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Author Topic: Concerned About Lack Of ROM Following High Tibial Osteotomy  (Read 1085 times)

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Offline wokeye

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Concerned About Lack Of ROM Following High Tibial Osteotomy
« on: April 03, 2010, 11:12:16 AM »
This is my first ever knee operation and as such I think I underestimated what to expect.  The inner joint face on my femur at the knee joint had a large chip out of it that must have happened in an accident when I was very young.  I am now 40.  The gap in the joint was filled using synthetic plugs as the surgeon though that it was to large for a graft.   I also have had my Tibia cut and opened up to straighten my leg and a plate screwed on to hold it in place.  I had this done 8 days ago.  The pain has been terrible and I ended up staying in hospital for 4 nights due to not being able to get out of bed and use crutches.  Physiotherapist's in the hospital tried to get me to move my leg and also put me on a CPM machine.  I managed to get my knee moving with a fairly small ROM.  I did a few excersises at home but I missed them out for a day, now my leg feels totally locked.  I am going to see a physiotherapist in 5 days time so hopefully they can help.  I have tried to move the joint myself but I can't face the pain.  Should I be really concerned abut this and get a family member to try and move the joint for me in the meantime.  I got my operation carried out in a private clinic in the UK through my works health scheme.  I have found the aftercare very poor to be honest.  I just wanted to know what other peoples thoughts are, I understand that I have had a fairly major operation and have vastly underestimated the pain, but I was just under the impression that I should be trying move my joint, however I can't face doing it myself.  At the moment for the pain I am using paracetomol, ibuprofen and Tramadol Hydrochloride tablets.  The pain is getting better, but it is still pretty bad.  Thanks for any advice.

Offline mmrocker13

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Re: Concerned About Lack Of ROM Following High Tibial Osteotomy
« Reply #1 on: April 03, 2010, 05:26:14 PM »
Well, you're only eight days out, so you probably still have a lot of swelling and stuff. I'm not quite sure what you mean by synthetic plugs...is it like an arthrosurface hemicap? Or like a microfracture procedure?

A lot of your pain is probably coming from the cartilage work--I didn't find my osteotomy itself to be overly painful at all. But anytime they monkey with the joint itself it def. hurts more.

Can you get a CPM for home use?

Regaining your ROM WILL hurt. That's just a fact of life. But the longer you wait (assuming your doc wants you moving it now), the harder it will get. Def. make sure A) your doc wants you working on it and then B) check and see if you can get a CPM.
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Offline smillie

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Re: Concerned About Lack Of ROM Following High Tibial Osteotomy
« Reply #2 on: April 03, 2010, 10:26:22 PM »
Are you staying ahead of the pain with your pain meds?  Until your pain is well under control, it's a good idea to take what they tell you to take right on schedule.  If you can take them and keep the pain from getting bad, it's better than waiting until it hurts and then trying to get to back down.  If you are taking all they have given you to take, then you could always let them know that isn't working for you.  If your pain was that bad in hospital, then they may not be adequately treating your pain.  I know from my experience with my TTT etc., they weren't treating my pain effectively in hospital and I had to stay for 5 days until it got under control and I could move on my own.  I hear about people with similar procedures doing all sorts of things on day 2 that I couldn't have dreamed of doing because my pain was so bad.  I hear of surgeons all the time who end up undergoing an operation like they perform routinely and they are shocked by how much it hurts and start to treat their patients differently because of that.  I digress, but I did want to emphasize that controlling your pain is important.  You can't rehab anything if it hurts too much.  Your muscles won't let you.

Oh, and are you icing your leg according to instructions?  That is also important for swelling and pain relief.
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Offline wokeye

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Re: Concerned About Lack Of ROM Following High Tibial Osteotomy
« Reply #3 on: April 04, 2010, 05:12:21 PM »
Thanks very much for the replies.  I am not sure exactly what the synthetic plugs are that were used to fill the gap in my joint.  That is all that the consultant described them as.  I am using an ice pack as instructed also this does improve the pain a bit.  I was just fed up in hospital as more or less on the second day even though I was in agony the physiotherapist started moving my knee it was unbearable. 

Yesterday with the help of my wife I managed to get a half decent ROM carrying out exersises without to much pain.  However at night following the exersises and also through today I have been in great pain,  I had very little sleep.  My leg just feels stiff and very painful, so I am having another day off as I think that exersising it could make it even worse.  I am going to have another go tomorrow, just not looking forward to the pain that follows it.  I really need to see if I can rent a CPM machine somehow.  The pain killers that I am using do not seem up to the job, but then again pain is expected.

I just wish that I had researched the operation much more in the first place, then this would not be as much of a shock I guess.

Offline Nettan

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Re: Concerned About Lack Of ROM Following High Tibial Osteotomy
« Reply #4 on: April 04, 2010, 06:53:57 PM »
If you get uncontrolled pain by trying to get better ROM, why not see if you can get better painmeds or maybe change the routines of the meds to get them working better ?
Call your OS or the place where you had surgery and talk with them. A stiff knee usually also makes pain worse.
So getting a CPM maybe can make things better for you.
All the best to you.
Surgery 6 times left knee torn meniscus, RSDS,chondromalacia, nervdamage cause constant nervpain,chronic inflamm.
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