High Tibial Osteotomy

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  • @Declan Bermingham, The doctor said that it is fine, just healing very slowly.. We (he) should just be patient.
    The doctor performed the same surgery on the other patient who is 45 years old, and he recovered fully after 6-7 months.
    On monday new rtg and 8 months after the surgery. Than there is still time according to your consulant and physio estimation.

    @Pewpewpew, I agree, everyone is different. He is not overweight, non-smoker, very active, swimming. Doctor sugests (maby) bone graft for the other leg.


    Thank you for your responses. :)
  • I am an American and was just told I need an HTO or full replacement. I have been searching all day for people like me and somehow found this thread. 

    Thank you all for your candid stories! I honestly cried when I read some of you have been able to run. I know I will not be able to myself, but the joy I felt for you is infectious.

    I am 39 and an active person from the day I was born. American football, baseball, football(soccer to me), track, and transitioned to distance/mud runs. I was injured at work 3 years ago and haven't run since. I am able to be on my feet all day with moderate pain, but have a 5 year old and 7 month old. My main goal is to be there for them and play like they want me to. Any more than that is gravy.

    I have no medial femoral cartilage and found out today that I have no posterior patella cartilage. I'm too young for a replacement, but the patella issue may make the HTO a waste of time. I am at the lowest I have been in years. I want to get the HTO and delay a replacement as long as possible. My fear is the HTO won't work and the recovery pain and frustration will be wasted energy. 

    Again thank you all for the stories and sounding board.
  • MacmadMacmad ✭✭
    <blockquote class="Quote">
    <div class="QuoteAuthor"><a href="/profile/Supersean">Supersean</a> said:</div>
    <div class="QuoteText">I am an American and was just told I need an HTO or full replacement. I have been searching all day for people like me and somehow found this thread. 



    Thank you all for your candid stories! I honestly cried when I read some of you have been able to run. I know I will not be able to myself, but the joy I felt for you is infectious.



    I am 39 and an active person from the day I was born. American football, baseball, football(soccer to me), track, and transitioned to distance/mud runs. I was injured at work 3 years ago and haven't run since. I am able to be on my feet all day with moderate pain, but have a 5 year old and 7 month old. My main goal is to be there for them and play like they want me to. Any more than that is gravy.



    I have no medial femoral cartilage and found out today that I have no posterior patella cartilage. I'm too young for a replacement, but the patella issue may make the HTO a waste of time. I am at the lowest I have been in years. I want to get the HTO and delay a replacement as long as possible. My fear is the HTO won't work and the recovery pain and frustration will be wasted energy. 



    Again thank you all for the stories and sounding board.</div>
    </blockquote>
    Hi Supersean,
    I think your own experience reflects what many of us have endured, and I think any good orphopeadic surgeon will be able to advise if the HTO is a viable option for you personally, after reviewing your scans, the HTO procedure is not a quick fix and it will not guarantee you will return to any active sports, this year after my HTO in 2013 my leg feels natural for the first time, no more numbness and I am contemplating a marathon, but I will need to learn to run again.
    best of luck with whatever you decide to do, and hopefully you get some quality of life back.
  • Hi All I'm 43 had HTO open wedge in Jan-18, I'm 4 months on and still find walking difficult, pain down my shin, knee crunching/ grinding, locks now and again. Still swollen & numb..any help advice greatly appreciated :)
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  • Macmad thank you for the insight. 5 years on and you finally feel normal again is a scary amount of time for recovery. I guess if it gets me to keep my parts for a bit longer it's worth it. I have accepted I will eventually get a replacement, I just want to avoid revision surgery once I get it. 

