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Author Topic: HTO? Decision time-HELP  (Read 1982 times)

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Offline 2soreknees

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HTO? Decision time-HELP
« on: July 02, 2006, 01:37:02 AM »
I hope one or some of you can give me some advice.  My OS has given me a list of choices concerning my chronic knee pain (right).  First a bit of background.
I have been wearing an unloader brace for 1 1/2 years.  If helps a little while I am wearing it but when I take it off the pain is AWFUL.  Also the brace makes my skin break out in a rash (I have very sensitive skin).  The latest MRI shows a bone spur on my MFC again and severe DJD.  I have already had two surgeries on this knee both included microfractures.  My patella is tilted and does not track correctly.  Now to my choices.

1. Stay in the brace and get Hylagen injections.  I did this once and it helped for about 6 months, but it is so expensive and my insurance company only allows it once a year.  He says I can wear this brace for another 3-5 years.  This is the choice my hubby would take.  But as I said the brace is SO uncomfortable.

2. Have another arthroscope, remove the spur and clean up what is floating around in there.  THen back to the unloader brace once I am healed from surgery...

3. Or last but not least, have a high tibial osteomy.  THis would get my out of the unloader brace but I am taken back by how serious my OS is about this surgery.  I have had a TTT and that took about a year to recover completely.  Anybody have any advice??  I would love some input from those of you who had had this kind of surgery!  And of course I appreciate any feedback from my fellow knee geeks.

THanks Guys
2/02 (R)arthro. meniscus tear, microfractures, grade 4 chondro. under patella.
TTT/LR on (L) 3/03. 
11/04 Arthro (R) MF
4/06 (L) clean up and trim back scar tissue from LR
11/06 (R) HTO
8/08 (R) Hardware removalMFR
8/09 L microfactures
12/09 LTKR
11/11 R TKR and last knee surgery!

Offline j_smi001

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Re: HTO? Decision time-HELP
« Reply #1 on: July 02, 2006, 08:24:03 AM »
I have had a HTO twelve weeks ago.  My knee pain is all but gone and so from that point of view I would recommend the procedure.  It is fair to say I was unfortunate to have complications and therefore you would not ask me to choose your lottery numbers, however this is significant surgery and will take time and effort to recover from but can be done.  Your medical team will explain it all to you. 
2002 plica removal, chrondoplasty both knees and LR right knee. Derotational tibial osteotomy rt leg 07/04/06.  Awaiting for left leg to be rotated and have no more knee pain!

Offline emphatic

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Re: HTO? Decision time-HELP
« Reply #2 on: July 05, 2006, 12:57:51 AM »

I'm curious... if you're having some relief from an unloader brace, then your joint damage must be primarily in one compartment? (A huge conjecture on my part, I'll admit.)

I'm wondering if you've ever been offered a unicompartmental knee replacement (also known as a partial knee replacement)? Or, a total knee replacement, if you have damage in more than one compartment.

Essentially, the HTO is just a super unloader -- it's meant to change your weightbearing surface to another part of your joint. Some people use it to buy time before having a total knee replacement, but if you're a candidate, a unicompartmental replacement is a very useful and successful alternative.

Just my thoughts...  :)