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Author Topic: WonkeyDonkey's High Tibial Osteotomy - Open Wedge Diary 11/11/11  (Read 38541 times)

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Offline WonkeyDonkey

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Re: WonkeyDonkey's High Tibial Osteotomy - Open Wedge Diary 11/11/11
« Reply #15 on: December 01, 2011, 05:38:56 PM »
Day 20 - Thurs

Having a good day, my husband took me to collect a wheelchair from the Red Cross. I can have it for up to 3 months, with no charge. For information, you need to get a letter signed by your GP to be able to get one long term with no charge. Have got a leg extension on it and also normal leg rest for later on when I can bend my leg better. If I want to get a self propelling wheelchair, I need to request one so they can get one delivered to them, so far I will settle for being pushed around, as using crutches tires the arms enough. Can't wait to get out to have some fresh air.

Leg still feeling good, without pain and have done my physio exercises. Physio tomorrow.

WD

Offline WonkeyDonkey

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Re: WonkeyDonkey's High Tibial Osteotomy - Open Wedge Diary 11/11/11
« Reply #16 on: December 04, 2011, 12:46:01 PM »
Day 21 Fri

Have done my physio during the day and visited the physio in the afternoon. Still can't bend it very far, but managed 56%. Went through the exercises again, and told to keep going with them. Going to try CPM next week to try to get a better bend at physio. Physio also going to phone OS to find out about weight bearing at 4 and 6 weeks. Some exercises are easier than others but I have to press on with the ones I find hard i e bending my knee.

Found that I had a stitch still in one of the wounds, so need to go to GP to have it taken out. I am still not allowed to take a bath until this stitch is taken out, so I guess it is strip washing for a bit longer. I have mastered this by using an office chair and wheeling around the bathroom on this. Also going to massage E45 cream into legs 2 - 3 times a day as the skin is drying out, and over the wound site to stop it drying out. I am still not having any pain in my leg either at the osteotomy site or the wound under my knee, but am still taking 6 - 8 Co-Dydramol a day. I still havig some bruising to my foot (on inside of ankle) and some yellow bruising around my leg. Looks a lot better that it did.

Day 22 Sat

Got 2 letters from hospital today. One is an appointment for follow up x-rays and long leg x-rays on 22nd Dec, the other is a copy of what my OS has written to my GP. This includes that I am doing extremely well, but need to work on my bending!! I can also progress to partial weight bear at 4 weeks and to build to full weight bearing by 6 weeks. This should help with my movement.

Day 23 Sun

Had a bit of a melt down this morning! Felt very tearful and burst into tears doing first set of physio today. My husband helped to me to bend my leg gently as I was in a bit of a state. Practiced more in order to get a better bend. Have got over it now, and I know how important the physio is, I have spent the last 18 months doing it!! I just feel that I should be able to bend the leg more than I can, and everyone else seems to thinks so too! I am perservering and doing my best.

I will be making an appointment with my GP next week, to have stitch out and sort out cutting down on my pain killers.

WD

« Last Edit: December 04, 2011, 12:54:21 PM by WonkeyDonkey »

Offline WonkeyDonkey

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Re: WonkeyDonkey's High Tibial Osteotomy - Open Wedge Diary 11/11/11
« Reply #17 on: December 07, 2011, 08:45:47 PM »
Day 26 Wed

I went to see GP yesterday, The stitch I add left in was a disolvable stitch that didn't disolve properly, so this was taken out. Was told not to reduce pain killers just yet as I am having pain whilst trying to bend my knee during physio exercises, so will be keeping up the co-dydramol for a bit longer. Have been for a couple of short walks along my road, to try and strengthen my muscles, to help bend the knee and to get some fresh air. Felt quite tired afterwards but it was great to have a trip outside.

Finally allowed to get in the bath, it wasn't as hard to do as I had imagined with the use of the loyal office chair, but was quite cautious to start with. It felt great, although it was not as full and bubbly as I would normally have! I know want I want for Christmas....loads of bubble bath!! plus a knee that bends more!

Have tried to keep up with all my physio, but my knee is burning around the wound area, also a hot feeling inside, not sure what it is. Any ideas??? Hope it's not an infection, sounds like the symptons the physio told me about. Also I have really cold feet, my operated left one is worse and turns a lovely tinge of blue (when leg is down), but GP checked the pulse in both feet and ankles yesterday and said they felt fine, but to mention it to my OS, who I don't see until 9th Jan, so will have to get some thermal socks for Christmas!! Might mention it to the physio on Monday. Still have some bruising to the inside of my left ankle, not sure if all this is related. I will see how it feels tomorrow, but in the mean time will use the cryo cuff to ease the burning feeling.

