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Author Topic: Proximal tibial osteotomy  (Read 6352 times)

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Offline a7yritch

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Proximal tibial osteotomy
« on: July 20, 2002, 07:35:42 AM »
 ::) HI everyone,  I would be most grateful for any and all comments on having a tibial osteotomy.

OS just told me I should really consider it.  History......I was in a head on collision Sept. '98, my knee went through the dash and suffered some tears, and my knee cap rotated.  Feb. '01 finally had a scope to fix the tears, also had LR.  June '01 had sin visc treatments, and tons of cortisone treatments since.  NOTHING has helped in the least.  Now, OS tells me that Im bowed legged, and this along with the aggrivation from the auto accident has worn my knee down to nothing.  He says I need a new knee, as well as some tendon surgery, but wants to try this first.  I havent yet had my 2nd opinion, but go on Aug. 2nd to the Rothman Institute at Jefferson, in Philadelphia.  

I am really not looking forward to this procedure, I'm scared and anxious.  I am only 33 yrs old, and now looking at 2 major joint replacements.  ( I also got TMJD from the airbag, and its tremendous strike on my face.  I will need to have my tempromandibular joint replacement as well)

Any and all advice would be appreciated.  Thanks so much --Angela
--To painfree Days--

Offline Allison

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Re: Proximal tibial osteotomy
« Reply #1 on: July 23, 2002, 08:25:03 AM »
I had an osteotomy 6 years ago. It took an entire year for me to be back to speed. However I couldn't even walk much prior to the surgery. My leg was collapsing in. My OS was a perfectionist and for that I am grateful. My leg is so straight and so strong!
Bad news :-/ I am not living a pain free life. Good news ::) the surgery gave me back strength in my leg that I needed. I now work-out 5 days a week...stepclasses, weight lifting, spinning etc. The only thing I can't do is run. I am 37. I also had my third daughter and survived that pregnancy. My leg stayed strong even with the extra weight.
I was a professional dancer and found it hard to let go and give up.
That forced me to get back on my feet and look at all the blessings I have. They initally thought I had bone cancer...because of the way the osteonecrosis appeared on the x-rays. So I can LIVE with the pain.
After your surgery do you best to stay in shape and keep those muscles surrounding the knee strong.
I know it is scary. I won't sugar coat this. The surgery was painful, but it gave me my active life back and bought me time until the inevitable knee replacement. Best of luck. Let me know if you have more questions!!Allison
Lateral release 1983
Arthroscopic  to diagnose problem1995
high tibial osteotomy 1996 due to osteonecrosis

Offline The KNEEguru

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Re: Proximal tibial osteotomy
« Reply #2 on: July 24, 2002, 11:32:52 AM »
For the un-initiated an osteotomy is an operation where the large bones of the knee are cut through and the angulation of the bone is altered, either by removing a wedge or inserting a wedge. The procedure may be done through the thighbone (femoral osteotomy) or the shinbone (tibial osteotomy).
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Offline The KNEEguru

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Re: Proximal tibial osteotomy
« Reply #3 on: July 24, 2002, 11:54:32 AM »
Arthritic bow legs generally imply that most of the damage of the joint surfaces is confined to one or other side (medial or lateral 'compartment'). The joint surface (cartilage) 'spacer' breaks down and the space collapses on that side and the knee joint becomes angulated.
For an osteotomy to be effective, the joint surface on the other side needs to be fairly good, and the surgeon attempts to wedge the long bone so that most of the weight is going through the healthy compartment rather than the collapsed one.
This only buys time, because the healthy one is then bearing a greater load than normal.
The whole philosophy is to try and delay 'the inevitable knee replacement'. The situation is not good.
Some units are now trying other things to help keep the spacing and prevent the strain on the good side:
1. The Unispacer - a plastic spacer which simply moves around in the joint space on the damaged side, restoring the long bone alignment - very new and not fully evaluated. Only done in a few places.
2. Uni-compartmental knee replacements - a metal and bone knee replacement, but just on the one side of the knee and not both sides like a total knee replacement.  These are not as new as the Unispacer, and there are a few problems still being ironed out, but they promise to 'buy time' and maybe prevent the need for a total knee replacement completely.
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Offline stuntcock

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Re: Proximal tibial osteotomy
« Reply #4 on: August 18, 2002, 09:07:17 PM »
hello everybody
                  new to pc so forgive typing, am 39 yrs old ex runner and competetive weightlifter, due to have a tib ost in november, am very scared ( dont tell my kids they think i am a tough guy) , what i need to know is how long will i be off work ( phys ed instructor ) thanks.
keep squattin !

