Hardware removal after tibial plateau fracture (tpf)

Posted by rileydog @rileydog, Oct 6, 2017

I am looking for others that have had experience with hardware removal after a tibial plateau fracture. I had my surgery in March of 2016 and am still experiencing discomfort from the hardware (plate and six screws) and am considering having mine removed. Would love to hear of your experience.

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Profile picture for Jennifer, Volunteer Mentor @jenniferhunter

@cockatoolady I hope you'll keep me posted on what your doctors decide. I'm sure this must be frustrating.

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Absolutely. I now have an appointment to see surgeon Friday. They will assess the wound and if they think it's safe enough they have me booked in today week. I still don't think it will be that improved for surgery but we will see l guess. I'll keep you posted.

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Absolutely. They have now got me booked in to see surgeon on Friday to review wound. If they think it's safe they will remove my large plate and 10 screws on Wednesday week (Oct 2rd) l personally don't think the wound is going to be safe enough tho it is starting to look better with the steroid treatment. I think l need a few more weeks to really let it settle. Just have to wait and see Friday. I'll keep you posted.

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Profile picture for blaira @blaira

Hi,

I had a bad tibia plateau fracture and 6 months later I got an infection. I had emergency surgery to remove the infection by the skin. They cultured the plate and while not seen, the culture came back positive.

I have 1 plate and 8 screws that need to be removed because of infection.

What is the reality of recovery after hardware removal? My surgeon says I can walk that day. My physical therapist says, I will be 2 weeks partial weight bearing and no driving due to pain.

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Wow I had no idea you could get an infection so many months later.

I am concerned because I have RA and take Enbrel to suppress my immune system. I had a bicondylar tibial plateau fracture about 7 weeks ago. Healing well, according to the surgeon and PT. But I have a deep fear every time I give myself a shot of Enbrel.

I'm at 80 degrees of flexion, it is painful to get to. Comfortable around 60-65. I see this small plate on the outside of my knee sticking out as I bend, and it pops WAY out every time I increase ROM

This is a discouraging injury, to out it mildly.

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Profile picture for cockatoolady @cockatoolady

Absolutely. They have now got me booked in to see surgeon on Friday to review wound. If they think it's safe they will remove my large plate and 10 screws on Wednesday week (Oct 2rd) l personally don't think the wound is going to be safe enough tho it is starting to look better with the steroid treatment. I think l need a few more weeks to really let it settle. Just have to wait and see Friday. I'll keep you posted.

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@cockatoolady I wanted to check in with you to see how you are doing. Did you have your hardware removed?

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I had my tibia plateau fracture surgery 3 years ago. I have a plate and 3 screws. I don't have a great deal of pain only some mild pain from the hardware. I am scheduled to have the hardware removed on 9/15/26. The Dr. didn't recommend the removal since I am not experiencing pain. I am 65 and in very good shape. I do pilates 5 days a week.
I want it out because I think 30 years with this hardware will be too long. My mother is 94.
The dr. said I needed 6 weeks off my leg (on crutches) after the removal to be sure the holes heal.
It seems like a long rehab. I feel he was exaggerating because he doesn't want me to remove the hardware.
The doctors seem to discourage the hardware removal from what I have ascertained. It seems they only want to do it when it is absolutely necessary.

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There are always risks with any surgery, probably why your doc doesn’t want to operate on what he sees as elective surgery. If something goes wrong, the doc saying "well, you wanted it, not me" doesn’t look good. However, if you have surgery, ask your doc about PEMF devices. They are expensive but do wonders to speed bone healing.

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Please consider this surgery very carefully. I had TNR in 2013 and got a faulty tibial component that would not attach to cement. This resulted in a loose component which fractured a side of my tibial plateau. When I got my revision, they attempted to build up the fracture with cement along with replacing the component. It didn’t work…the cement absorbed into my system and I was left with an empty space where the plateau used to be. Now I need a 2nd revision. After a recent evaluation the doc seems to be confident she can build out the plateau and completely replace knee components (both tibial and femoral), essentially a brand new TKR with a built out tibial plateau. I would never consider removing anything that is supporting my tibial plateau. It is much too important for balance and strength in my knee. Unless it is decreasing your quality of life, please consider keeping what is helping your knee. And your recovery time is just about spot on. It takes a long time for those holes to heal and yes, a bone stimulator can help. When my ankle was rebuilt, I had holes in my tibia where they put the fixtures to stabilize my ankle. It took at least 3 months for those holes to heal. Considering that a broken bone takes 6-8 weeks with just a small fracture and you’ll have holes to fill in! Good luck with whichever option you pick.

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Profile picture for rlwilliams @rlwilliams

Hi, I was wondering if you ever had your hardware removed. My tibial plateau fracture surgery was one year ago. I have 14 screws and two plates and still feel pain when I walk. My doctor says it’s probably not the hardware but the x-ray shows the the bone healed just fine! I also feel the tightness around my knee, feeling, like you said, a tight ace bandage. Doc said it must be scar tissue (?). He has no answer as to why I’m still feeling pain...

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@rlwilliams I encourage you to ask for an updated X-ray. I had a similar fracture and my screws were too long and protruding through the bone. This continued to be painful and limit mobility. I just had all my hardware removed (wait at least a year for this) and already I am feeling the benefit of feeling as though there is more space, reduced pain, and it’s only a week post surgical removal. I can’t wait to see what I will be able to do in a couple months. For the first time in ages, I feel hopeful and relief from nightly pain.

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