Advertisement - Hide this advert





Author Topic: Hardware removal after HTO post op diary  (Read 30648 times)

0 Members and 1 Guest are viewing this topic.

Offline casey2291

  • SuperKNEEgeek
  • *****
  • *
  • Posts: 1011
  • Liked: 0
  • User's Text
Hardware removal after HTO post op diary
« on: December 16, 2008, 09:27:20 PM »
Hi,

I decided that I would write a post op diary about my hardware removal from my high tibial osteotomy.  I looked all over these boards many times and had trouble finding information about the recovery from hardware removal after HTO. So I am hoping that my diary will give someone else information about what the hardware removal surgery involves. 

Yesterday, I had my surgery to remove the hardware and also to scope my knee to see how my new cartilage looks from my ACI surgery.  The good news is that my new cartilage from my ACI looks good.  I had a big band of scar tissue removed during my scope which is what I think was causing all my pain in the first place.  I'm not sure that my pain was from my hardware, but it is out of my knee now and I am happy about that.  I didn't like having it in my knee. 

My surgery was done under general anesthesia but I did have the option of spinal.  The surgery itself took about one hour.  The OS re-opened my old incision.  My incision is about 4 inches long and I have 11 staples holding it closed.  I also have several staples holding my scope incisions closed.  I have a total of 17 staples. 

I woke up in recovery in a fair amount of pain.  I was given several shots of some type of pain killer through my IV and then also given percocet by mouth.  I don't respond well to anesthesia so the ride home yesterday was miserable.  My OS is four hours from my house so it felt like it took forever to get home. 

My pain has not been terribly bad.  I have been taking percocet every four to six hours and have been keeping up with my pain meds.  If I remain still then my pain is pretty well under control.  When I get up to move around, I have a fair amount of pain.  I took the bandages off of my knee today and I have some swelling, but it is not nearly as swollen as I thought it would be. 

I am able to do a SLR with ease and I have already started working on my ROM.  I have lost a good bit of flexion and I can tell that I am going to have some work ahead of me to get it back.  My extension seems to be ok.  I don't want to push it too much yet with my ROM because the incision was bleeding just a little bit this morning when I removed the bandages.  I will start physical therapy next week.  I plan to do most of my therapy on my own and will see my PT once a week.  My OS gave me the option of rehabbing on my own or going to formal physical therapy.  I am going to go once a week just to make sure I get my ROM back.

I am allowed to do toe touch weight bearing for the first seven days and then after that I can progress to full weight bearing as tolerated.  I have to wear a big brace (similar to an ACL brace) for one month post op.  I am allowed to bend my knee as much as I want in the brace. 

My OS gave me my four screws and plate to keep.  The screws are a lot bigger than I thought they would be.  There are two long screws which are about three inches long and two shorter ones which are about 2 inches long. 

That's it for now.  I will try to update this somewhat frequently over the next two months as I recover. 

 

     
LOA #2 and hardware removal 12/15/08-new cartilage from ACI looks "GOOD"
LOA on left knee 3/18/07
ACI and HTO on left knee 10/22/07
scope of right knee on 6/21/07
microfracture left knee 3/18/05

Offline casey2291

  • SuperKNEEgeek
  • *****
  • *
  • Posts: 1011
  • Liked: 0
  • User's Text
Re: Hardware removal after HTO post op diary
« Reply #1 on: December 18, 2008, 01:46:26 PM »
Day four post op:  I am off of all narcotic pain meds now.  I had either a bad reaction to the anesthesia yesterday or bad side effects from the percocet that I was taking so I stopped taking percocet and am now taking celebrex.  My pain is not really that bad.  When just sitting around, I am pain free.  I have a little pain when I am up and moving around, but it is mostly at the incision site.  I had some trouble sleeping last night because I kept moving around and would irritate the incisions when I moved.  I could have used some percocet last night to sleep, but I don't need it during the day time.  I have been working on my ROM and strength.  My extension looks good and my flexion is at about 90 degrees.  I've been icing and elevating as much as I can.  Things are going well. 