    I am looking at a closed wedge Bigsoreknee. Hopefully you feel some relief soon. Follow your recovery protocol and don't get down. It takes time, but you will get there!
  • Hi everyone just come across this forum page.
    so I had an hto 3-4 weeks ago had some set backs and just wonder if anyone else had any of them as at present am very anxious and upset and kinda regret the operation but also know it was done for a good reason.
    Post op non weight bearing on op leg and crutches 

    so week after operation had rush back to hospital due to black bruising dr was concerned about dvt issue so had 3 days when had to hold injections and ice leg for 20 mins every hour. The swelling reduced and blood marks reduced so consultant was happy.

    week 2.5 while going bed (mobility at this point was great bend at 60 degree and walking round good and felt could go without brace) so the night while heading bed felt a twinge and the had excruciating pain and cramp after stumbling, next day spoke to hospital rushed back back for X-rays check screws and bone stable which was.... and dr happy bone healing and fusing well..

    so week later after cramp leg still tight especially calf which is frustrating me as mobility seems to have gone backwards we’re now only managing small distances, also now sleeping on sofa as can’t get up stairs to bed,
    anyone else had this? Is it normal as am trying do calf stretching and knee presses but obviously sore. At moment am so emotional and frustrated I wish hadn’t had operation which upsets partner as she knows how bad pain was before... I just need reassurance cos worried consultant said it normal but it just doesn’t feel right so help pls 

    sorry this is long just anxious 
  • digrzdigrz ✭✭
    Yes it’s totally normal to feel the way you do, I’ve been the same up and down. It’s a long process to get better and you have to take it easy. I was 8 was before I could get brace off. I’m 6 months on, still walking with limp and lots of pain. Been told it may take a year. Stay positive and don’t do too much, small steps to look after the surgeons work and don’t rush it
  • It’s the calf cramp and now pain in calf muscle that’s worse knee feels great. Just annoying cos before had bad cramp last week was mobile lots and felt good.
    just feel went backwards and as said the pain in cramp restricting my movement 
    glad know am not alone just scary and upsetting 
  • digrzdigrz ✭✭
    Everyone recovers at different rates, cramp is likely due to you needing to build up the muscle. Take it slow and build up thigh / hamstring don’t rush it. It sounds like you are doing well. I’m sore too bu pain is from the hardware.
  • Did you or do you get bad cramps in legs??
    sorry to be pain just not great wanting to do stuff an feeling restricted 
  • digrzdigrz ✭✭
    I do get cramps still and I’m 6 months on. I’m 43 and have bad osteoarthritis and no cartlidge left, I have pain down shin where hardware is and still have tremendous pain where it’s meant to be fixed. I think if you have cramps and still feel restrictive it’s positive, especially you said you don’t have knee pain.  Have you got one of those large elastic bands for resistance work? Also just swishing your leg gently aroun a swimming pool, using the water resistance and no weight on your joint. Always check with your physio and doc too though.  Main thing is be positive and try not to rush it as everyone heels at different rates
  • digrzdigrz ✭✭
    Ask all the questions you want it’s not a problem, I can only really tell you from my ongoing experience 
  • Thanks for the information just feel annoyed at self cos I probably over did it and frustrated cos feel upset.
    its the cramp an tight calf that was worrying me my dr said it’s natural but When frustration an upset nothing seems right. Nice know it not just me and it is common I just wanna get strong and better
  • digrzdigrz ✭✭
    Understand totally, if you rush it you can do more harm. Get a cryo-cuff and ice the swelling or after any activity. Be strong and patient, it’s natural to get frustrated. If you are managing pain and just cramps then I think you are doing really well to be honest.
  • Thanks yeah knee pain great all the pain I’m getting is from the calf muscles, my muscle definition has reduced so much already compared to my other leg 
  • digrzdigrz ✭✭
    So that’s correct you need to build the muscle slowly? If you have no one pain then it sounds successful... I’ve got knee pain / shin pain so I know you are in a good place?. My hardware has to come out, ct scan then to get partial knee replacement. So you are doing great
  • Hi, I am 54 years old. I am a cyclist, swimmer and climber - and I can do all these things with almost no pain, BUT I can’t walk for more than 200m without pain and swelling.
    12 days ago I had a High Tibial Osteotomy. I cannot weight bear for 4 weeks then the following 4 weeks I can partially weight bear. I’m using crutches which I find quite difficult, and I have to say it is a tough operation. You really do need great support at home as it is almost impossible to do anything for yourself. I’m spending nearly all day on the sofa with my leg elevated and I’m icing every couple of hours which really helps with the swelling. Static quad contractions are essential, as are straight leg raises. In the months leading up to this op I saw a personal trainer twice a week to focus on quad strength and shoulder/arm strength in preparation for a good recovery.. and using crutches! It’s a hard recovery but I reckon it’s preferable to a partial knee replacement.
  • KravKrav ✭✭
    Naruto77, I had mine done at the end of 2016. I remember having calf pain a few weeks post-operation. It was basically attributed to sitting/reclining with my leg elevated...in that position my foot would naturally lean forward a bit, which tensed up the calf; thus soreness and cramps. Best solution was to do lots of calf stretches with a band; gentle pressure.

