KNEE ARTHRITIS - Changing the forces through the joint :
osteotomy failure - - Posted by lam651 (lam651), 15 April 2004
Has anyone else had a HTO end up with bone on bone rubbing again? I've had 2 failed HTO's on my left leg. The first one never healed but the OS said it had, so I spent a year walking on it in pain. I had another HTO done by a different OS and for about 2 months it felt great. Now it hurts all the time again and the OS says I have bone rubbing on bone again.
He didn't say why this happened and he said we will talk about it after my right leg is healed from a HTO. Now my right leg hurts again so I think I'll find out that this failed too.
I just wonder if anyone else has had this happen to them and maybe they can tell me what went wrong. Did he not open a big enough gap in the bones to begin with? Thanks, Larry
Posted by JessToni (JessToni), 15 April 2004
I am so sorry to hear you are having so many problems with the HTOs. I definitely know how disappointing it is to go through surgeries that are supposed to fix something and then you wind up back where you started if not worse.
Unfortunately I cannot offer any advice, as I am scheduled to have an HTO in about a month. When you do find out what went wrong please let us know.
Jess
Posted by stefanie (stefanie), 15 April 2004
Sorry to hear about all the problems you are having. I am planning on skipping the unispacer & HTO, going to just plunge forward to the pkr this summer. I am scared of the unispacer's failure rate & the HTO sounds terribly painful, I don't have that kind of time for the recovery.
Sounds like you've really been through a lot lately & I sure hope that things start to improve for you & that your OS will have some promising answers for you. Let us hear what you find out.
~Stefanie 
Posted by hmaxwell (Heather M.), 21 April 2004
Larry,
Could it be that the osteotomy did it's job in realigning the bones and changing the mechanics, but you still have damaged sections of cartilage? These lesions can hurt if they are deep enough, and everyone has a different threshold for onset of pain.
An MRI or exploratory scope might be helfpul to determine how deep the lesions are. Then, depending on their location and your age, you're looking at options like lifestyle modification, cartilage replacement, or PKR/TKR.
Another option is that your knee is just outraged from all the work that's been done. Give it a little time to calm down, and you may want to do formal pain management. That can be helpful when there are nerves that have been sending painful stimuli for so long that they don't know how to turn off--drugs like neurontin can help with this type of pain and 'close the gate' to get the nerves to stop sending the wrong messages. This is not to say that your pain isn't very real, it just means that the source is neurological instead of mechanical. That might be an explanation if your mechanics are good and the cartilage lesions are still clean and not damaged further.
Best of luck. Please keep us posted and know that we all understand what knee limbo is like. It STINKS!
Heather
Posted by lam651 (lam651), 22 April 2004
Thanks for your replys. From what I could find out on the internet, if it is accurate, is the most common cause of HTO failure is is not having enough of an angle or not opening the gap between the bones enough.
My latest HTO failure involved moving my leg from 16 degrees bowed to 4 degrees knock kneed. Maybe it should have been moved further in.
This is just my impression. I saw my OS on Tues. but he wanted to talk about my other leg (right) and deal with my left leg later.
He did say that my left leg is bone on bone rubbing on the inside again and mentioned either a UKR or another osteotomy though.
I've had about enough surgery for awhile I think. Maybe a pain clinic can help me learn how to function and work with the pain.
Thanks for your suggestions and support. Larry
Updated Tue Dec 2 2008