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Author Topic: osteotomy QUESTIONS  (Read 8207 times)

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Offline knee-will-be-great

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Re: osteotomy QUESTIONS
« Reply #15 on: May 11, 2009, 03:56:12 PM »
This commentary is in reply to part of Lady's last comment and question ... "Another Question for you all.......I'm a preschool teacher and I am very busy for most of the day not sitting much and when I do in very low seats. So the question is how long do you all think before someone can go to work with that type of job?"
_______________

Keep in mind that a HTO is major surgery ... it is like having your leg broken - but on purpose.  I was able to function after four months - but I undertook a very aggressive exercise regime - and I was in top shape prior to the surgery.  It does take, in my opinion, at least six months to recover from the HTO surgery.

Lady, please note that I have about 10 years (age) on you and had an HTO three and one half years ago.  A late 40s kind of person.  Not old.  I am a very active woman with a very high-level of exercise in my life.  The HTO has been an absolute blessing.

If you think that you would have issues with an HTO, I would advise that you cruise this website and evaluate the unfortunate situations that you people (young people like you and like me) are having because of Knee Replacements.  After a knee replacement, there is no going back.  Many total knee replacements involve severing and then discarding the ligaments - to install the artificial knee.  So one's activity is not meant to be high after total knee replacement.

And with a knee replacement, there is no going back also - because the articulating ends of your bones that comprise your knee joint - are gone - sawed off to fit with the knee replacement.

In my humble opinion, there is way too much application of this surgery on people who could have other treatments done for them - but surgeons putting in artificial knees provides a continuous source of profit for the companies that produce these things - and of course folks, companies' objectives are to corner a market and make a profit. 

So, instead of research into biological remedies (which in my opinion, should be at the forefront of medical training and orthopaedic research), OS's become replacers of body parts - and these body parts do wear out - and, if not put in properly, or, even if put in properly, there are a lot of things that can go wrong - and essentially you would have only a few opportunities to have the knee replacement re-replaced and re-done.  Because every time there is a knee replcement surgery on one person's knee, bone stock is lost because the ends of the bone where the replacement go have to be re-carved to fit the new replacement.  And the edge of the bone where the knee replacement meets the bone often degrades (read up on osteopenia <bone loss> relating to knee replacements).  Bone loss occurs because of the wear and tear your bone will naturally experience at the site where the bone meets the metal (titanium steel) knee joint replacement.  Metal is harder than bone, and therefore the every day pounding and normal activity of daily life that you undertake results in the bone giving way and crumbling (just a bit) - if you are young and active and intend to continue having a long and active life.  Because it sure as heck will not be the metal giving way - because metal is solid; bone is porous.  In truth, (in my humble opinion), knee replacements just do not make sense - other than for the very old and very sedentary.

I have seen a variety of people become professional patients for life as a result of having knee replacements - be it using vast amounts of pain medication, seeing OSs regularly for follow-up on continuing knee joint clicking problems and joint laxity problems after the knee replacement, infection that will not go away, back pain (because the knee replacement was not put in properly, and one's walking gait is out of whack), depression medication, physiotherapists, psychotherapists, regular pain clinic visitors, and a whole host of other issues including RSD.

I do not mean to frighten you, but I convinced my OS that "waiting" for a knee replacement would nto be the the best option.  Having said that, I will never, ever, ever have a knee replacment.  If need be, I will go to Europe and have "abrasion arthoplasty" to repair the articulating surfaces of my knee - and then go on and on and on into old age.  There are ways to deal with knee issues other than cutting the knee out - so my question is why are orthopaedic surgeons not investigating these options rather than undertaking the Knee Replacement mantra? 

I apologise if this commentary seems harsh, but I am providing you with my concerns that may very well assist you in undertaking a better long term plan for your knee issue.

The knee messes resulting from Knee Replacements are what I have seen and witnessed in other people.  In reading about knee replacements on this web site, there most certainly are successes out there that should be noted and congratulated (with caution - because the proof in the pudding <as to whether a knee replacement is in fact successful> usually occurs three to five years after the knee replacement) - but invariably there are also big, big immediate (post surgery problems) as well as long term problems.

Cheers ... and my knee (which I predicted would be great <after proper HTO surgery>) continues to be GREAT!!!  Even some of the top guys I saw predicted that my HTO would not be a success - and that three years later I would "need"  ::) a knee replacement.  Not true. 

General Recommendation: More longitudinal study (20 - 30 year studies) seems to need to be done on patients who have had HTOs and other biological means of treatment - in otherwise physically and psychologically healthy, active people (from all age groups).  The people who do the best with any surgeries are people with an internal locus of control - and who feel they are in command of themselves.

Knee-will-be-great!!!
« Last Edit: May 11, 2009, 04:40:06 PM by 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 lady

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Re: osteotomy QUESTIONS
« Reply #16 on: May 12, 2009, 12:50:52 AM »
woweeKazawee, what a post. I found it very interesting and refressing and agree that I want my knee as long as possible if that is possible.

 I am very uninterested in surgery (of any kind) and thankfully my doc is all about trying nonsurgerical things as long as he can. He knows I don't want to even have a scope at this point but has said that may not be possible and also the oseotomy may be the route we need to go. He gave me food for thought and suggested I get as much info as possible on osteotomys before freaking out about it. Also that it was more like food for thought. So of course I jumped on here. A year ago he was saying maybe a PKR at 40 if the biological stuff doesn't work but that was last option. That is why I am thirlled to have him and his PA.