WD

Offline WonkeyDonkey

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Re: WonkeyDonkey's High Tibial Osteotomy - Open Wedge Diary 11/11/11
« Reply #18 on: December 11, 2011, 02:50:17 PM »
Day 30 Sun

Still taking the co-dydramols, but no pain in the op site, sometimes a little burning feeling.

My husband and I tackled the shops on Friday to do a spot of Christmas shopping. It was an experience. I have borrowed a wheelchair from the Red Cross (Thanks) so with that we went to the shops. My heart goes out to all those using wheelchairs, why do the shops stack so much stuff in gangways making it so hard to get in the shops and around the counters.  Some lady nearly tripped over the leg extension stuck out in front of the wheelchair. Why don't people look where they are going?!! Managed to do some shopping, I give a prize to HMV, where I had hardly got in the shop before a staff member offered help, shame not all the other shops do the same.

My husband thought it was all good fun, but agreed that it would have been better if he did not have someone with a dodgy leg in the chair, so he could teach some inconsiderate people a lesson in manners.

Had a good day yesterday, not sure if some swelling has gone down, but bending my leg felt a little easier. I might have imagined it though!

Today, bending does feel a little better, but the physio will let me know tomorrow, if I get further than 56 degrees bend. Have been for a walk to the post box to post some of the Christmas cards I wrote yesterday, got asked twice what I had done. I just say I have had an op. Why do people have to offer their piece of advice on subjects they know nothing about? How does an eye op relate to my osteotomy????
Leg is now back to resting position and the cryo cuff, ready for more physio later.

Sleeping the whole night is now appreciated, I only wake once to take off the cryo cuff, but then go straight back to sleep and sleep the whole night. Bliss. Leg is still stiff in the morning but I try moving it, and get it going quickly. Still have some bruising to my inside ankle, which seems to come and go, not sure whether this has something to do with physio or not having leg up all the time.

Have physio in the morning so will update how the knee is bending tomorrow.

WD

Offline WonkeyDonkey

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Re: WonkeyDonkey's High Tibial Osteotomy - Open Wedge Diary 11/11/11
« Reply #19 on: December 12, 2011, 05:26:14 PM »
Day 31 Mon

Hooray!!!

Been to physio today. My leg bend was measured when I got there and was 50 degrees. I was then put on a CPM machine set at between 48 and 52 degrees. I was on the machine for 20 minutes. My leg bend was then measured again and I got to 75 degrees. I was really pleased as I had had a few problems doing my leg bending, but now feel really good that my perserverance has paid off.  I have cryo cuffed my knee since I have been home just to keep the swelling under control.

Now feeling really positive. I have a session booked for next week, and one for the week in between Christmas and New Year, both sessions will be on the CPM machine in order to get the flex better before my visit to see OS in January.

WD

Offline WonkeyDonkey

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Re: WonkeyDonkey's High Tibial Osteotomy - Open Wedge Diary 11/11/11
« Reply #20 on: December 21, 2011, 12:41:11 PM »
Day 40 - Wed

During the week whilst in the bath, found yet another disolvable stitch, not disolved, pulled and out it came. So much for disolvable stitches!

Went to physio yesterday. I am so pleased!!!

He asked me what I thought my bend would be at, I said about 60-65 degrees, I actually got to 84 degrees.....pleased or what!!!!
I then spent 30 minutes on the cpm machine, and managed to get a bend of 90 degrees. All my physio and pain whilst stretching has paid off and the bending is not so painful as it has been.
The wound is healing really well and I rub in E45 cream 2-3 times a day. Physio checked my walking with my crutches and then took one away and showed me how to walk using just one crutch. I can use one crutch whilst indoors, but use two still when outside. Physio was pleased with my progress and said that I may not be using the cpm machine next week but will go on to strengthening exercises instead. I can feel the pain already!!!!

My shoulder ached by bedtime where I had been using one crutch, so maybe I will have to try and not be so clever on one crutch and take it slowly.

Been for a walk this morning after doing my physio, knee feels much better when bending and not so stiff. Last week my knee was very stiff after the cpm machine, but this week feels much better, and I feel more confident that all is going in the right direction. I have my x-rays tomorrow to see if my leg is healing ok, may try to have a look at them myself, otherwise I have to wait until Jan 9th when I see my OS again.

Will update soon

WD

Offline WonkeyDonkey

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Re: WonkeyDonkey's High Tibial Osteotomy - Open Wedge Diary 11/11/11
« Reply #21 on: December 29, 2011, 07:05:50 PM »
Day 41 – Thurs

I went to have my long leg x-rays and some other knee x-rays. All went well, and I asked to have a quick look at them as I was curious at what was inside my leg. It was not quite what I was expecting. I was expecting to see a metal plate and some screws, but they weren’t there! The radiographer asked me if I was expecting to see a plate as I must have looked puzzled, I said “yes”. She said that there was no plate. I didn’t understand. This gave my confidence a push in the wrong direction, I felt really down. But how was the opening in my leg staying open??

