Banner - Hide this banner





Author Topic: OPEN WEDGE HTO - DONE! Now the healing begins ....  (Read 25601 times)

0 Members and 1 Guest are viewing this topic.

Offline ninafin

  • MINIgeek (20-50 posts)
  • **
  • Posts: 48
  • Liked: 0
  • lateral PKR done on 3 April 06.
Re: OPEN WEDGE HTO - DONE! Now the healing begins ....
« Reply #15 on: March 26, 2006, 12:13:45 PM »
Hi everyone especially knee-will-be-great

I found this site by accident - was desperately looking for some info on knee surgery as I'm due to have an open wedge femoral osteotomy next Monday, 3 April.
I was really scared until I read all you posts.  Your very positive comments have made me feel so much better.  I feel much more prepared for the op now.  Thank you all so much.
I've always been very fit, a marathon walker, camper and climber until my knee gave out on me a couple of years ago.
I bought a small automatic campervan, Bongo Friendee, which has been a life saver and meant that I could at least go camping with my friends.  I've booked for WOMAD (world music festival) in Reading this July, so I hope I'll see some of you there.  How far along the healing road do you think I'll be at the end of July?
I'm not sure how much time I'll need off work.  My work is pretty sedentary but there's a steep flight of stairs between me and my office!  Does anyone have any idea?   The doc tells me between three and six months, but is pretty vague about it.  i suppose it depends on how I manage after the op.
Like you, knee-will-be-great, I've been trying to keep fit and healthy, I've lost the 7kg I put on a year ago and I'm able to use my exercise bike regularly so you're going to be my role model over the next few months!!
Good luck, all, with your rehabilitation.  It's great to have found a brilliant support network of people who know what it's like.
Nina



Offline knee-will-be-great

  • Forum Faithful
  • ****
  • Posts: 390
  • Liked: 0
  • Open-wedge HTO & ACL allograft done (YES!)
    • ACL Allograft #3 Post-Surgery Rehab/Wellness Diary
Re: OPEN WEDGE HTO - DONE! Now the healing begins ....
« Reply #16 on: March 26, 2006, 12:43:46 PM »
Hello All..... thanks for your comments about my comments .... It is good to know that people are encouraged by my words and experiences.

Firstly, my comment to Matt ..... An open wedge osteotomy means that you tibia, will be sawed open - then forced open with a jack (yes a jack), then a wedge of bone will be placed in the area that has been jacked open.  Matt you should know that open wedge HTOs can either be "internal fixation" (like mine - where there is a 4" to 5" metal plate that is affixed to the bone with 4 screws and washers - to keep the opened wedge open so that the donor bone can be packed into the open wedge).  See this link for an explanation.  See http://www.steadman-hawkins.com/images/osteotomy.pdf\  as an example. Note the bone for the open wedge, internal fixation can either be taken from your hip bone or (a donor (cadave)r or a real live person who may have allowed the bone cut out of their bodies <after knee replacement or hip replacement>.

Another type of open wedge HTO is the "external fixation", where there is no bone taken form anyone to pack the "open wedge".. Instead, your tibia is once again sawed through - but the open wedge in your tibia is kept apart by an external metal fixator - and in this situation you essentially grow your own bone.  See http://www.limblengthening.com/beforeafter.html Take a look at Case History # 7 and # 11 - and hit the patient's information on the left side of their photos - to get more details and more photos and x-rays.

For the lady having her HTO on April 5rd, here's a link; in fact Matt you should look at this link as well.  It is entitled a PATIENT'S GUIDE TO TIBIAL OSTEOTOMY .... http://www.eorthopod.com/eorthopodV2/index.php/fuseaction/topics.detail/ID/79791a8f7dd9f446b38653cbeab9a955/TopicID/b94a434439ab8222dc02c4c1283e4741/area/17

Folks, I cannnot state this more clearly .... DO YOUR HOMEWORK!!!  Get onto the web and google things like "High Tibial Osteotmony", before and after photos, studies, etc.
I cannot tell you whether you will be able to go do thoings by July, but I must tell you that you HAVE TO EAT PROPERLY AND WELL FOR YOUR HEALING TO PROGRESS QUICKLY.   tHAT MEN NUTRIENT RICH FOODS, NO JUNK, NO ICE CREAM.  REMEBER, YOU ALONE CAN MAKE THE DIFFERENCE IN HOW YOU HEAL.   For good information on the correct nutrition to invoke now, see "The World's Healthiest Foods" ... Here's the link.   http://www.whfoods.com/