LOA #2 and hardware removal 12/15/08-new cartilage from ACI looks "GOOD"
LOA on left knee 3/18/07
ACI and HTO on left knee 10/22/07
scope of right knee on 6/21/07
microfracture left knee 3/18/05

Offline fuzzybob

  • MINIgeek (20-50 posts)
  • **
  • Posts: 44
  • Liked: 0
Re: Hardware removal after HTO post op diary
« Reply #2 on: December 20, 2008, 10:56:01 PM »
Hi

Thanks for the post op info and you are right not much around relating to hardware removal so pleased you feel able to share your experiences.

I had an HTO in March and I have always 'felt' my hardware and now some 9 months post op still have discomfort. Initially I and my OS and PT wasn't sure if it was due to muscle weakness complicated by a lateral tibial fracture and posterolateral corner ligament /capsule rupture.............but despite rehabbing well and improving my balance and strength, yes I think I can differentiate my discomfort and I do think it relates to the hardware

My OS is aware and has indicated if I still expereince discomfort he will consider hardware removal but only after 1 year post op. I am due to be reviewed in late Jan when a desicion is likley to be made.

I am curious to know what made you have hardware removal. My discomfort is a tight band feeling or clamping feeling round the top of my tibia, sometime it feels like the bone and plate/screws are pulling in opposite directions....a very wierd and unpleasant feeling. This is usually worse when I bend my leg and my PT has never quite managed to get my full ROM and again thinks this is due to my hardware.

My leg is still very tender to touch and I still have numness and it swells up and throbs usually mirroring the level of activity during the day! The cold weather has also made me feel my hardware moreso with some increasingly deep pain within my osteotomy site.

Has any one else experienced this? Just looking for guidance and others experiences - just to make sure I make the right desicion next year and I am sure what I am experiencing is related to my hardware.

Also has anyone experienced ankle pain. I realise an HTO changes the forces through the knee, but does it change the forces through your ankle also? Over the past month the discomfort in my ankle has been increasing, it aches and throbs and gets very stiff and cracks and clicks horrendously now. It is also painful to walk on at times. Anyone else experience this? if so what did you do?
09/06 bad hamstring tear/undiagnosed knee injury
03/07 >6 months PT.OS referral
05/07 OS#1 diag. old age
07/07 OS#2 scope/EUA. Diag.LCL/PLC/ACL laxity, Grade3 medial femoral condyle damage, medial meniscus displaced
12/03/08 HTO,TPFx in surgery!
04/09 hardware out scope/EUA.PLCr not needed
ACI?

Offline casey2291

  • SuperKNEEgeek
  • *****
  • *
  • Posts: 1011
  • Liked: 0
  • User's Text
Re: Hardware removal after HTO post op diary
« Reply #3 on: December 22, 2008, 02:16:25 PM »
Hi,

Sorry to hear that you might be having trouble with your hardware and ankle.  I too could feel that my hardware was in my knee and had some occassional discomfort from it.  It would occasionally ache for a few minutes at a time but I never had periods where it would ache for long periods of time.  My hardware would hurt if I banged my knee into something...mostly when my dog would jump right on my screws.   I had discomfort when trying to sleep on my side at night.  It didn't hurt but I had trouble putting pressure on my leg where my hardware was and finding a comfortable position for that leg when trying to sleep on my one side.  I would also have some occasional pain if I walked for a long period of time and I did have a period of about a month where my screws were painful after taking a long walk....I would move my leg to stretch out on the couch and get some nice pain.  But overall, I would say that my hardware was more of an annoyance than a constant pain. 

