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High Tibial Osteotomy
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My story - at 14 was hit by a car and knee never healed right. The last 20 years of swimming (collegiate D1 level in US), basketball, distance running, and triathlons - my knee has basically worn down to nothing. My new favorite activity is distance trail running in Switzerland where I now live. But cannot do it anymore. I couldn't do anything but light cycling before the surgery. Even swimming was making me sore and giving me swelling. Now at 35 and with few options, doc said best option is an 8 degree HTO and clean up the knee (remove meniscus tears and bone fragments, some cartilage treatment, etc).
I am 6 days post op and feeling pretty OK. For all of you who talk about the pain - its horrible isn't it? I don't know if I knew what I was getting into, but reading the stories here makes me think it will be worth it and I can get back to some normalcy... one day. I am HOPING I can run (just jogging, no more marathons) and play basketball again, but will settle for hiking, swimming, and skiing.
Long road ahead. Thank you for all of your stories. Gonna go do my exercises now and then ice and elevate!
Obviously the exercises have been hit and miss due to not being seen in person. I am grateful I had my operation when I did especially when you consider people are not getting cancer treatment in some cases.
So this is where I am. I am obviously back at work but on modified duties, as my job requires me to be on my feet. I still have a limp which I am irritated about to say the least. Last time I posted I mentioned I had learnt to walk with a limp. While there is an element of that I am not completely sure. I can walk for about 1/2 mile before I start to limp. Sometimes I don't notice but my wife or others comment on it. It really irritates me that I can't seem to to shake this off. The mild pain I get only comes from the plate area, no where else. If I stop and rest for a minute or two the pain seems to go and I can walk a short distance without a limp then it starts again.
I finally spoke to my surgeon this week and I prepared a lot of questions! Again it was over the phone so not ideal. I explained about my limp and asked if this is normal as I was rather concerned? He then told me it can take a year for everything to knit together fully. I asked him point blank if I was going to have a limp for the rest of my days and he said he hoped not and the goal is to walk normally. He said my last scan was fine and not to worry. He asked me to measure my thighs with a tape to check muscle wastage. I have about 1/2 inch difference which he said was great. He would like me go on a cross trainer, rowing machine as well as my bike to keep building up my muscles.
I then explained that my occupational health gp, physio and employers are keen to know when I can move on to more duties. He said listen to your body but in the same breath he said you can do what you like you won't damage anything!?
He then joked I needed to stop limping.
Joking aside he said the plate can sometimes cause inflammation and affect the hamstring which may account for my limp. He said if I do still have a limp which hasn't improved at a year I could have the Tomofix plate out. He did say I should think about if I am seeing improvement even slow on a month to month basis. Which I think I do to be fair just not as quick as I would like.
In the past when I did some heavy impact work at home like going up and down a step ladder painting, I would suffer for days after with a heavy limp. Now I don't so much. I didn't tell him I had been laying laminate flooring, all be it with gel pads! I have to say I was dreading that job but actually the next day I have been fine so that is improvement!?
If I can get rid of the limp I would be so happy and would pronounce the op a complete success so I will have to wait and see. I am seeing a physio in person on Tuesday which I am looking forward too. The weird thing is I can bike for miles and go uphill on my tiptoes with no issues at all and no limping after.. Sorry for a long post.
My advice - I would push hard to try and get yourself more professional treatment to address the limp. My concern would be that the longer you limp, the more normalized it might become, and it might become that much harder to undo. Additionally, if you're limping, other parts of your body are making adjustments, and that can take a toll on other body parts also. Again, I was classified as an essential patient, and I think this is why - it's important you learn to walk correctly. Read that last bit again. We're talking about the way you walk for the rest of your life. Be the squeaky wheel - go get that oil.
I'm not sure what PT guidance you get there, but while i am using some specialized equipment, there is also a massive amount of work I do that is easily replicated at home with little or no equipment.
For example, standing on your surgery leg on a firm cushion, and throwing a tennis ball against the wall and catching it is an excellent balance exercise. Then doing the same, but face your body parallel to the wall, and turn, throw, catch, straighten body, and repeat. Do both - front on, and side on - and do it with each leg. As you get stronger, increase the distance from the wall, try the same with a soccer ball etc.
Leg muscles are obviously key - calfs, quads, glutes, hamstring - target them all individually, and do BOTH legs. Its very important for even walking the both legs receive the same strengthening. If you have some basic exercise equipment - a couple of dumbbells, a tension band - really, there's a huge amount you can do. Seriously I'm 1000% happy to show you a bunch of stuff I do at PT if that's helpful, we can zoom or something, just let me know. But, whatever you do, make it a priority. This is a critical phase of your recovery, and you have to get walking right.