Cheers to all from .... 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

  • Forum Faithful
  • ****
  • Posts: 390
  • Liked: 0
  • Open-wedge HTO & ACL allograft done (YES!)
    • ACL Allograft #3 Post-Surgery Rehab/Wellness Diary
Re: OPEN WEDGE HTO - DONE! Now the healing begins ....
« Reply #17 on: March 26, 2006, 12:59:59 PM »
FOR GOOD INFORMATION about HTOs, OPEN WEDGE htos and CLOSING WEDGE HTOs, and the PROGRESSION OF ARTHRITIS (animated) in a knee joint on the medial aspect of the knee, click on this site:

http://www.eorthopod.com/eorthopodV2/index.php/fuseaction/topics.detail/ID/79791a8f7dd9f446b38653cbeab9a955/TopicID/b94a434439ab8222dc02c4c1283e4741/area/17

The site was created by the Montana Spine Centre.  Read everything it has to offer on this site - and click on the links on the site, i.e. the Open Wedge, Closed wedge link, the Knee Arthritis and other links on the site.  This is a really top-notch information presented in an easy-to-understand and pictorial fashion.

Cheers again from 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 MWalker

  • Regular Poster
  • ***
  • Posts: 114
  • Liked: 0
Re: OPEN WEDGE HTO - DONE! Now the healing begins ....
« Reply #18 on: March 27, 2006, 05:18:38 AM »
That web site was the best information I got to date on HTO's. Thanks for suggesting it.  Can you tell me more about your recovery? I am very intersted in hearing about whether it worked or about your pain management etc.,. I am having the open wedge HTO. I remember my OS telling me I am not going to need the external device. I hope the HTO works. I know that the inevitable is a TKR but I am hoping for the best.

By the way, my MD put me on an oral steroid for 5 days. I started today and was able wo walk all around Manhattan today. I felt like I had my old knees back. I felt great. Just some info fo rthose in similiar situations. Thanks everyone.  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"

Offline knee-will-be-great

  • Forum Faithful
  • ****
  • Posts: 390
  • Liked: 0
  • Open-wedge HTO & ACL allograft done (YES!)
    • ACL Allograft #3 Post-Surgery Rehab/Wellness Diary
Re: OPEN WEDGE HTO - DONE! Now the healing begins ....
« Reply #19 on: March 27, 2006, 02:31:28 PM »
Hi Matt and everyone else.

Firstly, (Matt) remove from your mind the concept that you will definitely need a TKR in the future.  In my opinion, that is a way to live sub-optimally after you have had the HTO.  Check out alphaklinik and Dr. Juergen Toft (in Germany).  You will note that this highly repsected clinician and orthpaedic surgeon eschews TKR unless the situtation is dire and a person is elderly.

Why be defeatist in attitude ????  Get rid of the weight after HTO - and then go, go, go !!!!

Read these articles Matt.

http://www.alphaklinik.de/en/toft/news/20000kneeoperation

http://www.alphaklinik.de/en/toft/diagnosis_therapy/arthritis/joint_prothesis

Incidentally, my research indicates that total kne replacement costs the medical system 3 times as much as an Osteomoy .... and if the stats I see are in fact true, then why are so may TKRs being done on realtively young patients? 

I personally will opt for joint resurfacing at some time in the future.

Matt, I was given pain meds during my 3 day hospital stay post-surgery.  I used NO PAIN MEDS after I went home - yes, that's right, 3 days after the surgery I did not need pain meds of any type.  I think that too many peiple depend on such things when there is really no need.

I am healing very well - am walking on both leg using my crutches - but not putting the full weight of my body on the operated leg as-of-yet.

Eat well, heal well, don't self-medicate with food .... take control of your life - you only have one to live - so why let something else (like food) control it?

Cheers from 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

  • Forum Faithful
  • ****
  • Posts: 390
  • Liked: 0
  • Open-wedge HTO & ACL allograft done (YES!)
    • ACL Allograft #3 Post-Surgery Rehab/Wellness Diary
Re: OPEN WEDGE HTO - DONE! Now the healing begins ....
« Reply #20 on: March 27, 2006, 05:24:56 PM »
Hello Matta and everyone ... here's one more comment as to the inadvisability of the seeking popular "knee jerk reaction" (pun intended) to providing younger, not sedentary people with knee replacements ...

It seems that more efforts should be undetaken by the medical community to fix knees using patient's exisitng body parts - and not to implant said TKR parts which invariably wear out and cause problems.  Also, sports and TKRs are contraindications.

http://www.alphaklinik.de/en/toft/diagnosis_therapy/arthritis/joint_prothesis-detail

PS - Dr. Toft did not do my surgery .... so I am not advocating him for any other reason other than my belief that what he says about TKRs and their necessity on younger patients seems logical and rational.


