High Tibial Osteotomy

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Comments

  • naruto77
    I had my operation in Nov 17.I found that I noticed a big change after 10-12 months. Up until then I was cautious on me feet and had some pain. Not as much as you seem to have but all operations are different and we all recover in different ways. I am 51 and back doing all fitnes, running cycling etc but no more football. I am currently in Italy snowboarding, taking it easy and still a little cautious. You will notice a difference in the next couple of months, fingers crossed. Hope the pain subsides soon.
  • Hi Everyone,

    Thought I'd give an update after my HTO I had in November. It was an open wedge 7-10 degrees wedge.

    Well its approaching 12 weeks since the op so I thought I'd put my experience on the site. I found most of the previous comments useful information before I had my op.

    Operation went well and no complications. I was in hospital for 3 days in total.
    Once discharged I was off my feet for 2 weeks and basically hobbling around the house on crutches for 2 weeks.

    Once you get past the first 2 weeks the recovery does get easier. I started from hobbling on two crutches with leg brace for around 2-4 weeks. Then use of two crutches no brace and then slowly introducing one crutch walking. Obviously this was done really slowly and only when confident.

    At around 6 weeks I was walking with the aid of one crutch, walking the dog for around 30-40 mins a day and still doing leg exercises 3/4 times per day. Even managed to get down the pub over the Christmas period nothing crazy though as leg would swell after a few hours.

    Top recommendations;

    Take pain relief as supplied. I was on codeine phosphate; liquid morphine and good old paracetamol. I'm a 47 old bloke and have a high pain threshold. During the first two weeks after op the pain was significant. I never knew how painful excess potassium in your system could be. I experienced a burning pain every time I stood up on my crutches. I even returned to hospital thinking it was DVT due to pain. Hence the recommendation of take the pain relief and drink plenty of water which did help.

    Keep up the leg exercises during these two weeks - nothing two strenuous (leg raises; leg flexes 3/4 times a day) but important as when I took a day off I really felt my leg stiffing up the next day.

    I would definitely recommend a regular Icing regime. I usually iced my leg 3/4 times a day for around 15-40 mins at a time or when it swelled. I just didn't anticipate the amount of swelling in the lower leg. I used the Cyro/cuff cooler and aircast system. (Amazon etc) - I believe this has been a major benefit in my recovery and also helps with the pain relief - best £50 quid I 've spent.

    Nearly 12 weeks after op. I'm still taking a small amount of pain relief but only before I go to bed - basically just so I get a good nights sleep.
    I'm back at the gym doing leg strengthening exercises, static cycling; Leg presses ; wall squats; balancing on my weaker leg; hamstring stretching, etc.

    My physio thinks I'm about 2-3 weeks ahead of schedule and I do feel like I'm progressing well. However it is a slow process which I wasn't really prepared for. Overall I think the operation has been worth it. The pain/discomfort I'm experiencing now is from the operation and not the knee where is was previously. The X-Rays I've seen look good and I'm gradually getting back to normal. I estimate 4/6 months before I'll be back to cycling, plyometric training at the gym and generally doing what I was doing before op. I don't think I be doing much running from now on as I want this to last the estimated 20 years. All in all if it allows me to be active again it'll be worth it. Hope all the guff above helps anyone else thinking/having it done, cheers
  • Hi Wearsidewanderer

    Thanks for the update I’m due to have my HTO on the 26th Feb. Got my Cryo Cuff ready to go, was just wondering how mobile where you in the first 2 weeks.

    Thanks 

    Drewman
  • Hi Drewman,

    Hope all goes okay on 26th. Sorry about delay but I don't get notifications if there is a reply or anything. Glad you got the Cryo Cuff it really is worth the money. I'm still using mine after 12 weeks but mostly on evenings as it makes the leg much more comfortable. Anyway to answer your question.

    Basically I was hobbling around on 2 crutches going from sofa to kitchen for the first 2 weeks. I didn't leave house until around the 2/3 week mark. I was home alone for most days so I got a load of ready made soups from Marks & Spencer. I found it difficult to carry bowls/plates etc as your using both hands with the crutches, so the soups made things a bit easier.

    I would recommend having someone to assist you for the first few days after discharge from hospital if possible. Just so you can get your bearings and figure out how your going to do stuff when your on your own.