I do however feel as if I am becoming a proffesional patient. I have PT 2x a week and I seem to be visiting the docs every few months unless I'm getting a hylan injection and then its even more. I do feel like my knee is the focus of everything and Its getting old!!!

Ya know whats funny though is that the rehab is so loooooong for a osteotomy but for the PKR not so much so hard not thinking about that. But all good things come to those who wait and work hard, right? I hope all of you will have great knees. And I hope that at some point in my life my knee is not the focus of everyday. Oh ya and my hip which is really starting to bother me recently.
dislocated patella and chopped off most of chondal 1985
chondroplasty/medial meniscus repair 1996
ACI  quater size defect-surgery failure
lateral meniscus repair2002
chondroplasty, lateral Meniscectomy2006
synvisc & orthovisc injections 2008/2009
drained and cortizone injection 2008

Offline knee-will-be-great

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Re: osteotomy QUESTIONS
« Reply #17 on: May 12, 2009, 01:39:06 AM »
Hi Lady,


I am first referencing what you said in your last post:

Ya know whats funny though is that the rehab is so loooooong for a osteotomy but for the PKR not so much so hard not thinking about that. But all good things come to those who wait and work hard, right?

_________

People who focus on short term (so-called) benefits usually have long term negative consequences.

Short term gain usually means long term pain.
_________

I repeat, you are way too young to have knee replacements.  Find a top surgeon and get some options going - else you will continue being a professional patient - and a long term, continuous source of income for your OS, other OSs, physiotherapists, your HMO, pain specialists, hospitals, pharmacists and pharmaceutical companies once your first knee replacement fails (or wears out).

But you will not be a long term, continuous source of income for yourself and your family - if you do not address this situation.
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

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Re: osteotomy QUESTIONS
« Reply #18 on: May 13, 2009, 02:43:15 AM »
Read this PKR link about the perils one Knee geek experienced.

http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=47186.0;topicseen

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 lady

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Re: osteotomy QUESTIONS
« Reply #19 on: May 13, 2009, 08:50:13 PM »
So....I just got back from the docs but I didnt' see him I saw the PA. Who is stongly suggesting a HTO but wants to discuss it further with the Doc and then come in for another appointment in 3 to 4 weeks. Ya hello professional knee patient. But that is okay because I am glad they are not the type of docs/pa's to rush into cutting. He knows I'm very apprehensive I must have asked him several times is there anything else but cutting and he said No.

They don't do them often he all so said and that kinda makes me glad and nervous. Great they don't do such drastic things but crap experience would be a plus. lol.
Gotta run, what a crazy week. Thanks everyone for your help I know I'll be on again asking more questions. I really do appreciate it. Its so hard to make decsions like this. I want to make the right ones. Whatever I do is going to affect my life forever and man do I not want to screw it up. I got about 60 more years in me and that would suck. lol.

THANKS again.

« Last Edit: May 14, 2009, 01:01:59 AM by lady »
dislocated patella and chopped off most of chondal 1985
chondroplasty/medial meniscus repair 1996
ACI  quater size defect-surgery failure
lateral meniscus repair2002
chondroplasty, lateral Meniscectomy2006
synvisc & orthovisc injections 2008/2009
drained and cortizone injection 2008

Offline lady

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Re: osteotomy QUESTIONS
« Reply #20 on: June 18, 2009, 08:34:10 PM »
All the worry about a osteotomy and NO CAN DO. I think I've never been so thrilled yet so bummed out at the same time. Basicly no HTO it would have to be a DFO. But he would have to make it so I was significantly bowlegged and he doesn't feel the outcome would be good. Also very concerned with when it would be time for a TKR how it would "fit". Does any of that make sense.

After reading all the posts of people who have had any type of osteotomy I have to say you people are tough! I wish you the best.

Doc says the only thing to do is wait as long as I can for a PKR. Really the only option. I have to wear the unloader now until PKR as that is the only thing helping with pain and with proper walking. He said I can take a break but 2 days 3 at the most and thats pushing it. And now I have to wear it when I work out. I have already done this and I have noticed what an improvement my workout is.
I thought wearing a brace was bad for the muscles but he said so is swelling and if I'm working out with alot a swelling the swelling will only depleat my muscles more. But seriously who cares because I lost 2lbs since I started wearing the beast during workouts so I'm pumped about that. It really does help me to work harder and longer. And my good knee isn't to sore either.

This is the bummed out part. I'm completely shocked there is nothing else. I just have to wait. Thankfully I have the beast of an unloader to wait with and if I didn't have it I would be miserable. I asked how long and he said 2, 5, 10 years. Who knows right now. Go as long as we can.

Thanks again for all your help. Hopefully this thread will help someone else who has questions on this procedure.
dislocated patella and chopped off most of chondal 1985
chondroplasty/medial meniscus repair 1996
ACI  quater size defect-surgery failure
lateral meniscus repair2002
chondroplasty, lateral Meniscectomy2006
synvisc & orthovisc injections 2008/2009
drained and cortizone injection 2008

Offline knee-will-be-great

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Re: osteotomy QUESTIONS
« Reply #21 on: June 23, 2009, 03:16:26 AM »
I would be quite concerned about someone telling me nothing else can be done ... get more consults - I recommend the Hospital for Special Surgery ... where they do external fixation osteotomies.


Regards ... do not give up ...  >:(

KWBG
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















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