    I remember during the healing stages getting all kinds of different pains. The next issue I had was the intense pain in the foot (burning sensation) when hobbling around on the crutches. Elevation was the only thing that would calm it down. That lasted perhaps 2 weeks, but oye. Then it was the ankle once I could do light weight bearing with crutches. I ended up getting generic inserts for my shoes, still wear them to this day. It helped a lot. You're going to run into different issues; I suppose it's just all part of healing and improving.

    As far as strength and muscle size/tone...don't rush. It will take a lot of work to start regaining; just go slow and gradually add weight to your workouts. I was extremely dedicated to therapy and strength training ever since the procedure. I'm 1 1/2 years post-op and know I am still not back to "normal". But, I can do a heck of a lot more things than I could do pre-op. My strength has improved dramatically; but "that" leg is noticeably weaker. Probably always be that way, but I'm good with it.

    This definitely was not a fun recovery; it's a bit of a beast in my opinion. For me, I can't kneel on that knee for any extended period, and squatting down, as if in a catcher's position, has to be short term. I have some limitations and annoyances with the knee, and still have some nagging pain; but overall, it was well worth the headaches. I am much happier after having it done.
  • Hi Everyone,

    I have been advised I an open-wedge Osteotomy. Operation planned for November 2018. I've been doing some research since I was told by the specialist and to be honest a bit scared of having it done. I would appreciate some advice or help from the forum on whether it is worth getting it done as I'm in two minds whether it will be worth it

    My back ground is Male 46 yo a little on the heavy side with two young kids. I was regularly running Park run 5K around 20 mins; 10k around 40mins and the odd 1/2 Marathons. I started having issues with baker cysts around the knee when training for this years GNR 1/2 Marathon and have been advised I need the operation due to a damaged ACL from years ago.

    Basically I can't run but I'm pretty active gym 3/4 times bit of yoga and I cycle. A little bit swimming when my hangover won't let me get to gym. So I'm sort of healthy but I'm a bit concerned that once I have the operation it may actually set me back.

    Would appreciate a bit of advice on whether it will be worth it before I commit in November any help will be appreciated

    Thanks in advance
  • Hi wearsidewander,
    I posted a message in Nov 17, a few weeks after my op. I had an open wedge Osteotomy. The Doc said it was quite a large wedge10%.
    It is now 10 months post op and the leg feels great. I am running, 5 ks 3 times a week, cycling, (just finished a 113 mile ride) and swimming. I was going to do a sprint triathlon later this month but I am holding off to next year.
    In short I am very happy and to be honest I didn't expect to get to this level of recovery. I am generally quite active for a 51 year old and don't like sitting still for to long.
    Going on my experience I would definitely recommend the op, my problem was the inside of my right knee had worn the cartilage away to nothing. Straightening on my leg has worked really well. The recovery is quite long and although after 6 weeks I was driving, back to work and using only 1 crutch, the recovery slowed quiet a lot up to the 8 month period when the bone finally knitted back together. Progression from that point has been fast and large parts of the day I forget I have had an op. I concentrated on cycling to build up the leg muscles, circulation and stop weight gain. I only started running after about 8 months and then only slowly. I use to run at 7 minute mile pace over 6 miles but now I do 5 ks at 9 minute miles. I am getting faster but I think I will stick more to the bike so as not to put to mich pressure on the knee.
    At the rate I am progressing at I think that at the year point my knee/leg will be almost as good as new.
    Happy to answer any questions you have.
    Chris
  • Hi Chris,

    Thanks for replying. I have looked at your previous post also. Reading your posts you have put my mind at rest and I'll be going through with the op.