What made me decide to get my hardware out was that I went to see my OS after I slipped and had increased pain in the medial portion of my knee.   I was worried that I had torn my meniscus or damaged my new cartilage from my ACI.  After examination, my OS thought that my pain was due to my hardware.  When he touched the area where my plate was located, I was very sore.  My OS thought that the pain in the medial portion of my knee was due to my hardware.  He thought that when I slipped that I might have caused the hardware to shift.  Since I didn't want the pain in the medial portion of my knee, I agreed to have my hardware removed.  Although, now that my knee has been operated on and my OS removed a large piece of scar tissue, I think that the pain in the medial side of my  knee was from the scar tissue and not my hardware. 

Have you ever had any trouble with scar tissue?  I was just wondering because swelling and lack of ROM can be indicators of scar tissue.  How far are you from full ROM?   

I was told after my ACI/HTO that there was no reason for me not be able to get my full ROM back.  I didn't get my full ROM back.  After my last surgery to remove scar tissue, I was about five degrees from full flexion.  I did get full extension back.  I am hoping that I will get my full ROM back this time. 

My experience with this hardware removal surgery has not been bad.  Of course having been on crutches for 10 weeks with my ACI/HTO surgery makes a couple of weeks on crutches seem like nothing.  That is not to say that there is no pain involved.  I did have to go back on pain meds yesterday.  My knee started hurting again.  I'm not sure if it is due to the really cold weather that we have been having or because my dog jumped on my leg about 10 times yesterday.  I am still having some aching this morning.   My OS is not as conservative as some other surgeons.  I was told that some OS's have their patients non-weight bearing for 4 weeks post op, but fortunately for me my OS is not that conversative.   I get to start weight bearing tomorrow as tolerated so I am anxious to see how that goes.   

I too had numbness where my hardware was located.  I am curious to see if I will get feeling back in that area now that my hardware has been removed.

I have never had any problems with my ankle hurting, but I did lose a good bit of ROM in my ankle after my ACI/HTO surgery.  Have you had your PT check the ROM in your ankle?

 



LOA #2 and hardware removal 12/15/08-new cartilage from ACI looks "GOOD"
LOA on left knee 3/18/07
ACI and HTO on left knee 10/22/07
scope of right knee on 6/21/07
microfracture left knee 3/18/05

Offline casey2291

  • SuperKNEEgeek
  • *****
  • *
  • Posts: 1011
  • Liked: 0
  • User's Text
Re: Hardware removal after HTO post op diary
« Reply #4 on: January 15, 2009, 08:30:10 PM »
One month post-op:  I see now why people don't really post much about hardware removal following HTO.  The recovery from this surgery seems to be pretty uneventful.  There has not been much to report which means that things are going well.  I ditched my crutches at one week post op.  I probably could have used them for a couple of more days than I did, but I was eager to be off of them so I got rid of them as soon as I was given the ok to weight bear.  I continued to wear the big hinged brace for a full month post op.  Most of my incision pain was gone within the first two weeks post op and I was off of all pain meds within two weeks.  I did have to take pain meds at night for the first two weeks as my incisions healed but I did not need them during the daytime after the first week.  The big brace definately provided me with the support that I needed for the first month post op.  Right now, I am in the process of transitioning from the big brace to a smaller brace.  At one month post op I was told that I could discontinue use of my brace.  Even though I am at one month post op today, I don't feel ready to go without any brace at all.  The bones still feel weak when I don't have a brace on.  I do a lot of walking at work, so I plan to use a brace for a little while longer.  When wearing the big brace, I had no pain in the knee where the hardware was removed.  Now, that I am transistioning to the smaller brace, my bones are a little achy by the end of the day.  I'm sure with time and as my bones continue to heal and my muscles become stronger that pain will disappear.   I have been doing PT three days a week to increase my strength. I ended up doing three days a week of formal PT so that I could have my knee ultrasounded (to help with my scar tissue problems) and so that I could get electrical stimulation.  My strength is fairly good at this point.  There is still a difference in strength between my two legs but that will come back with time.  I have a tiny bit of limp but I am also having some inconsistent pain that I am pretty sure is scar tissue and that is what I think is causing my slight limp.  I almost have full ROM.  My ROM came back pretty easily within the first two weeks and I am about five degrees from full flexion.  I went into the operation about five degrees short of full flexion so I probably have as much ROM as I am going to get.  I have very little swelling.  This recovery has been pretty easy and uneventful....not as easy as recovery from a scope, but much easier than my last open knee surgery.   
LOA #2 and hardware removal 12/15/08-new cartilage from ACI looks "GOOD"
LOA on left knee 3/18/07
ACI and HTO on left knee 10/22/07
scope of right knee on 6/21/07
microfracture left knee 3/18/05

