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Author Topic: Cutting the tibia  (Read 1039 times)

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Offline Otte

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Cutting the tibia
« on: February 01, 2005, 03:36:53 PM »
Hi all,
In April, I am scheduled to have some knee surgery at UH in London, Ont. Dr. Giffin in the OS, and he wants to cut the tibia and insert a bone wedge which will be held in place by a plate and some screws. This all sounds pretty drastic to me, especially as it is the OA in my knee which is causing pain and difficulty walking. Has anyone experienced this surgery? Was it effective?
Thanks for your responses
A bit nervous in London...

shadehawk

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Re: Cutting the tibia
« Reply #1 on: February 01, 2005, 03:48:38 PM »
There are many on this board that have had these procedures and you can view their stories in the Rehab Dept. - Post-op Diary and in the Specialist's Office - Patello-femoral joint section.  Hope this will help you some...

Here is an article that might help you some.  I think this is the procedure that you are describing.

http://www.kneeguru.co.uk/html/steps/step_05_patella/realignment.html

Osteotomy: (sorry I missed you saying OA)
http://my.webmd.com/hw/osteoarthritis/hw125548.asp
« Last Edit: February 02, 2005, 11:15:59 AM by Shadehawk »

Offline Otte

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Re: Cutting the tibia
« Reply #2 on: February 01, 2005, 04:08:28 PM »
Thank you for getting back to me. I'll have a look at what you sent. I appreciate it.


There are many on this board that have had these procedures and you can view their stories in the Rehab Dept. - Post-op Diary and in the Specialist's Office - Patello-femoral joint section.  Hope this will help you some...

Here is an article that might help you some.  I think this is the procedure that you are describing.

http://www.kneeguru.co.uk/html/steps/step_05_patella/realignment.html



Offline Run Forest, Run !!!

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Re: Cutting the tibia
« Reply #3 on: February 02, 2005, 11:16:50 AM »
Hey,

I am exactly 4 weeks of what you are describing...
This is a High Tibial Osteotomy. 
I have done many posts on this, so, please feel free to look at all of them...
Here is one I sent to Lizzie-UK for her upcoming proceedure...
Please, feel free to browse all my posts on this OK ???...


This is Craig.  And you are somewhat correct about the type of operation that I had.
Just so you know, the Tibia is never Broken, It is precisely CUT at specific angles to allow overcorrection.  It is cut completely through and moved into place.
A wedge was taken from the inside ( medial ) of my Tibia, and a Allograft ( cadaver ) wedge was formed and set in place.
The Allograft is a bone from a deceased person.  A Graft was taken from the Iliac Crest of my hip.  The bone is used to facilitate
the graft into healing because different types of bones in our body react and heal different ways.  This graft is used to prevent a Mal Union
of the graft, or not taking.  The Tibia is moved to a point of over correction: From sliigtly Varus(bowlegged) to slightly Valgus(knock kneed).
The over correction is nesessary to allow proper tracking.  An Internal Fixator(there are many kinds) is screwed into place to hold it all together.
Now, your OS MUST be VERY adept at doing this.  Full length radiographs(x-rays) MUST be taken while you are weight bearing(standing).
ALL measurements are done before you enter the operating room.

Ok, that was alot.  There are different types of Osteotomy's.  I had a High Tibial Varus Repair.  You can have a Tibial or Femoral Osteotomy.
External Fixation is also a choice.  http://www.limblengthening.com/aboutll.html ,go here to examine that .  You can also have a CLOSING Wedge Osteotomy.  This is where a Wedge is removed and the bone is reset to take up that space, no wedge used, then internally or externally fixated.
Internal Fixation is Instant, but requires MUCH expertise.  Exernal fixation is slower, and you adjust the screws by yourself on a daily basis.  This slowly moves the Osteotomy into place and lets it heal.  Wonderful results have been obtained from both, as well as nightmares.  Recovery is a bit difficult, especially if you are active.  You will be non-weight bearing for 6-12 weeks, so plan ahead.

There are also Osteotomys that use Unispacers.  They haven't had much, if any success.  You will not be put into a cast.  You NEED to be able to move the leg ASAP and do excercises.  I am in a Townsend Bledsoe Brace.  A good brace that is open, and allows you to adjust degrees of movement as necessary.  Directly upon waking form my operation, which took about 3-4 hours, I was in an Immobilizer brace with a EBI Ice Cryo-Cuff for cooling, and had a JP Drain in my leg by the incision to drain fluids and prevent infection.  These two items are an ABSOLUTE necessity in a operation like this one.
The drain came out on the 4th day in the hospital(painless), and I was off the Cryo-Cuff on th 6th day.  I went to heat after that.

The hospital stay is anywhere from 3-5 days.  Make sure the OS you use makes all the proper precautions and knows what they are doing here, and that YOY know exactly what is going to be done.  I had brochures and information in my hand WELL before this was initiated.  My OS has no secrets.  I am fortunate to have that.  I did know that I needed to have this done 3 years ago, but opted for a second ACL instead.  That was my choice.

Ok, this is long enough.  There is plenty of info on the Web about all this.  Just search for Osteotomy, High Tibial Osteotomy, Proximal Tibial Osteotomy.
That is if you are having a Tibial Osteotomy.  If it is Femoral, search for that.  I have always said a I will say it again "ASK QUESTIONS, BE INFORMED".
Don't let any Doctor put you off.  You have all the rights to know what to do and all the proceedures as well as the consequences.

Contact me anytime and I will be glad to help in any way I can...

Remember, Ask many questons, Proceed ONLY when you are ready and comfortable, Ok

Craig
« Last Edit: February 02, 2005, 11:59:04 AM by Run Forest, Run !!! »
2000 Left ACL w/ Hamstring Autograft-Skiing
(failure)
2002 Left ACL REVISION w/ Allograft Ligament.
2003 Left ACL Screws Removed
2005 Left HTO w/ Allograft Opening Wedge, Hip Autograft, Internal Fixation ... Yeah !!!

Offline Run Forest, Run !!!

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Re: Cutting the tibia
« Reply #4 on: February 02, 2005, 11:20:22 AM »
Oh Yeah,

Go to this part of this site, OK !!!!

KNEE ARTHRITIS - Changing the forces through the joint


http://www.kneeguru.co.uk/KNEEtalk/index.php?board=34.0

Craig



2000 Left ACL w/ Hamstring Autograft-Skiing
(failure)
2002 Left ACL REVISION w/ Allograft Ligament.
2003 Left ACL Screws Removed
2005 Left HTO w/ Allograft Opening Wedge, Hip Autograft, Internal Fixation ... Yeah !!!















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