Cheers .... Stay Happy and Positive .... 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 MWalker

  • Regular Poster
  • ***
  • Posts: 114
  • Liked: 0
Re: OPEN WEDGE HTO - DONE! Now the healing begins ....
« Reply #21 on: March 28, 2006, 06:42:28 AM »
My fantasy is that once I get these two HTO's, I will be able to walk log distnces, swim in rivers again and be able clime the Adirindack Mountains to give praise to the Creator for brinking me healing and good medical care. Your vision for you is what I want for me.  The day before surgery, I am getting a haircut and pedicue ( you have to have clean feet for the doc's); I am going for a reikki treatment and massage and then offt to the movies. I will walk along the Williamsburg Bridge to get home to my 4 story apartment and collapse before my partner makes me a nice, nutrtious meal. Some phone calls to make to my family then I am off to sleep.

I am looking at this as gods grace to fine tune some parts becasue I have  alot more mileage to go on this long road called my life.
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"

Offline MWalker

  • Regular Poster
  • ***
  • Posts: 114
  • Liked: 0
Re: OPEN WEDGE HTO - DONE! Now the healing begins ....
« Reply #22 on: March 28, 2006, 06:48:42 AM »
few more question?

When you wake up, when do they expect you to start using your crutches? What happens the first day of surgery and what do they expect from you. Dou they use the dreade catheter in men and guys, does it hurt?

Whats the average lenth of stay for a HTO procedure?

When do they sent PT home to you?

What kind of pain killers are best for when you get d/c?

What will I wear, a brace, caste , stints?????



Sorry,to go on an on, but I am a bit nervous and the more I know the better. Thanks all---you guys are the best!

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"

Offline knee-will-be-great

  • Forum Faithful
  • ****
  • Posts: 390
  • Liked: 0
  • Open-wedge HTO & ACL allograft done (YES!)
    • ACL Allograft #3 Post-Surgery Rehab/Wellness Diary
Re: OPEN WEDGE HTO - DONE! Now the healing begins ....
« Reply #23 on: March 28, 2006, 11:13:03 AM »
Hi Matt,

Please read my first posting on this topic for a perspective on what I recommend generally.  Tjere are 13 points.

In answer to your questions, here are my comments:

1) Crutches - I was shown how to use crutches the second day after surgery.

2) Catheter - I am a woman - and did need to be catheterized when I awoke from surgery, because I could not void.  Some people just stop being able to because of the effects of anasthesia, the medication provided to you during surgery, or, the oxycontin/percoset given to you after surgery.  Men, similarly may be affected - and therefore you would need to be catheterized.  It is no big deal.  Just get over your fear man!  After the heavy post-surgical pain kililers are discontinued, a person is usually able to void.  I was able to void on my own after two days; and I crtuched to the bathroom - with a nurse/aid of course - because after the first two days post-surgery, you are still groggy and not so fast or steady on your feet.

3) Home Physiotherapist - I was not provided with a home physiotherapist.  I am very fit and did not need anyone to show me how to do exercises.  Fort hte first wek or two there are few exercises to do other than what specifically the physiotherapist tells you to do when you are in the hospital.  You may be given an exercise and activity protocol when you are still in the hospital - but that depends on your OS and the protocol he/she prescribes.

4) Pain killers - I repeat, one more time, I did not use pain killers after I left the hospital.  A minor or dull ache is no reason to be medicated.  I repeat, you really do not need to be medicated for the smallest little thing - and the ache (for me) just wasn't there.

5)  Brace - I woke up with the brace on my leg.  The leg was braced in a straight position while I was in the hospital - thereafter on the day I was released from hospital, (78 -79 hours after surgery), my brace was adjsuted to allow me to bend my knee up to 90 degrees.  You must have your brace on at all times, however - or until your orthopaedic surgeon says that you can leave it off while you sleep.

Cheers ......... 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 MWalker

  • Regular Poster
  • ***
  • Posts: 114
  • Liked: 0
Re: OPEN WEDGE HTO - DONE! Now the healing begins ....
« Reply #24 on: March 28, 2006, 01:23:46 PM »
Thanks for your post,

I am off to the gym now. I agree to get in as much as I can before the big day. My only question to you after reading all of your very helpful info is, don't we have to be completely non weight bearing for 2 months and to not bend the kness, in order for the bones to " join" . I am so confused about this. MY HTO is at the tibia to affect the medial compartment. I don't know where I would be without this site. Much thanks.  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"

Offline knee-will-be-great

  • Forum Faithful
  • ****
  • Posts: 390
  • Liked: 0
  • Open-wedge HTO & ACL allograft done (YES!)
    • ACL Allograft #3 Post-Surgery Rehab/Wellness Diary
Re: OPEN WEDGE HTO - DONE! Now the healing begins ....
« Reply #25 on: March 28, 2006, 11:15:13 PM »
Hello Matt and all other kneegeeks...