    Its 13 weeks for me tomorrow. The legs still swollen (not excessive) but I'm walking the dog for around an hour now with no limping and I'm at the gym most days to strengthen the leg. I'm back to doing almost most things I was doing before op. So all going well I so be back to light running/cycling around the 16 -20 week mark depending on physio.

    I hope all goes well for you. Any questions you have about the procedure I'll be happy to answer.

    Cheers
  • Hi I had a hto sept 18. I have terrible knee pain due to arthritis. I also have bowed legs so had a hto to offset the weight from the inside of my knee to the outside and to also prolong the need for a replacement later on. I was non weight bearing for over 8 weeks and suffered DVT after about 2 weeks. Slept on the sofa for 6 weeks in which I ruined the sofa so the other half keeps reminding me. To be honest I'm still struggling now. Terrible pain in the other knee, struggle to walk when I first wake up, and hto leg keeps locking and a terrible Sharpe pain when it unlocks. Also now I've got one leg longer than the other and walk with a waddle. Wish I never had it done. Consultant is also looking at doing a hto on the other leg. I'm only 45 and with 2 young children who I can't lift and chase around. Wondered if it got better for anyone as at the moment I walk like an old man, struggling to even sleep. Thanks 
  • Hey daveyc 

    i had had a hto in June 1 and after reading your story our journey has been the same. 
    I have posted earlier about it. 
    After 10 months seen the consultant yesterday 29th and he was happy with the operation outcome a few points though was I have what feels like movement in shin an that’s the tissue on pins and he said the easy part now over as the next 12 months recovering muscle waste and damage is the slowest part and causes most frustration as in total takes 18 months to be 100% new. 

    After a months post op I didn’t think it was going get better then when I should had brace off in sept an had keep for another 6 weeks cos bone didn’t heal in time I again felt omfg frustrated. 
    Even now goin back work on a busy hospital ward I still struggle but due to strength and muscle issues not the bone.
    if I sit for long period I do take a few steps when feel stiff before I walk right an normal but again it will improve just takes time
  • First of all, thank you to everyone who has contributed to this, it's extremely helpful. I'm 39 years old and just had a HTO on 30th May so only a few days post op. Reading this thread has been very informative but most of all a relief.

    I have a 20 year history of knee injuries primarily from playing rugby in my early 20s. After ACL, PCL reconstructions on both knees as well as various cartilage ops, the day-to-day pain of arthritis was simply too much to bear. Having 3 young children and not being able to play in the garden and simply missing out on so much family life led me to research alternatives. I initially did a lot of research into a stem cell procedure called Lipogems simply because i couldn't bear the thought of more surgery. There are a few options with stem cells now, the evidence for this is good (although long term noone knows) and a few consultants have started to offer it privately in the UK. However, the surgeon recommended i realign my knees first to get the best out of it. Reluctantly i knew this was best as i could tell my legs were bowed, and i think had worsened as the cartilage became thinner. 

    Anyway, I'm now very used to knee surgeries but compared to a acl or pcl reconstructions etc, this first few days has been really tough. Very little sleep for 3 nights. The bruising all over my lower leg looks as though someone has taken a hammer to it. My shin is very numb. Just taking paracetamol occasionally now but have been obsessivelly icing it, perhaps 12-14 hours a day. However, the worst thing has definitely been the pain when stood. I'm non-weight bearing but just hobbling around on crutches for one minute means the blood rushes to my leg, my foot goes almost purple and my lower leg feels like it going to explode. 
    Reasssuringly i have read a couple of posts and hopefully this will subside soon. 
    Visually, i look at my leg as though it's a donour leg - it's straight! Only now can i appreciate how misaligned my legs were. I am a bit concerned about getting used to this change - it'll be like walking on someone else's leg.

    I'll try to update people on my recovery. I think it's great to share these experiences. Even small details that are different to other people's experiences might resonate with someone and provide reassurances.

    As important as the physical experiences are the mental ones as well. Long term injuries and debilitating conditions like arthritis really get you down. Having to accept not playing sport, then after that not even running, then after that not even walking properly is very difficult to take. 
    But shared experiences on these types of threads are somewhat therapeutic. 

