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Author Topic: OPEN WEDGE HTO - DONE! Now the healing begins ....  (Read 25600 times)

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Offline knee-will-be-great

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OPEN WEDGE HTO - DONE! Now the healing begins ....
« on: January 24, 2006, 06:22:41 PM »
Hello Everyone,

Please excuse me for the typos.  I do not have the time to correct them all; although I thought that the website did have a spell-checker, I do not see it.

I am 5 days post-op for an open wedge HTO using donor (irradiated) bone for the bone graft.  I am happy to say that 3 days post-op I did not need pain meds.  I have a 125 degree range-of-motion; quite amazing considering that this knee is a bona-fide veteran of extensive knee surgery prior to the HTO.  I had a minimal dosage general anaesthetic, but did have a sciatic nerve block and a femoral nerve block put in prior to going under.  The nerve blocks are administered through IV drips and act directly on the two major nerves of the leg, thus essentially deadening the leg to sensation and movement.  To my understanding, this ameliorates the need for high dosages of general anaesthetic, thus expediting the process of feeling great after surgery.  I am delighted to say that I feel great, both physically, spiritually, cognitively, intellectually and emotionally!!!

I have read extensively on the subject of HTOs et al; here's my personal perspective about how to prepare oneself for this surgery, and how to undertake life post-surgery, be it in-hospital or at home:

1)  Be as fit as you can be prior to surgery.  Irrespective of how badly your knee hurts, don't habituate on it.  Instead, swim, lift weights, do stomach crunches, do anything and everything that you can, heck even bicycle on a recumbent bicycle using your one good  knee/leg - because using the good leg will have some degree of exercise benefit transfer to the bad leg.  The key point is that the fitter one presents to surgery, generally the better you will feel after surgery, thus giving you motivation for exercise during the ehaling process.  Note also, that you really should develop your upper body strength - because you will be carrying yourself on one leg, using crutches for at least 8 to 12 weeks.  You will have at least 6 weeks non-weight bearing - so you really should be strong.  Show your physician that you are going to be a compliant patient who cares about the well-being of their body - and that you are someone who will respect and 'take care' of their handiwork.

2)  Have a good and healthy diet prior to surgery.  I subscribe to the notion of eating a more-or-less caveman diet of read meat, chicken, fish, eggs, fruit, vegetables, turnips, dark whole grains like wild and brown rice - and soy milk or goats milk.  I also use extra-virgin, cold-pressed olive oil - which has an anti-inflammatory effect.  I do eat oatmeal with real wheat (the husk of wheat) bran put into the hot mixture.  i)  I have successfully utilised an 'anitinflammatroy diet' and just common sense.  You are what you eat.  I personally would not touch pop, chips, processed food, sotre-bought pastries, jam, butter, micro-wave pop-corn and white bread.  These items provide empty calories.  What your body needs prior to and after surgery is nutrient-rich foods - and high nutrients are usually delivered via simple, non processed foods.

3)  Eat slowly - and until you are 80 % full.  This will prevent you form over-eating and packing on wieght - particularly impaortant when you are rehabilitating.

4)  Visualise yourself doing activities that you want to do after you are up and walking.  Thinks positively, even though you may have lost a job because of knee problems, or, have money problems because of stopping work to go for this surgery.  I beleive that scientific evidence points to having a healthy spirit as a major factor in helping a body heal, all other things being equal.

5)  Stock up on healthy foodstuffs and prepare for your surgery in advance.  Freeze weeks of food for yourself and your family.  You could chop up sufficient numbers of veggies to have stir-fry dinners every day.  Then you can pop these items into the microwave on a daily basis, without having the urge or the necessity of ordering out and succumbing to the temptation of pizza and other doughy, sub-ultimate foodstuffs.

6)  Drink lots and lots of water post-surgically.  Drink at least 2 litres per day of water.  This will flush all of the anaesthesia out of your system and hopefully make you feel better soon.

7)  Prepare the body for habitual relief of constipation by injesting dried prunes every morning.  Have 3 prunes every morning.  Given that you will be relatively inactive, the propensity for constiptation exists.  Counteract this by utilising natural purgatives.

