KNEE ARTHRITIS - Changing the forces through the joint :

Osteotomy for the ignorant - - Posted by oli (oli), 6 March 2003

Here I am, 41 years old, keen to keep playing with my three children - which is meant to include ski-ing, windsurfing and cycling and tennis and such things - but suffering from significant pain due to an operation 25 years ago which appeared to involve digging a large lump out of my femur - result after 25 years - no cartilege on one side of the knee and 9 degrees of misalignment. Told that an osteotomy will do the job - and then that I can combine an osteotomy and a cartiledge transplant.

Is this really the best solution?  How long will I be unable to play my sports?  Is this what other people do in such circumstances?  All views very very gratefully received.

Oli
Posted by jathib (jathib), 7 March 2003

Once you've lost a cartilage there is really no solution that will render you pain free. I'm also facing an osteotomy. My doc said it will buy me about 10 years before I need a total knee replacement. He said it's just a temporary fix but I can stay fairly active afterwards. I'm not going for it yet, going to wait as long as possible. I can still swim and ride my bike so at least that is something.
Posted by JessToni (JessToni), 7 March 2003

Hi,
I dont know that I can offer that much advice, but I am also having an osteotomy along with an allograft (bone and cartliage from a cadeavor implanted in my knee) hopefully in the near future.  I have been waiting for the allograft for about 3 months now..very frustrating.
I don't know how long you will be out of sports, but i have heard it is a fairly long and rough recovery, but of course that varies from person to person.
My doc told me that the osteotomy procedure has been around for a really long time and has proved to be very successful.  At this point i have a lot of trouble even walking, so I am looking for anything that can help me.

Jess
Posted by Keith (Keith), 19 March 2003

Hi, I had a high tibial osteotomy 6/13/01. Prior to my surgury I could not walk more than a block or two. I had no cartiledge in the inside of my left knee and I was very bow legged. The operation was a success. A year and a half later I have no pain. I am 50 years old and hope it remains pain free for many years. I am very glad that I had the operation. I wish you well and hope all works out.
Posted by amazonia (amazonia), 22 March 2003

I had a high tibial osteotomy on Dec 5th '02 to put my tibia in better alignment before reconstruction of the PCL and PLC coming up in May - all from an injury in Jan. 02.  After the HTO, I was non weight bearing (on crutches) for 2 months - no brace/cast or anything, just using crutches.  The most painful part was the bone graft from the hip, but that pain subsided within a few weeks.  Now at post 3+ months I'm walking without any sort of aids and really no pain from where the osteotomy was.  Of course I still have the ligament problems to deal with, but I'd say that I'm back to where I was prior to the osteotomy.  There's just some numbness around the area, but that's about it.  I didn't find it to be too bad at all - and it seems to have helped with my PCL injury too, since the tibia is in a more aligned position.  (I guess I was somewhat bow-legged to start with, and didn't have the straightest leg to start with, so the ACL/PCL and PLC injury didn't help)  Good luck with everything, and from my experience the osteotomy was not too bad.....and if I need it down the road for my other leg, I wouldn't hesitate to get it done.
Posted by esbrit (esbrit), 7 April 2003

Hi

I just underwent a distal femoral osteotomy on 3/27/03 to treat painful lateral compartment OA resulting from a significant genu valgum.  I am now 9 days post-op.  It is too early to tell if the surgery has been successful.  I am doing okay, although I do remember waking up in the recovery room in extreme pain, however, after about an hour and almost constant medical attention my pain was controlled with IV dilaudid, a very strong narcotic.  I have continued to maintain adequate pain control with the dilaudid although now I am now taking it orally and have been able to reduce the dose from 8 mgs every 3 hours to 4 mgs every 6 hours.  I am totally non-weight bearing, on crutches and in a full leg cast (fortunately bivalve, so I can attack any unbearable itches!).  This is a life disrupting, inconvenient procedure, but if successful and if it buys me the additional time before I need TKR then I will be happy.  

Please feel free to contact me if you have any questions... I am in the learning phase myself, so have much to learn as my recovery continues.

Best wishes,

Esbrit
Posted by Donna (Donna), 7 April 2003

Esbrit,

Just wanted to wish you well on your recovery.You sound like a multiple-knee surgery patient like me. I had 5 on the same knee. Latest one on 2-13-03. Still too soon for me to tell how successful mine was too. Keep us posted.

Donna
Posted by zimjohn706 (zimjohn706), 19 June 2003

I had an opening wedge high tibial osteotomy performed in Dec02 to correct bowleggedness resulting from an ACL ligament failure 15 years ago (not treated) and severe OA in the medial compartment (no cartilage left).  

I was in extreme pain before the op and can only say it was the best thing that I have had done to my knee in 15 years.  The graft from the hip was very painful, but I never had any pain with the HTO, only numbness.  3 months later I had an ACL reconstruction using hamstring material from my right leg, and again that seems to be very successful.  I am not running but I can walk with a significant reduction in pain, which to me is a high measure of success.  There is still pain, but nowhere near the level previously experienced.

The downside was that I developed compartment syndrome in the right leg following the hamstring harvest, and had to have an emergency fachiotomy to save the leg, which was the good one!

However the work on my left has been brilliant in my opinion, and the fachiotomy only made for a more interesting post-op PT regime.  Go for the osteotomy, I works!
Posted by Di (Di), 8 August 2003

Hello,

I can understand where your coming from.  I was just advised by my Dr to have a Marquet TTT.  I am not sure I want to do it.  I Have had knee pain for a few years but until recently it did not effect my walking too much However for the last three weeks, I cannot walk more then a few steps without being in pain and am using a cane just to make it thru the day.  My problem is that the Dr did not recommed anything else to try but just decided on my second visit to him to do the surgery after looking at my MRI and saying all my Cartlidge is gone in the back of my knee.  I have decided to go
see a second dr just to be on the safe side before doing this.  As much as I want to be out of pain, this surgery scares me.

Thanks for listening

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