    Apologies for the essay - I'll keep future posts as succinct as possible.
  • Chris1Chris1 ✭✭
    JCK,
    It's a bit of a long road to recovery but well worth it. I had my Op in Nov 17 and I have nearly forgotten I ever had it done. Running 4.5 miles every other day, not that fast mind. The drop leg pain is quite something else but in a couple of weeks it will have gone. I was out cycling after four or five weeks, not very far but it was a start. Keep the posts coming, here to answer any questions you may have.
  • I'm 3 weeks post op now. My leg is still fairly bruised and surprisingly new bruising is appearing on my foot and thigh after more than 2 weeks. The swelling, however, is much better and the intense agony when i stood up thankfully stopped after about 10 days. That has been the biggest relief. The physio has also unlocked the leg brace so that i could start to bend my leg and do a few more basic rehab exercises that don't involve putting weight through the leg. Overall it's a lot better, everyday i can stand and potter around the house for longer. Next week I'll be able to partially weight bear which I'm looking forward to. I know everyone has different timescales but could anyone give me an idea of what level of activity they were doing between approximately 6 weeks and 3 months post-op? Thanks.
  • Hi Jck,

    Glad the op went okay. I agree before I had the op I found this forum was the best and gave me a sense of what i was getting into.

    Anyway between 6 weeks to 3 months activity. 6 -10 weeks basically just walking the dog around the local park on crutches then slowly going from 2 crutches to one then none and walking with a limp around the 8 week mark combined with physio excerises every day. Once I could drive I got to the gym, bit the bullet and hired a PT not something I've done before but it was worth it. He guided me and did'nt let me get too much ahead of myself and damage my leg. He just got me doing lots of single leg strength excerises as well as lots of closed chain work.

    You've just got to remember to take it easy. It's been 9 months now I've been doing a lot of cycling around +100km a week and leg workouts at the gym no running just yet. I tried but it just felt wrong ran 5km in 34 mins which was really slow but afterwards I think it was a risk but no pain in the leg that I was getting before the op !

    Leg still swollen compared to other leg but the cycling is bringing the swelling down plus I started taking 'curcumin turmeric' and found this helps. Got my final meeting with surgeon this month so expecting good news.