8)  Buy track pants that snap up the sides, from toe to waist.  These are so easy to pull off and on when needing to go to the bathroom.  You can wear them every day and then easily get out of them for sleeping/bathing.

9)  Oh, by the way, when in hospital, do not act like a princess or a prince and demand, demand, demand of the nurses.  Nurses are heavily over-worked irrespective of the country we live in.  The last thing you want to do is irritate the nurses by being demanding or whiny.  Be a good, compliant patient and remeber to wait your turn - because you are only one of the many on your orthopaedic surgical ward - and assuredly there are some folk on that ward who are quite elderly and have multiple, complicated, physical problems.

10)  Re-examine your life while you are rehabilitating; evaluate yourself intellectually, cognitively, spiritually.  Evaluate your relationship with others.  Perhaps this is a great time to start the preparation process for changing your life in other ways.  It's not like you don't have time to sit around and think.

11)  Follow post-op exercise protocol to a "t".  Don't whine about how difficult this will be, or how difficult this is; instead, as the Nike saying goes "Just Do It!".

12)  Remember, that which doesno't kill you will make you stronger.

13)  This is only my personal perspective on what has worked/is working for me - and should not replace any discussion that you may have with your physicians.

Cheers to all - and to all a good knee!!!!
Medial Menisectomy, 1 ACL Autograft, 3 ACL Allografts, HTO, numerous debridements, good now :)
ACL Allograft #3 Post-Surgery Rehab/Wellness Diary http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=37218.0;all
ACL Reconstruction VIDEOS http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=37773.0

Offline Run Forest, Run !!!

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Re: OPEN WEDGE HTO - DONE! Now the healing begins ....
« Reply #1 on: January 25, 2006, 12:00:21 PM »
Great Advice for All Involved, in all leg Surgeries !!! :P

I am now over a year out, and doing fine ...  ;)

Here's to your Knee, and to ALL Knees out there ... Good Healing !!!
Craigger ...  ::)
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 shade

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Re: OPEN WEDGE HTO - DONE! Now the healing begins ....
« Reply #2 on: January 25, 2006, 12:30:32 PM »
Hi,

You've a good healthy attitude.  Nice reading your post and your ideas, thanks!!  Like your spirit..

You mentioned a spell checker......

Here is where you can get iespell checker  http://www.iespell.com/

Have a great day.  ~Shade
July '05 (RK) - LR/debridement
Mar '06 (RK) - Open LR + Allograft w/OBI TruFit Plug + Fulkerson TTT
 Feb '07 (LK) - LR + Fulkerson TTT

Offline knee-will-be-great

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Re: COMMENTS - OPEN WEDGE HTO - DONE! Now the healing begins ....
« Reply #3 on: January 25, 2006, 02:32:58 PM »
Thanks Craigger and Shade!!!

These are observations I have made from my experiences, but also from watching others go through knee/hip/ankle/leg surgery. 

It's all in the attitude - and in doing as much as one can to circumvent potential problems and heal quickly.  I beleive that OS's and physical therapists are quite thrilled to see people taking care of themselves and doing everything that is right and healthy - particularly after they have given us of their time and of their extensive skills.

Not whining to the doctor or to the physical therapists AND staying in shape show our health care providers that we are worth their efforts and that we value their hard work (i.e., planning for surgery, during surgery and during post-op follow-up).  In my humble opinion, this allows for us 'positive orientation types' to be considered for perhaps new and experimental surgery to fix our knees - because our health care providers and OS's do not want the proverbial problem children on thier hands. 

But even types who see the glass 'half empty' rather than 'half full' CAN REORIENT their ways of thinking to incorporate a positive mindset.  You just KNEED to want to change badly enough!!!!

Cheers to all knee geeks and your families !!!!  :D

Knee-will-be-great!!!!!!!
Medial Menisectomy, 1 ACL Autograft, 3 ACL Allografts, HTO, numerous debridements, good now :)
ACL Allograft #3 Post-Surgery Rehab/Wellness Diary http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=37218.0;all
ACL Reconstruction VIDEOS http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=37773.0

Offline Run Forest, Run !!!

