WonkeyDonkey's High Tibial Osteotomy - Open Wedge Diary 11/11/11

[WonkeyDonkey]

Day 198

Have continued to do my exercises, and saw my physio a few days ago. He assessed my knee and to my relief we went through the exercises and how I had managed them. I had met all the targets we set and then we tried the stairs. I showed him how this had improved and I can now just about manage to get up okay (when I am not tired), and coming down my knee still moves inwards, although not quite as much as it did. He could see a marked improvement, so we have changed two of my exercises to make them slightly harder, talked about doing some exercises in the pool when I go and to continue to get the MCL moving and strengthened. I am not seeing him again for three weeks, once I have been to the hospital again and have the results of my MRI scan.

I asked about how I was doing in comparison to other HTO patients he had seen, I was told that I was in the top % for recovery and for the fact that I can bend my leg the same as my good leg. This was put down to the fact that I have the iBalance implant and do not have a metal plate on my bone. I am the only person so far he has seen with this implant. I was also told that I still need to give my knee more time to heal, but am doing really well. I feel some days that I should be doing better, but understand that it is a long haul recovery and it cannot be hurried. Having said that I am getting some of my life back and that is the important part.

I went shopping yesterday, on my own, I walked round fine but carrying the shopping made my leg ache. The longest shopping trip I have had for a while and my knee started to ache. I iced it and it felt ok again. I still ice my knee when I have a busy day, or have been standing for long periods of time. I went on two long bike rides, rested for one day and then went on another slightly longer ride, my knee told me I had done too much. I did not ice it until the next day when I got pains in the knee after a walk. However after icing twice the pain had gone and it felt fine again.

Keep positive

WD

[WonkeyDonkey]

Day 214 – 7 months

Have been busy doing my exercises, even managed to cycle 13 miles and also taking a week’s holiday in wet Wales!! since my last post. I did two walks each of about 3 miles. The second walk was along the coastal path for about 1 ½ miles and then turned round and walked back, totalling 3 miles. Some of the walk was up and down, and my knee felt every lump and bump especially coming downhill! I iced my knee after both walks, and felt quite good, maybe with a little ache but nothing too much.

Since I have been back, my knee has felt a little stiff and aching. Today has been the worst day for pain for a very long time. I stopped taking pain killers back in January, but today I actually felt I could do with taking one or two. Every time I walk and put weight through my knee, I get a pain down the medial side. Luckily I had an appointment with my OS today, and mentioned it to him. He asked why I had had my latest MRI scan, and I explained about not being able to get up and down the stairs very well. I was told that there was some slight damage to my meniscus, and we discussed the options. They are: leave it and see how it goes, another arthroscopy to trim it and sort it out, or possible PRP injections, (which I need to investigate). I will be seeing him again in Nov/Dec, when we will discuss the options again and see how I am getting on. I mentioned that the exercise that the physio linked to the clinic gave me, I couldn't do!! Also, that I have a private physio of my own. He said the waiting list for the arthroscopy is 9 months, and asked if I wanted to go on the list today, or to wait. I decided to wait as I felt I had been getting on fine (except today) and improvements were being made. I can ring his secretary if I change my mind. He asked if he could take some pictures of my knee - straight and bent and the gait, which he did and then a video of me walking up and down the corridor, for a presentation he was doing!!
I felt a little down when I came out of his clinic because I was hoping for the all clear from my MRI scan, however once I got home and had explained it all to my husband, he put it all into perspective for me and I felt a bit better.  I am now going to investigate PRP Injections.

I am seeing my physio on Thursday, so will discuss the results with him. I will keep on with his exercises, cycling, swimming, and hopefully see improvements, so I do not need any further treatment. I hope I am not wishful thinking.

Hope all those knees out there are getting better.

WD

[Rothera]

Wonky Donkey how do I PM you. We share the same surgeon and I was in clinic today! Might have passed you.

[WonkeyDonkey]

Hi Rothera

Click on the mail sign (white envelope sign)next to my details and you can then mail me.