    You don't get notifications when someone posts hence the gap in my last post. Keep positive I was doubting whether it was worth the op a few months back but every month I'm getting back to normal and starting to see the benefits and glad I had the op, take care and take it easy
  • Great to see this thread is still going in 2019. I first posted in October 2104 leading up to/following on from a HTO on my left leg. My consultant has just advised i need the same procedure on my right leg. Holiday in Florida is booked for late July 2020. Decision needs to be made whether I have the HTO in January and hope for a good trouble free recovery or hold off until after the holiday.
  • Hello fellow HTOs :)
    First of all I'd like to thank everyone on this forum as your posts really helped me during my first weeks recovery after my HTO which was in January this year.
    I am now 10 months post-op and I must say that I am definitely better then before the opp. However, I still have issues. Unfortunately I am still on regular painkillers even though it's just paracetamol, I haven't missed a day without it. Unfortunately (and probably unsurprisingly) my operated leg is now slightly longer than non operated. I had it checked and measured several times and every time I am told that the discrepancy is tiny and I shouldn't be able to notice it. However, I do notice it and it causes me pain in my the hip and back on the non operated side. Has anyone found a solution for this kind of problem?
    Second question is about cold weather and arthritis. It's well known that arthritis doesn't like cold. I started getting rather annoying pains since it's gotten colder and I was wondering if anyone else is struggling during winter and how do you go about it?
    Thanks :)
  • I was told yesterday I will needed an HTO on my left knee - still in a bit of shock as was expecting a bit of physio! I have found this forum and found it to be helpful, but wondered if anyone had any experience with using weights after HTO. Whilst I do run, I've not done since July but my real passion lies in lifting heavy weights (think squats and deadlifts). I can find lots of success stories regarding recovery and the ability to get back to running, and whilst I know this is a runners world forum wondered if anyone had a feedback on weight lifting specifically. Thank you. I get married in July 2020 so am hoping I can wait until after then for surgery incase recovery is poor.
  • Hi All, Thanks for this forum has been great to read peoples experiences. I am just after some advice or if anyone has experienced similar. I am 53 years old from Melbourne Australia and had HTO operation 4 months ago. As far as my knee is going i don't have much pain but get calf pain if i do too much walking or gym exercises Bike or Cross trainer and then i will start to limp. My biggest problem is for the past month i have really bad lower back pain and hip pain which is worse if i sit and is really painful 1st thing in the morning. I have been to physio and massage but it is not improving. Has anyone had this as well? My surgeon did tell me recovery would be 6 to 9 months, i am going back to see him in late December I just wanted to know if this was part of the normal recovery.
  • > @PeterM said:
    >My biggest problem is for the past month i have really bad lower back pain and hip pain which is worse if i sit and is really painful 1st thing in the morning. I have been to physio and massage but it is not improving. Has anyone had this as well? My surgeon did tell me recovery would be 6 to 9 months, i am going back to see him in late December I just wanted to know if this was part of the normal recovery.
    >
    Hello PeterM, do you have pain on your operated or non operated side? I have pains on my non operated side because my operated leg is a little bit longer now and I overcompensate. Have you noticed any leg length discrepancy? It could be a contributor to your pain.
    From what I know the recovery period is more like 12-18 months, so in your case it's still early days.
    Perhaps you could arrange to see your surgeon a little bit sooner to discuss the pains.
  • Hi Salsadudette, thanks for your comments and agree it will probably be more like 12 or 18 months recovery. I have a pain on both sides but more on the operated side and as well towards middle of lower back and glute muscle. I haven't noticed too much change in leg length but i am walking differently and compensating when i have pain.
  • Hi everyone,
    I’m a 48 year old and I had an HTO on my left knee 9 days ago. I’ve played sport and trained hard all my life in and out of the gym. I played semi-pro rugby league for 15 years up to 2005 but since I finished running was my favourite activity, mainly £5K and £10Ks.
    Then one day, my life changed. The knee was painful, and the scans showed osteoarthritis, cartilage degeneration and bone edema. The specialist recommended the HTO but said running was still not recommended even after the op to maximise the results of the procedure.<div>For the eight months leading up to the operation I worked hard in the gym doing CrossFit type circuits incorporating power cleans, deadlifts, Dbell squats etc which I was able to do as I stayed away from full lock out at the top where the bones made the worst contact. My question is, regarding weight training, has anyone had the HTO and been able to get back to lifting the same weights as they did before? Having lost running, I really need to be able to do the gym based movements. The surgeon and physios understandably won’t give me a definite answer.
    Cheers</div>
  • Good morning new to the forum. I have found the comments very informative. I am 44 year old man who has had a right HTO exactly one week ago. I had arthritis on my inside joint due to an arthroscopy at 21 years and then continuing to play saturday and sunday football on poor standard pitches. I work on my feet actually on trains and had been having intermittent pain for about 2 years which has been getting a lot worse. Saw a really good consultant after a not so good one, who suggested HTO straight away. He said in Germany this is standard procedure for anyone my age, giving longevity to the knee rather than waiting to wear out and have knee replacement. I had the operation and wow he said it would be painful!! I woke up in the recovery room and was in absolute agony even though they put pain killer in my knee during surgery. Then they put me on Fentanyl which really helped. Anyway I found it interesting to read many had a brace after surgery, I had none and was encouraged to put full bearing weight on my knee the same day and do gentle exercises right away. I had the option to go home same day, I decided to stay one night (so glad I did) as the fentanyl would not be prescribed for home use. Next day went home with soluble morphine only after insisting I needed it. So glad I did absolute agony again that night again. I took more morphine than prescribed, I had to! Night sleeping has been really hard as usually a side sleeper which you physically can't do. I come off the morphine after 2 or 3 days as I was taking too much of the stuff for my liking. I have now decided to only take it a night ,to help me sleep which it does.
    My leg was really swollen for a couple of days but is now about normal size. It is bruised from the sole of my foot to the upper thigh which I think is normal for this procedure. My mobility now is actually pretty good , I can bend leg really well.
    Stand without crutches, obviously won't try to walk even if tempting. I bought a really good knee ice pack off amazon , brilliant best buy I made, VIVI ,think they are American, so easy to use and it is heaven to wear costs £20 approx. I am convinced this helped my swelling. Now you may laugh but I am sure he said after 2 weeks I may be able to walk without crutches? Maybe I was still high, but sure I heard him say that?!!! A few days ago I would of said no chance, but now maybe.. I did a lot of research before choosing my consultant, my advice to anyone is do your homework before choosing. I am off to the physio tomorrow and having the waterproof plasters off in about 5 or 6 days. Also add I had an arthroscopy just before the HTO as he wanted to make sure the rest of my knee could support the HTO as I mentioned I had a few other niggles in the knee, he did this even though had a recent MRI. I could of had no HTO if the arthroscopy showed other problems but gladly it didn't. Will keep you posted how it goes.
  • Just to add I am going to ask the consultant some questions when I see him again. I will ask whether he recommends taking the plate out. I will also ask about the pain in back some have experienced due to different leg length. My gut feeling is this is down to how much angle was put on the wedge inserted, some consultants play it safe as if you get it wrong it can put too much stress on one side which may account for later pain? I remember I had a leg allignment scan on a wacky piece of machinery, it was like Jurassic park with a big glass screen there were loads of people watching I
    felt like a test subject. I asked the lady outside why she said it is the only equipment of its type in the country. I guess that helps the leg alignment be more accurate as in exactly the angle of wedge needed?
  • Just an update. It has been 2 weeks today since I had the HTO. I have been in a lot of pain particularly at night. My ankle are was particularly sore felt strained / tight and me inside knee was really bad when I tried to sleep on that side.
    I also think too much exercise increases the pain especially if you over do it. TBH I was getting depressed watching my wife struggle with the kids and looking after me as well. However I have woken up this morning after a broken nights sleep, feeling a little better and I thought I would try and walk unaided again expecting shakes and wobbly knee again and mind telling me no way. Yet I could walk very small steps and very slowly! My ankle feels a little sore again now but can't wait to show my wife when she gets home from taking the kids to the school and raise her spirits. Early days but I am feeling a lot more positive.
  • Hi Folks - Brit living in the States here. 43yr old, injured my right knee circa 1993 playing rugby in England, always manageable. Took a fall playing soccer (footy!) in January this year and things quickly became unmanageable. Had some broken bone and cartilage on the base of my femur behind the knee. Solution was a procedure called OATS – essentially 2 bone/cartilage plugs from a cadaver bone. Plugging those in correct both the broken bone and cartilage issue completely – however, my alignment sends my weight right through the donor site – so I also needed a HTO to make a minor change to my alignment (5 degrees), moving my weight away from the donor site.