Offline fuzzybob

  • MINIgeek (20-50 posts)
  • **
  • Posts: 44
  • Liked: 0
Re: Hardware removal after HTO post op diary
« Reply #5 on: January 18, 2009, 11:47:30 AM »
Hi

Thanks for the up date and great to hear you are doing so well. Its reassuraing and encouraging to know that hardware removal is not too bad!

I see my OS this coming Thursday (Jan 22nd) where a decision will be made as to where we go next. Possibly hardware removal, possibly PLC reconstruction, possibly both?

My PT feels I have reached a plateau and if she tries to progress it is just flairs up.  I have reached a point now where I am getting fed up with my knee and just want to get back to a reasonable level of functionality in every day activities, let aone the thought of doing sport again!

Once again thats for the update, very helpful and best wishes your recovery continues to go so well.

09/06 bad hamstring tear/undiagnosed knee injury
03/07 >6 months PT.OS referral
05/07 OS#1 diag. old age
07/07 OS#2 scope/EUA. Diag.LCL/PLC/ACL laxity, Grade3 medial femoral condyle damage, medial meniscus displaced
12/03/08 HTO,TPFx in surgery!
04/09 hardware out scope/EUA.PLCr not needed
ACI?

Offline jimbo63

  • MICROgeek (<20 posts)
  • *
  • Posts: 2
  • Liked: 0
Re: Hardware removal after HTO post op diary
« Reply #6 on: January 18, 2009, 08:33:39 PM »
hi im new to this site i have a question or two.im due to have an osteotomy on jan 20.due you have to have the hardware removed or is it only if you have problems with the hardware.and has any one had problems with blood clots after the osteotomy.ive had clots in my leg before so im kind of nervous.its bad enough worrying about clots i also have to worry about being put to sleep i cant stand being put to sleep .does anyone know of a crutch or device one can use to take the weight off ones wrist.i had three surgeries on my left wrist where they removed a piece of my ulnar and the fusion didnt take so the bone never healed.even the screws in my wrist busted so they removed the heads of the screws and left the rest in.so i cant put alot of weight on my left wrist.my left wrist is really floppy and you can actually seem my ulna move in my wrist. so it hits my other bone in my forearm .my surgerie is gonna be on my oppisite knee.i cant use a wheel chair becouse i dont have a ramp.i hope im sending this message the right way.i appreciate any info you all can offer.

Offline casey2291

  • SuperKNEEgeek
  • *****
  • *
  • Posts: 1011
  • Liked: 0
  • User's Text
Re: Hardware removal after HTO post op diary
« Reply #7 on: January 23, 2009, 06:48:17 PM »
I have finally ditched the brace.  I wore the brace about a week longer than my OS told me that I needed to wear it.  I can feel that my bones are healing. 

Bob...what did your OS say about removing the hardware?  I can totally understand wanting a functional knee and the desire to return to sports. 

Jimbo...How did your surgery go?  I think that the hardware only has to come out if it causes you problems, but I'm not 100% sure about that.  My OS told me before the surgery that the hardware typically comes out at one year post op.  However, he never told me that it was a requirement.  Hope you are doing well after your surgery.   
LOA #2 and hardware removal 12/15/08-new cartilage from ACI looks "GOOD"
LOA on left knee 3/18/07
ACI and HTO on left knee 10/22/07
scope of right knee on 6/21/07
microfracture left knee 3/18/05

Offline fuzzybob

  • MINIgeek (20-50 posts)
  • **
  • Posts: 44
  • Liked: 0
Re: Hardware removal after HTO post op diary
« Reply #8 on: January 24, 2009, 12:02:58 PM »
Hi,

Thanks for the up date and great news you are brace free etc. Hope all continues well for you. Have you noticed a difference/improvement compared to pre op? How's your ROM and have you got full functionlity back and back to doing things you could do pre injury?