Matty, i'm in a similar situation to you and i was wondering how you are coping with your recovery now? I'm a 24 year old male who had a HTO done on my right leg Dec 13, 2019 so i am currently 7 months post o.p. I've been playing soccer all my life and had zero knee issues up until i randomly dislocated my kneecap one day during a match in April 2019. After months of rehab and PT, nothing seemed to fix the pain and discomfort that i was experiencing due to damaged cartlidge that the initial injury had caused, so my surgeon suggested a HTO as a means of using the lateral side of my knee to take most of my weight while protecting the damaged side. At the moment, my main concern is that the new alignment still feels so weird and unnatural, and now my left leg is starting to feel out of alignment. Have you started to experience problems on the OTHER leg due to this operation? And are there any particular exercises that you found most helpful during the recovery process?
Thank you very much and sorry for all the questions!
I live in Switzerland, as you can see from the name, and am now 3.5 months post op. YES, first few weeks are tough sledding (sledging in UK?). I chose to go completely off pain meds when I came home, and I am VERY glad I did. I think it is good to feel what is going on in your body and know what is pain to stop and when you can push a little further, especially when starting to do PT and flexibility exercises. I also had a super balanced diet, drank bone broth every night for more protein, and did not drink for 6 weeks. Seriously cut out the sugar and eat an anti inflammatory diet - it WORKS. I am already feeling like my old self at 3.5 months. (I would also add I am only 36 so that helps with recovery time).
Anyone reading this, do the hard work and eat right, it will pay off. Covid has been really good compared to other places so I have been fortunate to still have PT 2x/week and that has been a lifesaver. I am up to biking now for 60 mins plus, long walks, cardio HIT workouts on youtube, and even beginning to jog again for short bursts on grass and gravel. I just jogged my first consecutive mile on grass last week around the edge of a football pitch. It has been over a year since I could run a mile without pain
Neos - work out your legs and glutes like crazy. I have always been an athlete, triathalons, basketball, you name it I did it. I THOUGHT I had a strong core and glutes until I started physio; I was wrong. When you are bored and watching, tv, do lunges and squats - and watch your knees! dont let the creep inward but keep them aligned from ankle to hip. We have to re-train our legs to rest in a new position with the new alignment and not overcompensate with our off leg.
For anyone questioning an HTO - find a good doc you like, consider all options, and if you pull the trigger know it will hurt like crazy and require discipline.
I went to the beach and I would highly recommend bare foot running on damp sand I felt really good compared to off road or on tarmac. I would love to know if anyone had their plate out at some point and specifically why and how was the op. Not that I have to have it but just in case.
So nice to discover this forum and read all your stories. I’m looking forward to hearing from everyone as our recoveries continue.
So briefly I had my HTO on right knee March 2020. The Osteotomy was successful in that I now have a satisfactory gap on my knee joint. I had my plate removed 3 weeks ago and was surprised at how painful this procedure was. My surgeon said I was one of the fastest recoveries enabling plate removal early which is good I guess?
The road back to the start line is already underway....I’m aware my Marathon days are probably over altho I do have a spot for October’s London Marathon. <div>
</div><div>Are there ANY successful returns to running post HTO ( 5K / 10K Trail races ) peeps out there? I am feeling like running is most discouraged by our surgeons which is disheartening.
Best wishes to everyone.
Matt from SoCal now in UK x </div>
He says the bone/joints need to bend and flex properly once healed and the plate restricts that movement...4 weeks post surgery and starting to feel less stiff and painful. i am so glad to hear you can run again....it is the impetus for having the HTO in the 1st place.
So glad you have no pain too.... i'm trying to be patient!
Thanks to everyone for sharing their experience!
Best,
Sidney
Thanks to everyone for sharing their experiences so far
Thanks for those kind and inspiration words. I am now three weeks post surgery and that burning pain has now mostly disappeared. I want to eventually run and hike. It will be interesting to see how long that takes. My leg muscles have halved in size and I can’t contract the quadriceps. Does anyone have any thoughts. ?!
It’s now 6 months since my surgery. I’m
In a much better place. I can run now but really poorly. Still so much better. I still get the pains from the arthritis but less so. I walk with an unusual gait but that is to be expected. However I am really happy with the outcome