    HTO is by far the more significant of the two procedures, in terms of both pain and recovery time. Both procedures were to be performed at the same time.
    My absolute goal is to be back playing sport (footy) ASAP. I’m fortunate to have access to some top surgeons because of where I live (Los Angeles) and because I have excellent health insurance – I sought out opinions from two surgeons, both affiliated with NFL/NBA teams, and experts in operating on athletes, and picked one of them.

    Had surgery Feb 4. - procedure was well executed. Week 1 I was on pretty heavy pain meds (oxycodone) for the whole week – a couple of times the meds wore off while I slept, and it wasn’t pretty.

    Bandages came off after 1 week. Surgeon did a fantastic job with the stitches. Week 1 I began mild home exercises, and used a CPM machine. Studies have shown that using/not using a CPM has little impact on long term range of motion recovery. My surgeon is one of the few that still promotes the use of the CPM - he feels Range of Motion early on can be essential to reducing/eliminating the build-up of scar tissue. The CPM makes movement of the knee possible in those first few days after surgery when doing so is painful/uncomfortable/undesirable etc.

    Week 2 I began physical therapy, which I do 2x per week, plus home exercises. I came off the hard pain meds at 7 days post surgery and just take the occasional over-the-counter ibuprofen.

    By yesterday, 15 days post surgery, my unassisted range of motion was 124 degrees – based on my other leg, 132 degrees is my goal. I’ve gotten rid of the CPM now, as I had maxed out its capabilities. I ice 2-3 times per day to reduce swelling.

    My expected time-table is to start to progress to partial weight bearing at 6 weeks (currently I’m no-weight bearing on crutches). Surgeon thinks I could realistically be playing footy by August (6-7 months post surgery). That sounds optimistic based on the experience I’m reading here. But I will certainly aim for that timetable.

    In terms of issues; my muscle atrophy has been dramatic, and I will work hard to recover it once I am load bearing, but I’m amazed at how much I have lost in my right leg in such a short time. Pain is mostly fine, but my worse pain is not at the surgical sites – its in my calf. I’ve had it checked, it’s not a blood clot (if you get painful, red, sensitive to the touch calf, after surgery, treat it as an emergency, as its likely a clot), seems to be more like cramp/muscle pain. Being vertical for really over 10mins makes my leg and foot in particular swell, and foot gets painful. Biggest issue is sleeping – as I’m wearing a steel brace locked at 0 degrees, which is uncomfortable to sleep in. Would love if anyone has any tips on a decent night’s sleep! I’ve tried over the counter sleep pills, but no luck.

    I don’t see mention of it in the chain - has anyone here been recommended by their surgeon any vitamin supplement post surgery – like calcium and/or Vitamin D2/D3?