Had a long chat with my OS at my last consultation. My hardware is still causing me discomfort and very tender etc so yes my hardware is to come out. He emphasised that normally would keep hardware in if not bothering me, but clearly I have been having issues from day one and have continued through rehab etc so he is happy to remove. But will only do this after one year post op becuase of bone strength etc. I am sheduled for surgery at the earliest late March / early April - just waiting for a date to be confirmed.

At the same time he plans to do an arthroscopy and evaluation under anaesthetic (EUA) to review my tibial plateu / fracture site and ligaments etc and clean up/ wash out knee if needed. He has got cold feet again about doing the PLC reconstruction and will make the decision if any soft tissue repair is needed after my scope.

So now faced with surgery no.3 for this knee/injury and possibly another surgery afterwards! Part of me is relieved that my hardware is coming out; so hopefully will remove some of my pain and discomfort, but as for sorting out my instabilty issues; I can't beleive my OS will not do reconstruction and wants to go in and have another look. He did this in July 2007 so I can't see the point and it is just dragging out getting my knee sorted! I respect him for is considered and careful apprpoach but this is now starting to frustrate me.

My PT is on holiday currently so don't see her until Feb 6th. so will be interested to hear what she thinks!

Interestly my OS was not too bothered or interested in telling me about my rehab following harware removal. He just said this is minor surgery compared to the HTO (yes i agree), no brace required afterwards and expects me to be walking after surgery and off work for a couple of weeks!!

Again I was surprised in that taking out a plate and 4 long screws bolted through my tibia - I am weightbearing and have no protection for a least a short period. I thought that bone usualy takes on average 6 weeks to heal? I really need some advice as work wants to know....and so do I!

From what you have said as well what other more conservative OS's rehab schedules at least have indicated a slightly longer recovering compared to having just a scope!

So that's my update so far!
 
09/06 bad hamstring tear/undiagnosed knee injury
03/07 >6 months PT.OS referral
05/07 OS#1 diag. old age
07/07 OS#2 scope/EUA. Diag.LCL/PLC/ACL laxity, Grade3 medial femoral condyle damage, medial meniscus displaced
12/03/08 HTO,TPFx in surgery!
04/09 hardware out scope/EUA.PLCr not needed
ACI?

Offline fuzzybob

  • MINIgeek (20-50 posts)
  • **
  • Posts: 44
  • Liked: 0
Re: Hardware removal after HTO post op diary
« Reply #9 on: February 14, 2009, 02:52:57 PM »
Hi Casey,

Quick catch up to find out about your recovery. How's the leg now?Are you back to activities yet?

I am due for hardware removal, scope and EUA. Op was sheduled for March 25th, but I have had to cancel due to my partner being away and no one around for the first few days to help look after me. Waiting for a new date!

When you get a chance would be good to know how your rehab/recovery has come along since your last post. I am assuming no news / updates means good news and nothing to report really. But for me just keen to arm myself with as much information as possible from someone who has gone through hardware removal recently following HTO. I realise you had ACI also whereas I have a lateral TPF and PLC/LCL/ACL laxity etc, but still interested to hear how you have got on and how you have found your rehag / recovery.

Best wishes

09/06 bad hamstring tear/undiagnosed knee injury
03/07 >6 months PT.OS referral
05/07 OS#1 diag. old age
07/07 OS#2 scope/EUA. Diag.LCL/PLC/ACL laxity, Grade3 medial femoral condyle damage, medial meniscus displaced
12/03/08 HTO,TPFx in surgery!
04/09 hardware out scope/EUA.PLCr not needed
ACI?