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Re: OPEN WEDGE HTO - DONE! Now the healing begins ....
« Reply #4 on: January 25, 2006, 04:24:16 PM »
Hey Guys ...

I almost forgot ...
Please, check out Active Release Techniques...
I do it for all my scar tissue buildup, sports injuries, etc .
After my operation, I had TIGHT Hip Flexors, and Physical Therapy does not address this ...
A.R.T. does, and did ... And, you only have to go for 5-10 visits ...

Go Here ... http://www.activerelease.com/ ...
Or, lookup Active Release Techniques, or A.R.T., for short ...
You WILL be thanking me !!!

Craigger ...  ::)
No more tightness, binding, tight calves and tibials ... All gone ...
And the best yet, it REDUCES swelling GREATLY !!!
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 katmomx2

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Re: OPEN WEDGE HTO - DONE! Now the healing begins ....
« Reply #5 on: January 27, 2006, 02:16:35 AM »
Hello,

I have to comment on #10. I knew in December of 2005 when my OS said " femoral osteotomy" that my life was going to change. I had my job for 10 years and was faced with a huge paycut. I schuduled my operation for june 2005. I had 4 months off work. During that time I decided to go to school. I am in a 2 year program for surgical technology. I am 40 and a single parent of 2 great boys. Ad for relationships mine with my father is better than ever. He is so proud of me doing this. It is also very rewarding to come home and tell my 13 year old how well the old lady did at school.

Your post is so inspirational. People ask " How will you stand in an operating room ?" I just answer " I will do it"

Thanks

Kat
OA lateral compartment left knee
Scope, chrondroplasty,debride, Menisectomy Jan 03 ,Hyalgan series
Lateral offloader brace
Over 30 degree valgus
Distal femoral closing wedge osteotomy 6/05
Loose staple, staple removal and another scope 11/05
Surg tech graduation 2/08
Tech Labor and delivery

Offline knee-will-be-great

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Re: OPEN WEDGE HTO - DONE! Now the healing begins ....
« Reply #6 on: January 29, 2006, 08:32:43 PM »
Thanks for the comments; yep, thing do in fact have a way of working themselves out; sometimes circuitously, but they always work out!!!!  Good for you on the career change!!!!

Cheers!

Now could a few folks post about how long it took them to be walking on both feet (no crutches), post high-tibial osteotomy (open-wedge) .....

Here's hoping to hear from you soon!!!! :-*
Medial Menisectomy, 1 ACL Autograft, 3 ACL Allografts, HTO, numerous debridements, good now :)
ACL Allograft #3 Post-Surgery Rehab/Wellness Diary http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=37218.0;all
ACL Reconstruction VIDEOS http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=37773.0

Offline knee-will-be-great

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Re: OPEN WEDGE HTO - DONE! Now the healing begins ....
« Reply #7 on: February 10, 2006, 06:21:23 PM »
Hi All,

I am 22 day post-surgery now.  The knee feels great!!!

  • PAIN MEDS - NONE: Stopped taking paid meds of any kind 3 days post-surgery.
    RANGE OF MOTION - 0 to 125 degrees
    SWELLING: Just araound the imajor ncision site.
    SCAR: Well, I'll never have um, two beuatiful legs - but I am least have one!!! - that being the multi-operated one!!!! Makes for good dinner party conversations; me and my knee have been on quite a journey!!!!  I am using Vitamin E oil on the wound, since I now have a scab on it.
    FITNESS LEVEL: I feel great !!!!  My left leg's quadriceps, gluts and hamstrings are strong; my bicenps and tricpes are pronounced and can hold me while I am crutching around (no complaints).
    WEIGHT
-BEARING: None yet.
OVERALL:  Still feel weak owing to the rigours of the surgery, but that too will pass!!

Love ya' all!!!!

Knee-will-be-great! :-*

Medial Menisectomy, 1 ACL Autograft, 3 ACL Allografts, HTO, numerous debridements, good now :)
ACL Allograft #3 Post-Surgery Rehab/Wellness Diary http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=37218.0;all
ACL Reconstruction VIDEOS http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=37773.0

Offline knee-will-be-great

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Re: OPEN WEDGE HTO - DONE! Now the healing begins ....
« Reply #8 on: March 06, 2006, 08:11:07 PM »
Hi All,

Now 6 1/2 weeks post HTO !!! 