    Also, no mention of cost – it looks like it’s mostly Brits, so that makes sense with the NHS. Just to give you an idea, and again, I used a top surgeon who’s expensive, and my insurance covers this so I don’t have to pay it myself, but the bills I’ve already seen for my surgery (they’re not all in yet) are north of $110,000. Yep.
  • > @MattyLA4 said:
    > Hi Folks - Brit living in the States here. 43yr old, injured my right knee circa 1993 playing rugby in England, always manageable. Took a fall playing soccer (footy!) in January this year and things quickly became unmanageable. Had some broken bone and cartilage on the base of my femur behind the knee. Solution was a procedure called OATS – essentially 2 bone/cartilage plugs from a cadaver bone. Plugging those in correct both the broken bone and cartilage issue completely – however, my alignment sends my weight right through the donor site – so I also needed a HTO to make a minor change to my alignment (5 degrees), moving my weight away from the donor site.
    >
    > HTO is by far the more significant of the two procedures, in terms of both pain and recovery time. Both procedures were to be performed at the same time.
    > My absolute goal is to be back playing sport (footy) ASAP. I’m fortunate to have access to some top surgeons because of where I live (Los Angeles) and because I have excellent health insurance – I sought out opinions from two surgeons, both affiliated with NFL/NBA teams, and experts in operating on athletes, and picked one of them.
    >
    > Had surgery Feb 4. - procedure was well executed. Week 1 I was on pretty heavy pain meds (oxycodone) for the whole week – a couple of times the meds wore off while I slept, and it wasn’t pretty.
    >
    > Bandages came off after 1 week. Surgeon did a fantastic job with the stitches. Week 1 I began mild home exercises, and used a CPM machine. Studies have shown that using/not using a CPM has little impact on long term range of motion recovery. My surgeon is one of the few that still promotes the use of the CPM - he feels Range of Motion early on can be essential to reducing/eliminating the build-up of scar tissue. The CPM makes movement of the knee possible in those first few days after surgery when doing so is painful/uncomfortable/undesirable etc.
    >
    > Week 2 I began physical therapy, which I do 2x per week, plus home exercises. I came off the hard pain meds at 7 days post surgery and just take the occasional over-the-counter ibuprofen.
    >
    > By yesterday, 15 days post surgery, my unassisted range of motion was 124 degrees – based on my other leg, 132 degrees is my goal. I’ve gotten rid of the CPM now, as I had maxed out its capabilities. I ice 2-3 times per day to reduce swelling.
    >
    > My expected time-table is to start to progress to partial weight bearing at 6 weeks (currently I’m no-weight bearing on crutches). Surgeon thinks I could realistically be playing footy by August (6-7 months post surgery). That sounds optimistic based on the experience I’m reading here. But I will certainly aim for that timetable.
    >
    > In terms of issues; my muscle atrophy has been dramatic, and I will work hard to recover it once I am load bearing, but I’m amazed at how much I have lost in my right leg in such a short time. Pain is mostly fine, but my worse pain is not at the surgical sites – its in my calf. I’ve had it checked, it’s not a blood clot (if you get painful, red, sensitive to the touch calf, after surgery, treat it as an emergency, as its likely a clot), seems to be more like cramp/muscle pain. Being vertical for really over 10mins makes my leg and foot in particular swell, and foot gets painful. Biggest issue is sleeping – as I’m wearing a steel brace locked at 0 degrees, which is uncomfortable to sleep in. Would love if anyone has any tips on a decent night’s sleep! I’ve tried over the counter sleep pills, but no luck.
    >
    > I don’t see mention of it in the chain - has anyone here been recommended by their surgeon any vitamin supplement post surgery – like calcium and/or Vitamin D2/D3?
    >
    > Also, no mention of cost – it looks like it’s mostly Brits, so that makes sense with the NHS. Just to give you an idea, and again, I used a top surgeon who’s expensive, and my insurance covers this so I don’t have to pay it myself, but the bills I’ve already seen for my surgery (they’re not all in yet) are north of $110,000. Yep.