Offline casey2291

  • SuperKNEEgeek
  • *****
  • *
  • Posts: 1011
  • Liked: 0
  • User's Text
Re: Hardware removal after HTO post op diary
« Reply #10 on: February 15, 2009, 06:50:52 PM »
Hi,

Sorry that I have not updated lately on my progress.  I am now two months post op and I would say that the hardware removal has gone well.  Just this past week, I really started to increase my working out.  I waited until almost the 2 month mark because my OS said no impact stuff for two months.  I returned to rock climbing and really increased the resistance on the ellipitical and continued to increase the amount of weight that I am lifting at the gym.  I think I may have slightly overdone it because I had some pain in my bone this weekend where the hardware was removed.  That is the first that I have had pain in probably over a month.   I was actually quite surprised that I had any pain.  I thought that it was totally healed.  I guess even at two months the bones might still be slightly weak.  I have had some increased swelling as well which I assume is just due to increased activity.  I had no pain when rock climbing and when working out at the gym.  I tend to get into this mind set that I am suddenly healed and I go all out and do whatever I want and then I pay for it.  the pain in the bone only lasted one day and it seems to be better now.  I did rock climb with my brace on just for some extra support.  I probably could have climbed without it but I figured it wouldn't hurt to use it.  I have most of my ROM back.  I am about 15 degrees from active full flexion but I can passively achieve full flexion.  My extension is good.  I am still having some trouble with my knee but I'm pretty sure it is due to scar tissue.  I think my lack of ROM is due to scar tissue although my PT thinks it is from weak hamstring muscles.  I am planning on going back to my OS to discuss the possibility that I might have scar tissue again.  The strength in my leg is pretty good at this point.  There is still some weakness but there is not a whole lot of difference between my two legs at this point.  I still need to continue to work on my strength.   

Your OS seems to have a very laid back attitude about your hardware removal.  I guess you can always just stay NWB as long as you like.   I'm sure they will at least send you home from the hospital with crutches.   I'm surprised that your OS won't take care of all your problems while he is in there.  I would want to get it all done and over with and not have to go back in for more surgery.  Have you considered having a second opinion?  Sorry to hear that you had to reschedule your surgery.  I hope you can get in soon so that you can get some relief. 

Feel free to ask any more questions that you might have.  I think you will find that the recovery from hardware removal is really not that bad.  Overall, I was surprised at how easy the recovery seemed.  I thought that it was going to be a lot harder than it was since it was open surgery.  I often felt ready to push the knee sooner than I was given permission to do so.  I guess given the surgery that we have already gone though made this surgery seem easier. 

Good luck and keep me updated. 

 
LOA #2 and hardware removal 12/15/08-new cartilage from ACI looks "GOOD"
LOA on left knee 3/18/07
ACI and HTO on left knee 10/22/07
scope of right knee on 6/21/07
microfracture left knee 3/18/05

Offline fuzzybob

  • MINIgeek (20-50 posts)
  • **
  • Posts: 44
  • Liked: 0
Re: Hardware removal after HTO post op diary
« Reply #11 on: March 08, 2009, 07:55:16 PM »
Wow,

Rock climbing and increasing your work outs - this is encouraging and re assuring. Thanks for the up date. I have my surgery date - April 15th! Yes you are right my OS does seem to have a laid back attitude to hardware removal. I will go home on crutches although not sure if I will be NWB or WBAT etc. No doubt I will find out on the day. My PT has said its not as bad as most people think it will be and I should be fine. She will keep a close eye on me and seems to think I will not go back too far in my rehab programme.

They seem to think my leg / bone will be OK quite quickly, whereas I think it won't be. I don't understand how it can be with a plate and 4 large screws bolted right through my tibia - surely this needs time to heal, just like any break to a bone!?