Range of Motion is 0 - 125-130 degrees .... the rest of the flexion will definitely come as I do more controlled, by-the-book and mandated exercises.  Possibly some more extension may occur, say to - 3 degrees (other leg hyperextends)  .... but only time will tell (and a lot of hard work <always according to the doc's and physio's strict orders>)

Swelling is minimal.

Still non-weight-bearing (no big deal) for another 2 weeks ... as per doc's orders.  After that, partial weight-bearing with the good old crutches by my side.

Starting to use stationary bicycle (little or no resistance) - every day for 20 minutes.

Lifting ankle weights with straight (locked knee) - 3 times/day

To all bad knees out there: Don't give up on your crap knees folks !!!!  Life will be good - and just think, our knee problems, while great to us, are just a drop in the bucket for many others ... I keep thinking of the para-Olympics which are just starting in Turin - to keep me focused and real.  If the para-Olympic athletes can overcome their physical issues and be shining and positive examples of vibrant lives lived, so can we crappy-knee folks !!!!!!!!

Cheers to all from Knee-will-be-great !!!!!!!!!!!!!!

Open-wedge, internal fixation HTO = Best thing I ever did !!!! 
Medial Menisectomy, 1 ACL Autograft, 3 ACL Allografts, HTO, numerous debridements, good now :)
ACL Allograft #3 Post-Surgery Rehab/Wellness Diary http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=37218.0;all
ACL Reconstruction VIDEOS http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=37773.0

Offline katmomx2

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Re: OPEN WEDGE HTO - DONE! Now the healing begins ....
« Reply #9 on: March 06, 2006, 08:25:22 PM »
Sounds like you are doing great. I am so happy for you. Your attitude is truly inspirational. I am almost 9 months post op and getting better each day.

Kat
OA lateral compartment left knee
Scope, chrondroplasty,debride, Menisectomy Jan 03 ,Hyalgan series
Lateral offloader brace
Over 30 degree valgus
Distal femoral closing wedge osteotomy 6/05
Loose staple, staple removal and another scope 11/05
Surg tech graduation 2/08
Tech Labor and delivery

Offline knee-will-be-great

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Re: OPEN WEDGE HTO - DONE! Now the healing begins ....
« Reply #10 on: March 21, 2006, 10:05:51 PM »
Hi Everyone !!!!

I am now 8 1/2 weeks post-HTO - and I am extremely happy with the outcome; in fact I am so happy I could just, well, burst, jump up for joy, shout halleluyah to the stars, float on cloads ... well you get the point - I am quite pleased.

I took my first step on two feet yesterday.  I am still using crutches and only partially weight-bearing - but the pain-free feeling is absolutely invigorating to my mind, body, spirit and soul !!!

I have been faithfully following my cojoint Physiotherapist?Orthopaedic Surgeon prescribed protocol.  I started bicycling on a recumbent bicycle approx. 11/2 weeks ago (no resistance on the pedals, however) - and have brought up the time frame from 20 minutes to 1 hour - essentially 3 rounds of 20 minutes.
May
Remember folks, attitude regarding rehab does make a considerable amount of difference when recovering from such intensive surgery.

May God bless all of us bad knee folks with less pain and fewer mobility problems in each and everyone of our respective futures!!!!!

Cheers from the crap-knee rehab pit !!!!!!!

Knee-will-be-great !!!!!!!!
Medial Menisectomy, 1 ACL Autograft, 3 ACL Allografts, HTO, numerous debridements, good now :)
ACL Allograft #3 Post-Surgery Rehab/Wellness Diary http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=37218.0;all
ACL Reconstruction VIDEOS http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=37773.0

Offline meljoh

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Re: OPEN WEDGE HTO - DONE! Now the healing begins ....
« Reply #11 on: March 22, 2006, 08:06:07 PM »
I have to say that your post was an absolute pleasure to read. I have it bookmarked on those days when I am feeling less like myself!!