    Hi Matty nice to hear from you living in the States. You have certainly been through the wars! My first feelings are if I was you, is give up the football ,it is probably the WORST sport you could carry on doing after HTO. All the surgeons seem to suggest this, add the cartilage issues you have and that would be enough for me.
    I love football played it twice every week when younger it was my life at the weekends, I packed up 15 years ago after already doing quite a bit of damage. My surgeon told me if I had carried on then it would have been a knee replacement at an early age. I appreciate I am not you and it sounds like you are determined to play again and of course that is your choice, I just wonder what standard you would play at again and how long before problems arise. Yes you might play for a couple of years but remember if you look after your knee after HTO you could get 10, 15 or even 20 years out of it. Playing football would dramatically reduce this, and after HTO at the moment only 1 option knee replacement. I just feel I have been given a second chance with my knee, for a good quality of life with my young kids and I want to grab it , and do my best to make it last as long as possible.
    As for your pain in calf yes I would of worried it was a clot, but glad that isn't the case for you. I am now approx 4 weeks post op. On reflection I would say it is a beast of a recovery in terms of pain. I had pain in one area, then it would move to another, ankle to knee to shin etc.. I hit a brick wall about 7 days ago and was actually worried the operation may not of gone well as I was well healed everywhere apart from the front of the knee between the bottom of the knee and shin I think there is a tendon that joins the 2 together , thought it might be bursitis. Either way it was really painful especially after walking without crutches anywhere for long periods. I actually booked an appointment to see the consultant early I was so convinced something was wrong. My step dad had a knee replacement and he was convinced I was milking it, he said I needed to get on a bike like he did to build up muscle.
    I don't always listen to him but tried it, and it actually worked a treat. I guess building up the other muscles took the pressure off the knee. I cancelled the appointment as I am now in a lot less pain and can walk without crutches with a slight limp.
    My advice for anyone recovering is to do all the exercises your physio advises and stick to it where pain allows you to. My mistake was focusing on trying to walk longer and longer distances I am sure this just put pressure on my knee and caused inflammation and pain. Cycling would of been much better as not weight bearing on the joint.
    As for sleep my heart goes out to you. Lack of sleep is one thing I really hate. No easy cure in my opinion I tried everything. I would just go to bed when I physically couldn't kerp my eyes open anymore
    and take the prescribed pain killer just before bed. This would knock me out even with the pain ,but be prepared to wake up 3 to 4 hours later and actually appreciate you got that much rather than worry about it which just makes it worse. It WILL get better and it isnt like you have to drive or go to work.
    I am going to stick to cycling, swimming , occassional light hiking with a very small bag in Snowdonia and taking the dog for a walk daily from now on. I am glad I had this operation for sure even at this stage. It was really painful and emotionally a rollercoaster, and you do need to try and keep positive and mentally strong. I would love to know how you get on with your recovery, keep posting! I wish you well.
  • Just to add having read your post again... Ibuprofen.. I remember thinking why was I advised to use paracetamol and not Ibuprofen after coming off the heavy painkillers? Then I read that Ibuprofen is not recommended after HTO as can affect bone healing recovery. Perhaps you might want to check that.
    As for cost of HTO in UK I am not entirely sure but I reckon no more than 10k perhaps someone else can advise, I used the NHS.
  • thanks for your response. I know what you're saying about the footy. I actually stopped playing all sports in my early 20s, and became quite obese. I started playing footy February '19 - and within 5 months I'd lost 40lbs (about 3 stone). I'm playing with mostly folks in their 20s. We play hard, but it is a 'just for fun' rec league. That said, playing on the team has been a huge motivation for losing weight, and I plan to watch the games during my recovery from surgery as a means to keep motivated to stick to the PT/rehab program. I might be fooling myself - but my surgeon is also very positive about my return to footy. He thinks there's every chance I could return to the level I was before, and says he thinks even better - as I won't be playing with the cartilage/bone issue I've been managing since I was a teenager. That said, I'm not a good footy player, i just enjoy it, and i love my team. Whether this is realistic, i don't know - but i'm pushing for it. As to whether it's foolish....well, i think my circumstances are a little different from some - essentially, the damage to my knee was all impact damage, not, as many have had, a gradual long term wearing down of tissue. Aside from the actually damaged bone/cartilage, the rest of it is in very good shape, and the damaged bone/cartilage has now been replaced with actual real bone and cartilage, which should fully heal in to place long before the HTO rehab is completed. That said, at the end of the day, I'm 43, and probably only have a couple of years at best to play, and having not done anything for the last 20yrs, i'm desperately hoping i don't need to hang up my boots just yet.

    My PT recommended rolling out my calf on a foam roller before bed, as that is where most of my discomfort is. I tried that for the first time yesterday and it worked well. I had an improved nights sleep, so I'm going to keep trying that and hope for the best.

