outpatient, and takes about an hour to perform. Amaya will be asleep during the surgery, so once she wakes up and recovers from anesthesia she'll be able to go home. Dr. Nelson said that compared to her other surgeries this is easier and a "small" surgery. She won't need a wheelchair or walker for this surgery. She should be able to walk and bear weight in about a week or so. The eight-plate will be in for about 6 months depending on how her leg responds. Every three months Dr. Nelson will order x-rays to see how its doing then decide when to remove it.
Here's a picture of what the eight-plate and screws look like and how they work
 Here's a close up of the knee with the eight-plate
(this one shows the plate on both the femur and the tibia,
but Amaya's will only be on her femur).
This is her x-ray from two years ago 
Here's a look at her knees (you can see the "knock" in her left one)
Here's her most recent x-rays
Thank you all for the love and support. This surgery is coming up quickly (only three weeks away!). Amaya is a bit anxious, but is open and honest about her feelings and we're walking her through the process and her emotions. We're also gathering information for her (she's curious and nervous about  the incision size, scars, recovery time, pain, anesthesia, etc). Thankfully our PFFD friends are sharing their experiences and photos with us. 
Amaya is so sweet! She bought me a treat and wrote me a card to thank me for taking her to all of her appointments and for all my "support."