Look forward to hearing from you

[WonkeyDonkey]

Day 218

The knee pain continued for a couple more days, and had calmed down slightly by the time I saw the physio. I explained how it was feeling and what I had been doing. We also discussed the MRI results and what my OS had said. I am to continue with all the exercises I had been doing, as these are all geared towards building up my muscles and strength on the medial side of my knee. This will stabilise my knee when going up and down the stairs. He also used the ultrasound on my knee to help with the pain.
The day after, I felt good; the knee ached a little but no pain!! Hooray!! I went for a bike ride, doing only 8.8 miles. Thought I would make sure that it wasn’t the biking that caused the pain. I have been fine since.

Today, I have been for the longest walk that I have been on for a good couple of years and walked 4.5 miles. My leg started to ache by about 3.5 – 4 miles and I knew I had walked a long way by the time I got back to the car. No pain so far, so hopefully that was a small hiccup in my recovery. I am going back out on my bike tomorrow, all being well.

Good luck to all knees

WD

[pennstatexc]

WD,

Glad to hear you are feeling better after you had some pain a couple days back.  I would definitely pay attention to that meniscus, especially if you have a tear.  My meniscus issue began as a slight tear, then over time due to my activity levels, it ended up as a complete tear leading to a potential meniscus transplantation ahead for me.  If you meniscus is torn, it is not functioning properly, so the articular cartilage ends up taking more load therefore causing greater wear and tear.  There was a point where my slight meniscus tear felt really good when I worked out and was not an issue, but over the course of a year it ended up getting worse.  I would highly consider surgery to remove the torn area of your meniscus as that will resolve some of your pain symptoms and prevent something greater!  This is just my advice from personal experience but take it how you want!

Joel

[WonkeyDonkey]

9 Months Post Op – Day 280

I am now 9 months post op. I feel very positive and relieved at having had my HTO back in November 2011. I have come a long way since that day. However I do have so much of my life back, the really good parts, like being able to do more activities. I am cycling now to keep up the strength and movement in my knees. I have been discharged from the physio for the second time, however my file is being left open just in case I need any further help. I have plenty of exercises from my physio, and how to develop them further when I feel comfortable with them.

I can manage to get up and down the stairs now without clinging on, although I still find it hard on downhill slopes and uneven areas. I know I have a tear in my meniscus, and get pains from this. I recognise the pain as I did a similar injury over 3 years ago. I had a partial menisectomy in March 2011, after doing physio for months and now it looks like I may be heading for this again. I do not have the pains/aches from the HTO or my OA anymore, and feel that this was the right decision for me.

I went away a few weeks ago, and went into the sea, great for numbing the knee after walking to the beach, with the cold, but found it hard to have the waves banging into my leg. May be I just needed more confidence or maybe warmer sea!!

WD

[silverghost]

Hi WD

Glad to hear your getting on well with your HTO.. apart from occasional pains!!

Just interested im about 2and a half months now and am interested to hear if/when you were able to drive again?  Also I know I've had a few more procedures on top but are you into any other sports and do you think you would be able to go back to any now?  I used to play golf and just wondered how and when i'll be looking at returning..

What sort of bend have you got in your knee now.. my os is looking at full bend after 3 months!!ive only got about 110 at the moment.

Im a bit concerned that they told you it would be a 9month wait for an arthroscopy if your still on their books i would think they would get you in quickly as your still a statistic on their hospital records...  Do you think your gonna look at getting the metal removed at 1 year? it could be the metal that is causing the pain and agitation?

cheers for your advice

SG

[WonkeyDonkey]

Hi silverghost

The occasional pains are from the meniscal tear and thankfully not the HTO. I think I started to drive again at about 3 months, I drove home about 5 miles with my husband next to me. It felt strange as if the leg was not strong enough but I sat slightly closer to the steering wheel than normal to compensate. I swim and cycle as my main sports now, however I increased my walking even when on crutches and a walking stick, and slowly ditched all and walk fine without any aids.  I can cycle 14 miles without any effects, and consider I had not cycled for 20 odd years, for me than was an achievement. You will be able to return to golf, but may have to start with a few holes and not do the whole course!