Over the next few days I researched the probabilities. I started by looking at the information I was given upon leaving hospital, and there was my first clue. iBalance
So the internet got a bashing, and I found what I was looking for.

iBalance HTO is an implant and has no metal plate holding the bones in place. Links below for those who are interested:-

https://www.arthrex.com/innovations/index.cfm?adid=42

http://www.orthoillustrated.com/

I have many questions for my OS in January but am much happier as I know that I will not have any plate to be taken out in the future. My confidence has now come back and I have managed to put more weight through my leg.

Day 47 - Wed

Physio today. Mentioned to my physio about my x-rays, and he said he was going to look up my iBalance details. He felt the skin around my wound and could not feel any plate. He measured the bend today, I was hoping for about 100 degrees but got to 95 degrees (100 after he had helped). I was told that 90 degrees was the goal at about 6 weeks post op. No cpm machine today and I had to walk with one crutch and then my physio took it away. Help!! It felt good to walk on my own, be it half a dozen steps!! I was then shown another four exercises, including stairs to improve the strength of my leg. Must allow longer to do my physio now! Only allowed one crutch around the house now.

During the afternoon, leg stiffened up and had some pain on knee where the exercises had used some of the muscles that hadn’t been used too much recently. Took some painkillers, which eased the worse.

Day 48 Thurs

Knee felt stiff this morning but still managed all the physio exercises including the new ones. Also went for a walk, about twice as far as I had managed before. New music on the ipod for Christmas helped. It felt good to be outside, although it was a little windy. Used the cryo cuff to help with swelling and stiffness during the afternoon.



drmark

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Re: WonkeyDonkey's High Tibial Osteotomy - Open Wedge Diary 11/11/11
« Reply #22 on: December 29, 2011, 07:26:31 PM »
Could you find out from your Orthopaedic doctor what independantly conducted and peer reviewed research exists on this implant?
Thank you very much.
Happy New Year,
Mark Sanders MD FACS

Offline WonkeyDonkey

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Re: WonkeyDonkey's High Tibial Osteotomy - Open Wedge Diary 11/11/11
« Reply #23 on: December 31, 2011, 02:39:10 PM »
Hi drmark

If you want to contact my OS through his website, he is Mr Adrian Wilson, see below:

http://www.hampshireknee.co.uk/

or email [email protected]

He has written the course on KG on osteotomy and other topics.

If not, I am more than happy to ask him your question when I see him in 10 days tme.

Happy New Year

WD


Offline WonkeyDonkey

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Re: WonkeyDonkey's High Tibial Osteotomy - Open Wedge Diary 11/11/11
« Reply #24 on: January 03, 2012, 09:40:27 PM »
Day 53 - Tues

Been doing my physio regularly, even on Christmas day!!! I can definately see an improvement. I am now walking twice a far, a fair bit only on one crutch, although I take both crutches with me. My bend is increasing, I think and my strength is starting to built up slowly. I am a lot more mobile around the house and can actually carry things for myself from the kitchen, at last I can raid the cupboards of christmas goodies.

My confidence is not always on top form, but it is building upwards in order to attempt new exercises and physio. I cannot do one of my last lot of extra exercises, which is to step up backwards on to a step. Have tried holding on to the walls each side, holding my crutches and holding on to my husband. Just have to go back to the physio on Friday to say I can't do it. I will have to try again.

I have physio on Friday and see my OS on Monday, so have a few busy days along with home physio 3 times a day, plus trying to dodge the rain and wind to go for a walk. Missed out on this today as the weather was horrendous!!

Will update soon

WD

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Re: WonkeyDonkey's High Tibial Osteotomy - Open Wedge Diary 11/11/11
« Reply #25 on: January 06, 2012, 10:28:38 PM »
Day 56 - Fri

Been to physio today. It was great I bent my knee 110 degrees on my own, I was really pleased. My physio said that I was doing really well and was ahead for this operation. We started by me saying that I had had a few bad days and I haven't been able to do last weeks step up backwards on to the step exercise. On Wednesday I had a bad day, home physio didn't go too well, during my walk I nearly fell over after my knee wobbled sideways a little which made me a bit unbalanced, during the day this happened 5 times. I used 2 crutches to balance me out a bit. The bad days could have been from reducing the pain killersover the week, walking further and walking more using just the one crutch.

Confidence back, I went to physio on one crutch. We then moved on to try out some of the gym equipment, the steps again(still couldn't do them without pain), moved on to the bike, the wobble board, trampette, and of course the gym wall. Managed all the exercises. I am now progressing and am going to the knee class weekly on Tuesday mornings for 6 weeks. Looking forward to it, means I am moving in the right direction.
 