Any way April 15th is the day I hope my road to recovery will finally start! I will get rid of my hardware which is causing me so much discomfort and get rid of that stiffness and soreness. At the same time I will find out what other damage I have done to my knee - not only from the original injury but as I am now 2.5 years post injury walking round on my knee, I am curious to see if there is more damage to my knee or not? Then of course moment of truth.............can the instability problems be sorted and can my knee be fixed?

April 15th is a day I am looking forward to and dreading!

Hope your recovery is going well still. I will keep you all posted on developments
Keep smiling!
« Last Edit: March 08, 2009, 07:58:29 PM by fuzzybob »
09/06 bad hamstring tear/undiagnosed knee injury
03/07 >6 months PT.OS referral
05/07 OS#1 diag. old age
07/07 OS#2 scope/EUA. Diag.LCL/PLC/ACL laxity, Grade3 medial femoral condyle damage, medial meniscus displaced
12/03/08 HTO,TPFx in surgery!
04/09 hardware out scope/EUA.PLCr not needed
ACI?

Offline zoeygrl

  • Regular Poster
  • ***
  • Posts: 53
  • Liked: 0
Re: Hardware removal after HTO post op diary
« Reply #12 on: April 18, 2009, 06:09:24 PM »
Hi everyone! Just checking in to see if fuzzybob had the hardware removal on the 15th? I had my hardware removed on the 16th and doing very well.   I am walking on the leg, not using my crutch at all and feeling pretty darn good.   I'm so happy to have that metal out of my leg.  The surgeon even gave it to me to take home for show and tell.   I have some pinching and soreness in the incision site as it still has staples in it, but by and large the pain is non exisitent and I'm just taking tylenol as needed.  I hate taking perocets as they make my stomach upset.   I am taking it easy working on my computer at home and doing personal stuff and napping when I get tired, but mostly I feel great and can't wait to get back to exercise and activity.  I have a bike I bought a couple of years ago that is calling my name!  I am 13months post op hto/aci.  The doctor did an arthoscopy to check out the aci and he is very pleased with the results.  I see him a week from Monday to get my staples out.   I plan on going back to work on Monday.   All in all the hardware removal was a piece of cake compared to the 8 weeks nwb and 6 months of physical therapy from last year.   

I have a ton of braces now that I wish I could sell on ebay...maybe I'll try that...tee hee

Happy beautiful sunny Saturday! 
1989 first arthroscopic surgery to clean up knee
1992 2nd arthroscopic surgery for clean up of cartlidge flakes
1/24/08 harvesting of cells for carticel transplant
3/27/08 HTO and Carticel transplant

Offline fuzzybob

  • MINIgeek (20-50 posts)
  • **
  • Posts: 44
  • Liked: 0
Re: Hardware removal after HTO post op diary
« Reply #13 on: April 20, 2009, 12:24:31 PM »
Dear all,

Zoeygirl, sounds like you are doing really well. As you sat hardware removal is so much easier compared to the the HTO etc. Well thought I should up date everyone following surgery on April 15th. I had my hardware removed (plate and 4 screws) from my open wedge high tibial osteotomy site 13 months after HTO surgery. At the same time my OS did an arthroscopy and EUA to examine my knee to assess what else can be done..or not!

I suffered some post op complications with pain control, breathing and cardiac problems (relating to the anaesthetic....some form of reaction). I was kept in for 2 days then returned home but have felt really exhausted and out of it and just sleeping and resting up since. I am WBAT, pain under control now, quite swollen and bruising starting to come out so quite sore now, but otherwise OK.