Don't worry too much about your bend, as I struggled to begin with and now I have a bend of 130/135 which matches my good leg. Keep up the exercises and that will help. It took me about 10 weeks to get my bend to 135.

I am not too worried about the 9 month waiting time for the arthroscopy as, I see the OS in Nov/Dec and we will be discussing the arthroscopy or PRP injections, so no decision has been made, as I did not want to contemplate another op when I had had 2 in 8 months. I do not need to have a second op to have a metal plate out, as I do not have one. I had an iBalance implant put in my osteotomy site, and as this is not metal this does not have to be taken out. Below are the websites if you want to see what I have in my leg.

https://www.arthrex.com/innovations/index.cfm?adid=42

http://www.orthoillustrated.com/

Keep positive and do your physio!!!

WD

[silverghost]

Thanks WD

Trying to stay positive but have good days then bad days where can't do anything.  Although i am off crutches now after 10 weeks so guess thats a good thing, (they are a pain in the ####)

good to hear how much cycling you are doing i haven't ridden for bowt 20 years either so should be fun!!

take care thanks for the advice

SG

[fiona_mc2002]

WD,

Thanks so much for taking the time to write this diary, just spent my lunch hour reading it! I was hoping to be driving and back to work within 3 months though, maybe I have to lower my expectations a wee bit!
But it's good to hear that you don't regret the surgery. Hope the knee continues to keep well


Fiona

[silverghost]

Hi fiona

Just stay positive about the op, it's hard at times and feels like everything's going wrong. some days you will feel like you have gone backwards a few steps but in the long run you will be better than before!

I got confirmation to drive yesterday at 3 months and if i had a normal sit down desk job i might have been able to return, as it is im out of work (was in manual work) and am taking the time to give myself the rehab i have been advised to do!

Good luck

SG

[WonkeyDonkey]

One Year Post Op – Day 360

I have had a couple of setbacks over the last couple of months. It started with some pain, and then an urgent visit to my physio, some ultrasound to try to relieve the pain. No cycling for this week. Another visit to the physio a week later, to be told my knee was getting worse rather than better. A phone call to the hospital and I had an appointment in two weeks. My OS checked the knee out and I have been put onto a Knee Fellow’s waiting list for an arthroscopy to hurry things along. I have seen my OS once a month for the last 2 months and will see him again in another month in the pre assessment clinic before my op. I have a tear and also an extruding anterior horn in my medial meniscus. Nothing to do with my HTO, thankfully. I have resorted to taking some pain killers recently, but only take them when I really need to, not nearly as many as I was taking before my HTO. I have learnt to recognise the signs when they are needed.

I had my yearly check-up for the HTO yesterday and all seems to be well, bone healing nicely and all ROM okay. I completed a Research Programme questionnaire and had a check-up with the physio linked to the HTO patients, my ROM is the same on both legs. Passed with flying colours. Then I saw my OS, discussed the pain I am having and he suggested a steroid injection with local anaesthetic, so I moved to the treatment room. Injection wasn’t too bad, but the walk back to the car park, down two flights of steps was a laugh. You should have seen my walk, as I couldn’t straighten my leg properly and now I really appreciate the hand rails on the walls. It feels a bit better today, mainly because I can now straighten my leg again properly, but it hurts where the needle went in. The steroid should start to work in about five days, so here’s to pain relief.

I have a date for my arthroscopy to clean out my knee again as 21st December 2012, so not long to wait, although if the injection works wonders then I can defer it for 3 months but will have to have it done at some point in the not too distant future. Looks like my husband will be cooking Christmas dinner again this year!

To those contemplating the HTO as an option, from my own experiences, I would recommend it but you must realise that the recovery is long and hard. Things will not always go the way you plan and emotions will be up and down. Physio is a must and home exercises need to be done. I now appreciate my legs more than ever and would not do anything to hurt them intentionally.

Thanks to all the KG’s who have helped along the way, and have kept me going when I needed some support. It made me realise that I wasn’t alone in knee problems. Thanks to my husband who has waited on me, worried over me and put things into perspective when needed, and to my two children who have regularly filled up my cryo cuff without moaning about it.
 
Good luck to all who have read my post op diary and hope you are all on the mend.

WD