    I'm amazed you're walking so early on. My surgeon wants no weight on my leg for 6 weeks, and the various literature i've read online for HTO advises no weight on it typically 4-8 weeks to allow the bone to heal. I'd love to be able to walk a little without the crutches, as i basically cannot carry anything right now - but, I will stick to what my surgeon tells me. Perhaps your HTO is a newer variation on the process?

    Thx for the note on ibuprofen - I will check in to that.
  • I understand what you are saying Matty about the football. I am sure that even if you find you can't manage the footy you will find another suitable sport you enjoy. My kids want to do skiing lessons on the dry slope but I am again very hesitant as its all on the knees again. I reckon I will be doing mountain bike riding with the kids in the local forests which is actually pretty good fun.
    I am interested in your cartilage procedure will look into that, as you say NBA, NFL pay a lot of money developing techniques I am sure. I did a lot of research into HTO. The research does seem to suggest some have a brace for HTO with no weight bearing for a little while or very minimal. I was told on the same day I could put weight on it with crutches of course. Studies have shown the recovery time is usually slightly quicker which makes sense as no brace and a lot muscle waste. The break is a controlled cut and wedge inserted and the tomofix plate attached which I gues means its unlikely to move. I guess in your case the cartilage operation was a factor anyway. You are the perfect age though for this kind of operation and your chances of a full recovery are good, HTO has a very good success rate. I do feel a little weird when I walk you can tell something isn't quite natural when you go up stairs but I guess that will pass.
  • thx - there's a good short 3min youtube video which shows the bone/cartilage OATS procedure - its animated (non-graphic, not gory!): https://www.youtube.com/watch?v=Uj6dJ_bbsXE
  • Hi Matty thanks for the video. Took a while for me to get my head around it but am I write in thinking this a new type of surgery for articulate cartilage? Never heard of articulate cartilage until now! I think I am right in saying I have meniscus cartilage damage. I did enquire about stem cell treatment for this but it is still early days in this field. My thinking being stem cell treatment and HTO would of been great. Am I right in thinking you must of had a very big trauma to have damage to articulate cartilage as normally it's the meniscus one that gets damaged. Sorry I am limited in my knowledge but it is very interesting.
  • This link is really helpful actually, it explains why you are on crutches, protected weight bearing and crutches all part of the 'oats' procedure. I did ask about the surgeon if he would perform microfracture or Sub-chondral Drilling to try and stimulate regrowth of cartilage I will ask him if he did this next time I see my consultant. Stem cell procedure mentioned at bottom of page. Here is the link..
    https://www.thecambridgeknee.co.uk/cartilage-repair-and-transplantation/
  • Noticed it mentions your diet questions.
  • yeh, i don't know a great deal about the history of the various processes - all my learning has come from the last few weeks. But yes, basically it's about repairing the cartilage that actually covers the end of the bone itself. In my case, i had damaged bone behind the damaged cartilage - but the process is the same, as both are removed in the applicable area. Both sports surgeons I saw recommended the HTO/OATS combo for me - and both thought I would return to footy this year - although one stated 6 months, the other said 8-10 months. Either time line is a win in my book.

    The trauma wasn't that bad really - it was probably a combination of a very precise hit, at the wrong time. I was scoring a try in rugby, one guy around my waist rolled me as i was grounding the ball, and a second tackler came down 'studs first' on my knee cap as I rolled. It hurt, but wasn't terrible, I think in most contact sport, and esp. rugby, most people are playing with various forms of pain - i continued to play sport for about 9 months before i thought to get it checked out. At that point i'd never broken bone before, and had just thought a broken bone would be excruciatingly painful - which this wasn't. I had a round scar for many years (not visible now) over the spot on my knee cap, which looked exactly like a stud had hit it! By 'wrong time' - I mean i was 15 - and was told at the time that the bone/cartilage is far more susceptible to damage in teenage years, as both soften for the considerable growth experienced during that age. I was also told there was a good chance it would repair itself, but that didn't happen. As I said, I've had pain since then, and would occasionally get the sensation my leg was going to hyper-extend (it never did though!), but the pain was always manageable. The fall I took in footy in January was heavy but not terrible, finished the game fine - but the next day I couldn't walk, and the MRI revealed the old injury, and inflammation spreading up my thigh bone - the pain was far more significant than ever before, and it was a situation that wasn't going to improve without action.
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