From what I can recall with respect to my OS visitng me after surgery as well as me asking to read my op report when still in fairy land.............It appeasrs my HTO and correction of the tibial slope has improved significantly my stability issues. Compared to pre HTO my hyper extension, LCL and PLC instability has signficiantly improved and almost comparable to the 'my good leg'. This is good news - meaning that surgery last year has worked. My OS feels that further PLC reconstructive surgery is unnecessary as he does not believe any further improvement can be gained. My ACL, PCL and MCL are all instact. The bone graft has incorporated well. My lateral tibial fracture site has healed, no depression but do have a fissure (not such good news). As for my chondral impact damage  - well unsurprisingly this is still very damaged and something I have to live with for now, although my HTO will help but me some time. He cleaned up and smoothed/ shaved down my condral surrfaces and removed some scar tissue and floating debirs from my knee. He emphasised that it is good news about the stability aspect but I need to remember I still have a signficantly damaged knee due to impact damage and this will limit what I can and cannot do! Ultimately looks like I am facing a TKA.

I will see my OS 6 weeks post op for the full run down and where I go from here. But it appears my hyperenstension, LCL and PLC instability issues have been resolved, although I still feel I have instability, so may be this is all to do with muscle weakness and retraining of my gait and muscles, ligaments and tendons etc after so long or either inactivity or being used wrongly! So will be over to my PT to try to sort this one now we are certain that surgically all sorted!

I see my PT on Friday so will see what she has to say! It does feel so much better with the hardware out, so with this foreighn body removed alongside the clean up I hope I can progress my rehab a little further now and get back to doing some of the things i enjoy in life

For now back to resting, icing and basic rehab exercises and take it day at a time.
09/06 bad hamstring tear/undiagnosed knee injury
03/07 >6 months PT.OS referral
05/07 OS#1 diag. old age
07/07 OS#2 scope/EUA. Diag.LCL/PLC/ACL laxity, Grade3 medial femoral condyle damage, medial meniscus displaced
12/03/08 HTO,TPFx in surgery!
04/09 hardware out scope/EUA.PLCr not needed
ACI?

Offline DukeOfEarl

  • MICROgeek (<20 posts)
  • *
  • Posts: 3
  • Liked: 0
Re: Hardware removal after HTO post op diary
« Reply #14 on: March 08, 2010, 08:42:22 AM »
Hi Guys Thanks for all the posts on HTO & ACL Recon hardware removal. Coming at you from Perth Australia. After 20 yrs living life to the fullest and thus grinding my knee lining down with broken ACL's and no reconstruction [yep] I found myself with advanced osteoarthritis and a prime candidate for TKR x2. Not too mention hip and lower back issues. I am only 40 yrs now so an HTO + ACLR was the only option for  now [TKR's have a min 10yr life].

Anyway had my Left leg/knee HTO and ACL in March 2008. Was meant to have that hardware removed and have my Right knee  HTO+ACLR done [all in one go!] Feb 2009 but that was pl;aced on hold when I was made redundant... Not sure when I get my full RIght knee ACL+HTO done but for now I am so happy to be having my Left HTO 'Puddu' Plate, 6 or 7x HTO screws, and 1xACL Screw removed this Wednesday 10-March-2010 - YAY   ;D

Your posts have been very helpful .I also found this thread on hardware removal usefull too: http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=48480.

I am hoping that all you are saying about HTO plate removal is true and easy because I need to get back to work in a week and be driving at that. I will keep you informed anyway, I trust this is of interest. My biggest question is the holes left after the screw removal must need plugging up with bone graft right? [I call it 'bone putty']. It feels like the screws [the 6 or 7 HTO screws and the 1 tibial ACL screw] are being forced out of my bones! It's like the bone must be growing up from underneath and forcing the screws out! That's my theory anyway but they are better in than out so I cannot wait. I've also posted a pic here of my left knee post HTO & ACLR March 2008.

I will be keeping my plate and screws... I've grown quote attached to them!  :)

Cheers for now!
« Last Edit: March 08, 2010, 01:30:41 PM by DukeOfEarl »
1886: Left knee ACL break. Partial meniscus removal
1992: Left Knee Tibial lining gouged
1993: Right Knee ACL break
2008: March Left knee ACLR
2008: March Left HTO 
2010: March Left HTO+ACLR hardware removal
Late 2010 or Early 2011: Planned Right Knee ACLR+HTO
Scopes don't count as knee ops C-8 !















support