I am just a tad over 6 months post op for open wedge HTO. My surgery was on September 14th last year. I was partial weight bearing from day one per OS instruction. I dropped to one crutch the beginning of November and remained so for 2 weeks, again per OS instruction. The week of Thanksgiving I was walking with no crutches, cane, any other assistance. So total assistance lasted for about 9 weeks. At about the 6 weeks point I was using crutches more for balance (for lack of a better term) and support than acual walking itself. At that point I was total weight bearing, again using the crutches simply to keep me from "falling" as I regained strength and what not in my leg.

As far as success, I would so for the purpose intended, the surgery worked. I have not been able to find anyone else who had the procedure for the same purpose I did, so it's hard to compare. I did have some other issues that there was a small chance of this surgery helping with, but seems it didn't. It's crappy because I know I likely face another operation this year, but on the same token I am ok with that. Because I knew that going in, understood it, and have 200% faith in my doctor, it's not a bother. The reason for which I had the HTO was by chance we found it out. Nonetheless, it was a huge deal and was the cause of very much pain. So hey, at least it's one less problem for me  ;D

Again, a pleasure to read your post and the best of luck with your continued awesome recovery! You are an inspiration to so many people on this board. I think because of where this is posted, some who could use it might not see it. I sure hope they explore and find it. Regardless of the procedure, I think this is awesome advice for all!!

~Melissa
3/93 scope torn meniscus, 10/00 sched for LR but remvd exc. scar tiss 11/01 LR,  repair  degen men. tear 10/02 TTT with agg. trauma since 12/04 screw rem. dlng w/bone mass loss in knee, medial subluxg 9/05 open wedge HTO. More to come...

Offline knee-will-be-great

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Re: OPEN WEDGE HTO - DONE! Now the healing begins ....
« Reply #12 on: March 23, 2006, 04:14:02 AM »
Thanks so much for your coments Melissa.  It is very humbling and an eye-opener to have lived in constant pain for so many years - and now to have had it be gone.  I want to make people aware that there is an opportunity to have grace and feel good.  Yes, sometimes it takes a while to find a surgeon who will beleive in you - and who is willing to work on you - particularly if you have had many previous knee surgeries ... but I say this over and over again folks - chin up - and just keep on going.

May God bless us all and provide us with good surgeons (who are decent human beings) available to work on us.

Cheers to everyone .....

Knee-will-be-great!!!!!!!!!
Medial Menisectomy, 1 ACL Autograft, 3 ACL Allografts, HTO, numerous debridements, good now :)
ACL Allograft #3 Post-Surgery Rehab/Wellness Diary http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=37218.0;all
ACL Reconstruction VIDEOS http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=37773.0

Offline meljoh

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Re: OPEN WEDGE HTO - DONE! Now the healing begins ....
« Reply #13 on: March 23, 2006, 04:36:53 AM »
You are so very welcome!

If you don't mind my asking, what is your history that you seem to have overcome so well? As I said eariler haven't found anyone with a similar problem to mine as far as why I had the HTO. What was the problem with your knee? Are you feeling confident that it was the last surgery (if it wasn't your first)?

Take care and best wishes!

~Melissa
3/93 scope torn meniscus, 10/00 sched for LR but remvd exc. scar tiss 11/01 LR,  repair  degen men. tear 10/02 TTT with agg. trauma since 12/04 screw rem. dlng w/bone mass loss in knee, medial subluxg 9/05 open wedge HTO. More to come...

Offline MWalker

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Re: OPEN WEDGE HTO - DONE! Now the healing begins ....
« Reply #14 on: March 26, 2006, 07:56:22 AM »
Hi

I am going in for a HTO on 47/06 at the HJD in NYC. What is an open wedge? Is that the plate stickingoutside of your knee. Your pstings were spectacular..........hope to get n as much exercise and good thoughts over the next 12 days b4 the big day.   Thanks again,  Matt
Dislocated knee in 1989 in Budapest, Hungary
Arthoscopic surgery in September, 2004 on left knee
HTO on right knee in April, 2006
Presently "bone on bone" in both knees
"I am too young for this"