RE: Your last posted questions about the HTO:

1) WEIGHT BEARING - Yes, you will be completely non-weight bearing for 2 months.  You perhaps should go down the stairs from your 4th floor apartment to the 1st floor - on your rear end - perhaps one step at a time.  Remember, a fall is not something you want to experience.  I would stay in the house for at least 3 weeks.

2) LEG BRACED IN STRAIGHTENED POSITION (no allowance for bending in the brace post-surgery), OR LEG BRACED WITH ABILITY TO FLEX BRACE FROM STRAIGHTENED TO NON-STRAIGHTENED POSITION (about 90 degrees) - this really depends on your surgeon and how your knee can bend 3 days after surgery.  What the physiotherapist at the hospital said to me was that the ywould assess my range of motion (ROM) post-surgery.  This was done 2 days after surgery, as I said.  My ROM was 0 degrees (totall straight leg) to 130 degrees (almost totally bent - when compared to the 'good knee').  USUALLY A 'GOOD KNEE WILL BEND TO ABOUT 135 DEGREES).

Cheers again .... stop worrying .... gives thanks for you are lucky and blessed to have this done ..... be confident that it will all be okay ....

Knee-will-be-great....
Now Matt, I cannot tell you nor anyone else whether you will have the same orthopaedic experience as I.  Each surgeon has different protocols.
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 MWalker

  • Regular Poster
  • ***
  • Posts: 114
  • Liked: 0
Re: OPEN WEDGE HTO - DONE! Now the healing begins ....
« Reply #26 on: March 29, 2006, 05:49:52 AM »
Thanks again,

I plan on being in the apartment for a few weeks. And, you are so right that I am lucky. I was telling the RN today how lucky I feel that I have great insurance and great health care. I am never one to complain, anyway. I obsess and worry but never complain,   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"

Offline ninafin

  • MINIgeek (20-50 posts)
  • **
  • Posts: 48
  • Liked: 0
  • lateral PKR done on 3 April 06.
Re: OPEN WEDGE HTO - DONE! Now the healing begins ....
« Reply #27 on: March 31, 2006, 03:17:04 PM »
Hi folks
It's great reading all your comments - and to share your experiences.

I thought I was going into hospital on Monday for an open wedge osteotomy.  Well, I've just got home from seeing the consultant surgeon and it looks as if an osteotomy is out for me.  I had lotsa Xrays, including a one from hip to foot.  Apparently my knee is so turned inwards that it would not be possible to do.  I think he said something about a 14 degree angle!  So he has recommended a partial knee replacement.  So now it's back to the drawing board to research PKR.  Is there anyone out there who can point me in the direction of a website or share their own experiences?  I'd be really grateful for your help.  Great lesson though in change - I have been expecting to have an osteotomy for so long that I feel a wee bit disoriented now that I know I'm not going to have one!!

"Knee will be great" - your posts have really inspired me and gave me the push I needed to continue with healthy eating, exercise and spiritual contemplation.  Thanks for that - and it would be great to hear more about your rehabilitation.
"Matt" - I'm scared too, this is the first op I've had to have (apart for an emergency caesarian but that was quite a long time ago).  However, like you I'm finding so much support, both from this site and from friends and family.  Like you, I too like to know what to expect.  Good luck with your pending op, and I'll be thinking positive thoughts for you across these thousands of miles.

Soooo....I'll post more about my PKR and how I'm feeling after the op on Monday.  I must admit that the nursing and radiology staff here in Wales have been fantastic to date.  My OS has a fabulous reputation too - phew!!

Lotsa love knee geeks all
Nina

Offline MWalker

  • Regular Poster
  • ***
  • Posts: 114
  • Liked: 0
Re: OPEN WEDGE HTO - DONE! Now the healing begins ....
« Reply #28 on: April 01, 2006, 05:22:18 AM »
Hi Nina,

Yes, do oyu research. A PKR sounds good though I think the only downfall is that it may make a TKR toughter down the road. Speak to your OS about this . Keep us posted. Thanks for your good wishes. I am off next Friday to get it done. I hope to post to give others feedback. Thanks and keep in touch         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"

Offline ninafin

  • MINIgeek (20-50 posts)
  • **
  • Posts: 48
  • Liked: 0
  • lateral PKR done on 3 April 06.
Re: OPEN WEDGE HTO - DONE! Now the healing begins ....
« Reply #29 on: April 01, 2006, 09:28:32 AM »
Hi Matt
Good luck with your op next Friday.  I'll be thinking about you.  You sound very positive about it and just think about the long term benefits..............
We'll be able to compare notes!  I'll keep you all posted on my progress.  Apparently my right knee is beginning to turn in more but I thought that was related to the problem I have in my left knee.  I think I'll need to keep an eye on that one.  I've always been a bit knock kneed though!!
Lotsa love to all you knee geeks out there across the world.  Great to have that support network.
Nina















support