    I was just having a wobble a regarding the recovery time and looking at you tube vids did'nt help...I work on a ship and my sick cover only lasts about 4 months but there good employers.

    The wedge I'm having inserted is around 7% and I have the same problem on my right knee as you had. If I can get back to what your doing I'll be more than happy. I'll be building my leg and upper body strength before the op. Just so mentally I'll feel a little more prepared.

    Will you be having the plate removed at some point as some of the previous posts have ?

    Anyway thanks for your advice I appreciate the fact you'd posted it's really helped me make my mind up, cheers. Good luck with the sprint triathlon next year and the current running. Atb
  • I think I'll leave the plate in as it doesn't cause me any problems.
    Good luck with the op.
    Chris
  • Hi hi everyone. I stumbled upon this blog regarding the recovery for HTO and have enjoyed reading everyone’s posts. 

    I am a 23 year old female. I have a very active lifestyle, as I am a personal trainer, love going to the gym, and used to play college volleyball. I got a lateral release done 8 months ago to help with patella femoral pain. It did nothing. The surgeon then suggests a HTO, which I agreed to. I got the surgery on sept 6, so I’m almost 2 week’s post op. Im in this leg brace for at least another 2 weeks. I’m mostly worried about muscle mass loss, and how long it will take for me to be able to regain the muscle i have lost. Is it normal to have bruising on the foot from this procedure?

    I’m also wondering what the weening process to stop using the leg immobilizer brace looks like.  

    Any responses about this, or any advice would be stellar! 
  • Greetings,

    Like many of you, I stumbled on this thread. I’m 54 male, live in the states, and was an avid runner for many years. I also decided to go with HTO on my left knee w/ iliac autograft after debating for months. My main goal is to be able to run half-marathons again in a year pain-free. It is day 14 post surgery and recovering as expected. I was actually stupid enough to start working 3 days post surgery on heavy pain meds – fortunately, I do have a desk job working from home. However, I DON’T recommend sending emails for at least week, speaking with experience :) No weight bearing for 6 weeks except for feather-weight toe touching for balance. I hate traditional crutches since I used them 10 years ago for ACL recovery, and opted for the “UP” old man walker when I left the hospital. My walker was unfortunately vandalized by 2 very drunk women at a 50th b’day party last week accessorized with unicorn and Frozen stickers, and party ribbons. I did purchase alternative crutches – Mobilegs Ultra on Amazon.com. These are much better than your traditional crutches! Less pressure on the underarm and more stable. Even stairs are a lot easier. Hopefully, these crutches are anti-sticker proof!

    I started PT today and currently have a ROM of 40 degrees. Hope to hit 60 degrees by next week. Interesting to see my quad quivering from mis-firing doing simple exercises. I also weaning myself off “the good” drugs today with the intention that I’ll be driving in a week. I do drive a glorified electric golf cart, so I don’t have worry about a clutch :) Like many of you, I’m relying heavily on family and friends, and this is difficult.

    Appreciate reading all your post that there is a light at the end of the tunnel. I know recovery will be long and hard, but I hope it is worth it…right???
  • Nivlek34 - I had it done 2 years ago at age 47. And yes....it IS a long and hard recovery. Is it worth it? Absolutely. As long as you dedicate yourself to continued improvement (without thinking you can rush it; you can't) then you will be very happy with your outcome. Very happy.

    Wearsidewanderer - good luck in November! The recovery is definitely a beast. You will definitely have ups and downs, and frustrations. Just try staying positive. When it is all said and done, you will be glad you went through it. From where I was before surgery, I can do far more after having it done....far more. And...there are no restrictions on physical activity, as opposed to a replacement. I like that the best.

    Vball09 - I had definite muscle loss in the operated leg. Loss of mass and loss of strength. Take it slow, and gradually build on it. I really needed to focus on using the operated leg during the exercises; I seemed to favor it and use my other leg as opposed to an equal distribution. I'm 2yrs post op; I have been steady with weight training from the word "go". I've added bulk and tone (more than I had before the surgery), but...the operated leg is still a bit smaller. With you having an athletic background...knowing the dedication it takes to play college ball...I have absolutely no doubt that you will get the results you are hoping for; strength, mass, activity level; and get them a heck of a lot quicker than the majority.

