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Author Topic: knee osteotomy  (Read 1061 times)

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Offline bergew

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knee osteotomy
« on: January 26, 2006, 10:30:06 AM »
Our orthopaedic surgeon has just mentioned that my wife might have to undergo osteotomy of the knee. She is nearly in constant pain. Is there some kind of alternative treatment like physiotherapy or drugs that might relieve the knee pain and maybe help to avoid the operation.  thanks.

Offline Doc79316

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Re: knee osteotomy
« Reply #1 on: January 26, 2006, 10:41:32 AM »
Hi,

There are many drugs out there that may relieve pain but won't resolve the problem. Physio can be very effective in terms of regaining muscle strength and flexibility which depending on the problem, can postpone surgery for a time.

It would help to know exactly what's wrong with your wife's knee. Why does she need an osteotomy procedure? What sort of procedure is it - Femoral? Tibial?

If you could give more info, we could advise you better hopefully,

Laura
Left knee surgery
08/06/02 - L/Release
13/08/03 - Fulkerson TTT
05/06/05 - Stabilisation & Medialisation/Tendon Transfer
13/01/06 - Proximal Hamstring Superior Stabilisation
06/03/06 - RSD/CRPS diagnosed
20/07/06 + 03/04/07- Excision of scar tissue
30/07/07 - PKR suggested by OS (no date yet)

Offline bergew

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Re: knee osteotomy
« Reply #2 on: January 26, 2006, 10:55:32 AM »
Thanks Laura for your prompt reply. The problem is that the cartlidge of the knee got worned out on one side. The doctor siggested that an knee osteotomy may be indicated to throw the weight on the remaining good part of the knee. A unicompartmental knee replacement was mentioned too, but my wife is still young for a knee replacment. Hope this info will help to explain the situation.

Offline Doc79316

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Re: knee osteotomy
« Reply #3 on: January 26, 2006, 11:09:09 AM »
Hi,

OK. At a guess (& I could be wrong so speak to your OS) the osteotomy procedure has been suggested as a way of altering the forces through your wife's knee as she uses it.
I had this done 2 1/2 years ago - the procedure being the Fulkerson Osteotomy/TTT surgery/High Tibial Osteotomy.
There will probably a load of x-rays/scans etc to be looked at before the surgery to see what changes have occurred in her knee, if any, since it was last examined. Have you had a date for the surgery yet?
Before the surgery, physio may help to strengthen the quad/VMO muscles at the side of the knee. Mine were very weak after surgery and still are. If you go into surgery with strong muscles then it's much easier to cope after the surgery. Other than that, I don't think there's any way of avoiding the surgery as there's no way of reversing the damage that's been done.
Your wife may also consider taking Glucosamine Sulphate supplements. They help with joint flexibility etc so may ease a little pain for her. There are no side effects and she would only notice a difference after a few weeks of taking them so don't give up too early. However, for some people, they just don't have any effect. But ya don't know until ya try!
My personal opinion is that it would be better to have the problem rectified now withe Osteotomy than try for a more difficult surgery like knee replacement.

Hope this helps. If you want to know more details about the surgery, let me know.

Laura
Left knee surgery
08/06/02 - L/Release
13/08/03 - Fulkerson TTT
05/06/05 - Stabilisation & Medialisation/Tendon Transfer
13/01/06 - Proximal Hamstring Superior Stabilisation
06/03/06 - RSD/CRPS diagnosed
20/07/06 + 03/04/07- Excision of scar tissue
30/07/07 - PKR suggested by OS (no date yet)

Offline bergew

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Re: knee osteotomy
« Reply #4 on: January 26, 2006, 12:44:21 PM »
Laura for the time being many thanks for your assistance. We will speak again to our OS.

Offline Charliemouse

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Re: knee osteotomy
« Reply #5 on: January 26, 2006, 01:08:08 PM »
Just a word about Glucosamine, it isn't quite side effect free.
It doesn't agree with everyone. I can't take it as for some reason it upsets my stomach and I believe I'm not the only one here who has suffered this.
18/06/05 Injured trampolining
Fixed Flexion 20-90 deg until...
01/09/05 lateral meniscectomy (40%)
09/06/06 Patella tendon aclr
09/09/06 Back on the tramp (carefully)
10 years on and still going strong
!!Stop twisting when you land or it hurts!!

Offline katmomx2

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Re: knee osteotomy
« Reply #6 on: January 27, 2006, 02:32:56 AM »
Hello bergew,

What type of osteotomy is the os recomending?  Why?? Does she have medial or lateral damage?? I ask this because I had a femoral osteotomy for lateral damage. I am 7 month post op. Glucosamine/chrondroitn and msn did not help me as my lateral compartment was to worn out. I am a "younger patient 40" If I can help please let my know.

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 Heather M.

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Re: knee osteotomy
« Reply #7 on: January 27, 2006, 08:13:14 AM »
Depending on how widespread her damage is, she may benefit from an unloader brace.  It essentially does the same job as the osteotomy--shifts weight from one compartment (lateral or medial) to the other, with the intention of taking weight of areas of damaged cartilage.  If she only has damage in one area (medial or inner knee or lateral/outer knee compartment) then this might be a good conservative option.  Some doctors will try this as a 'test drive' to see if the osteotomy will work.

While the TTT or osteotomy will often successfully take the weight off the damaged area, it will not actually do anything to address the damage itself.  And an area of deep articular cartilage damage can still hurt, even if it has been 'unloaded.'  Kind of like a skinned knee can hurt even when you aren't walking on it.  Of course, this is not true in every case, each and every knee is different...but it is something worth considering and discussing with the surgeon.

When in doubt, and when major surgery is recommended, it is never a bad idea to get a second opinion.....

Heather

PS Here's some good, easy to understand information on articular cartilage damage:  http://www.steadman-hawkins.com/knee_chondral/overview.asp  Unfortunately, there is no sure-fire way of fixing damaged hyaline cartilage.  It is literally the Holy Grail of orthopedics, meaning everyone is searching for some way to do this.  But there are a couple of different cartilage restoration techniques out there, and each has pros and cons and indications.  So that might be worth discussing along with the TTT/osteotomy.

Scope #1: LR, part. menisectomy w/cyst, chondroplasty
#2-#5: Lysis of adhesions/scar tissue, AIR, patellar tendon debridement, infections, MUA, insufflation
#6: IT band release / Z-Plasty, synovectomy, LOA/AIR, chondroplasty
2006 Arthrofibrosis, patella baja
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Offline bergew

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Re: knee osteotomy
« Reply #8 on: January 29, 2006, 08:04:55 AM »
Many many thanks for your assistance. I want to thank all of you. With the info you provided us, we now have a clearer picture of the sutuation. Thanks again.