Offline ken

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Re: Proximal tibial osteotomy
« Reply #5 on: August 18, 2002, 11:45:29 PM »
If you really want to delay your surgery then your OS should put you in a brace from Generation II.  I am a certified surgical technician and I know from experience that their unloader braces relieve symptoms of osteoarthritis and correct bowleggedness.  If you have an osteotomy your surgeon may have problems when you have a total knee in the future.  Delaying surgery is not always the answer because I do not know your condition (history) but there are alternatives that your surgeon should be discussing with you such as NSAIDS (Celebrex) and bracing because of your age.
Take everyone's opinion but have faith in you OS.
Thanks
Ken

Offline agoertze

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Re: Proximal tibial osteotomy
« Reply #6 on: August 23, 2002, 01:31:19 AM »
Hi all!

After years of pain and 2 surgeries later I am on the waiting list for a tibial osteotomy. I had a TTT last december that left me unable to do the simpliest of tasks like walking up stairs! Unfortunately the surgery wasn't as successful as we'd hoped. So a new surgeon and a new outlook later here I go again.

I currently have a Gen II brace and highly recommend it. It really helps with stability. As far as pain goes I found that Celebrex helped in the beginning but it is getting harder to even drive now (right leg). The surgeon is discussing the possibility of doing both as the same time as the left one is not far behind. Hummmm.

I'm just wondering if anyone else out there has had this experience and what I am looking at as far as post-op.

I hear that I will be off 6 weeks non-weight baring (as I was with the TTT) and probably drugged to the eyeballs again.

I understand and accept that I probably won't ski again but stairs would be nice. Any thoughts, suggestions, words of wisdom would be appreciated.

Offline Keith

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Re: Proximal tibial osteotomy
« Reply #7 on: August 23, 2002, 08:09:17 PM »
 :) Hi All,

6/13/01 I had a high tibial oesteotomy. Dr. Sharkey at the Rothman Institute  in Philadelphia, PA performed the operation. Prior to the operation I could not walk more than two block. Today walking is no problem. The operation was quite extensive but well worth the effort.

Offline a7yritch

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Re: Proximal tibial osteotomy
« Reply #8 on: August 31, 2002, 12:01:17 AM »
Hi Keith,  as you might have read in the begining of these postings I mentioned that my OS said I should have a tibial osteotomy.  I went for a second opinion, in the beginning of the month.  I saw Dr. Pepe of the Rothman Institute, but at the satelite office in southern New Jersey.  He told me he wanted to take the "do no harm" route and says I should just learn to live with the pain.  i'm 33 yrs old and cannot imagine living with the pain!!!  Maybe I should see your doc for a 3rd opinion.  Im at wits end, with no relief in sight.   Angela :'(
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Offline Keith

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Re: Proximal tibial osteotomy
« Reply #9 on: September 03, 2002, 06:59:28 PM »
Hi Angela,

I was 49 when I had the operation. I could not walk 2 city blocks. My knee seems to get better each day. I worked on my house installing spouting over the weekend without any pain. Intially I had an appointment with Dr. Rothman. He refered me to Dr Sharkey because he does most of the osteotomies. I was told about 10 years ago to live with the pain and I will know when its time to do something. It is not worth living with the pain. Once it changes your quality of life it is time to have something done.
Good luck!!

Offline The KNEEguru

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Re: Proximal tibial osteotomy
« Reply #10 on: September 19, 2002, 12:28:43 PM »
An osteotomy is a procedure to 'buy time'.  It may be all the patient needs, but most OSs think of it as a procedure where the joint integrity is not breached so that the patient, often a young patient, can 'buy' a few more years until knee replacement - giving him/her the opportunity to benefit from design improvements, new innovations (eg unispacer, meniscal transplant, oats).  Also the extra time may make the difference when it comes to 'revision' - no-one can really say how long a knee replacement will last, but '10 years' is frequently bandied around.  So if one is young and can buy 10 years with an osteotomy, then it may mean one less revision (and revisions can be big and problematic procedures, especially if the bone is weakened say from osteoporosis).

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