    Good luck to each of you!
  • Hi Krav,

    Thanks for the reply.  Just been for my pre-op assessment and all good for op in next 2 weeks.  Glad I found this forum as it’s given me a bit of confidence in going through with the op.  Totally going to take the advice on taking it easy and doing correct exercises.  Comes at the right time as well as I’m usually sitting on my bottom most of December, enjoying crimbo anyway....

    Thanks all the advice I’ll probably post an update in-between netflix boxsets 🤔
  • Hi everyone.

    Krav, thank you for your reply. I'm glad to hear you're going strong two years post-op. It's also really encouraging to hear you've added more bulk since before your surgery! How long did it take for you to be able to run again? This is something that is still a work in progress for me.

    I'm now about 4 months post op. My knee is still a bit tender if I'm leaning on it. One side of my incision is still numb, but I was told this would take a while to come back. I've noticed on days I'm not being active (like when i'm at work) that my knee hurts more than days I go to the gym or physio. I'm starting to do lunges now, which is something I haven't been able to do since I was 17 because it was too painful. Sometimes my knee still feels weak when I walk and i feel I might fall sometimes, but I think that will go away when I regain and build more muscle strength.

    Have any of you ended up getting the screws removed from your leg? My surgeon mentioned I could have this option in six months or so, once the bone is fully healed.
  • vball09 -

    I was never a runner, here and there, but it just never was my thing. I have tried a bit since surgery, but it hurts in the medial meniscus area. It's tolerable, but noticeable. I had two meniscus surgeries within the two years before the HTO, so that pain might simply be unique to my situation with the tissue snipped away. Biking and elliptical, no issues at all. Jumping rope, walking, no pain. Walking on a good incline or running stairs, hurts in the inner knee area; tolerable or I simply scale back. So I do still have some "limitations", but overall, nothing that is debilitating.

    Feeling like you might fall... I hear you. It took quite some time before I had confidence with it. Partially because of the lack of strength, and partially it was my mind simply not trusting it. Walking down stairs was the biggie...that leg would shake and shiver. But, I know that was just because it was weak; and quite honest, that took a long time to finally strengthen. Strange...do squats, deadlifts, you name-its with no problem. But simply isolate some body weight on it and boy did it humble me.

    Numbness...yes. I still have some in my inner shin area. From what it had been, until now...I'd say it is about half the numbness I used to have.

    Screws. My doctor told me he would remove them after one year. When I saw him on my very last check-up, he looked surprised when I asked how long of a recovery it was when I get them taken out. He told me he had no intentions of removing them; not unless there was some dire need. So.. mine are there to stay. The only thing that annoys me with them is if I bump that area of my leg (or bump a screw)...that really smarts.

    Aches... It's been awhile now since I had aches with it. But when I did, it was usually because of something as simple as standing on a ladder or on my feet all day. And the locations where it would ache were sporadic; sometimes below the knee cap, sometimes the back of the knee, sometimes the outside of the knee. Never in the operated area though. I got a scrip for anti inflammatory meds which seemed to help. But no need for those anymore.

    Good luck, keep working at it, it will continue getting better; which definitely will give you a boost. I'm sure you will experience little speed bumps along the way, but I bet you are going to be very pleased with the end result!
  • <div>Hi sorry for the post am week 38 I went back work about 5 weeks ago on reduced hours but return to normal now. </div><div>After the above post everything settled but I still have discomfort and aches in my shin (operation site) does anyone else still have these aches 8 months later am still taking paracetamol and tramadol (came off gabapentin end of December but gp said wait to reduce rest while getting back work)</div><div>I also still find applying ice especially in bed helps settle the aches to help me sleep.</div><div>
    </div><div>Just be nice know am not alone as it makes me anxious it’s never goin get better</div><div>
    </div><div>Am still doin stretches and exercises as discharged from physio December 31st but obviously as nurse I walk about 8-10 thousand steps just on shift so exercise is not as hardcore as when I was off recovering.</div>
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