Knee stiff and aching since physio, using cryo cuff to help. Also had wobble when I got up from the chair, will ask my OS about this on Monday when I see him. Will update next week.

WD

Offline WonkeyDonkey

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Re: WonkeyDonkey's High Tibial Osteotomy - Open Wedge Diary 11/11/11
« Reply #26 on: January 11, 2012, 09:40:41 PM »
Day 61 – Wed

On Monday I had an appointment to see my OS, saw his Registrar, who is very knowledgeable about Osteotomy. He asked about knee movement, could I bend my leg, could I straighten it, I showed him both. He noticed that I had one crutch propped up against the wall, and asked if I was still using them. I said that I used one crutch outside and tried to walk without it indoors. Although he was really nice it made me feel that I wasn’t doing as well as I should be, maybe it was just me! He checked my wounds and said that they looked good. We talked about my x-rays, which showed that the bone had filled in the gap by about a third (at 6 weeks) and that it would take between 6-9 months to completely fill in according to recovery rates of the body. We also talked about the fact that I had expected to see a plate and about the iBalance implant and that it was made from polytherertherketone (PEEK). The advantage is no plate to be taken out later on. I asked lots of questions that had been on my mind, about the numbness on the side of my knee, the burning feelings inside my knee on occasions and the cold feet I have been suffering. All normal apparently. I can now go swimming, but until I am off crutches completely I cannot drive to the pool, and can’t expect my husband to drive me there as well as all the other appointments and physio. I will be seeing my OS or Registrar again in 3 months time.

Yesterday I went to my first knee class. I was there with 2 other ladies. My physio had checked out what was in my leg since my last visit, the iBalance, and shown it to his boss, who had not had anyone with this implant before.
The physio explained what was going to happen during the class, how we were going to warm up, do 10 exercises, two minutes of each one and then stretch to cool down. Sounded good!!!! I was ready to go. I used the bike, the wobble board, the stairs, resistance bands, leg press amongst other exercises. During the class I used the trampette and marched on it, but my knee wobbled about giving some pain. I tried to use the cross trainer but didn’t have enough strength to move it, I was gutted!! I am not used to not being able to do things like that. But then I cannot go up the stairs without two crutches because of a strength/confidence issue. I find I just cannot do it. I look a bit stupid even if I say it myself, trying to get up one step. As my physio reminded me, I have no banister on my stairs, so have nothing to hold on to, to help me up.
At the end of the class I had my knee bend measured and it got to 118 degrees. Yippee. Another 8 degrees in 4 days. As my physio had said would happen, my leg stiffened up and with the use of the faithful cryo cuff during the afternoon, it eased up a little. I then went for a short walk as well, and did some more physio during the evening. Slept very well.

Today I have kept up with the home physio, and been for a walk. My knee had two wobbly moments when I was out, but I think it is probably the knee moving sideways slightly, making the leg feel as if it is going to give way, but doesn’t. It probably needs more working muscles to support it better!!! I did my walk mainly on one crutch (except my 2 wobbly moments) and felt much better, as I had not taken any painkillers today and all was well. I will take two before bedtime, as I am still weaning myself off them. Hope I have a good nights sleep tonight.

WD


Offline WonkeyDonkey

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Re: WonkeyDonkey's High Tibial Osteotomy - Open Wedge Diary 11/11/11
« Reply #27 on: January 19, 2012, 03:29:30 PM »
Hi

Day 69 – Thurs

Been to my knee physio class this week. Met a lady who was rehabbing from her 2nd Osteotomy. She was doing better than me!! We started with a warm up, did 2 minutes each of 10 exercises and then we stretched out. Whilst there I had my bend checked again and I managed to get my bend to 125 degrees on my own. I was aiming for about this amount. My walking on my own was checked, and was told that I had to stay on my one crutch. My physio said that I was not confident enough to move over. Maybe, next week. Gutted as I was hoping to move to a walking stick this week.

I have still been having wobbly moments when out walking, which I think is due to a movement to the side in the knee, (uneven paths do not help!) and me not having strong enough muscles to support it without any pain. This seems to be getting a little better as time is going on.

This week I have had a break through and can now sleep on my side – right side. It makes such a difference and a great relief to change positions. I have put a  cushion/pillow between my knees, but it was okay when I forgot it as well. I was still comfortable, but I have no metal plate to make it feel uncomfortable.

Offline WonkeyDonkey

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Re: WonkeyDonkey's High Tibial Osteotomy - Open Wedge Diary 11/11/11
« Reply #28 on: January 21, 2012, 01:01:36 PM »
Day 70 – 10 Week Post Op Reflection

I seem to have come along way in the last 10 weeks. I started by not being able to bend my knee, put in lots of time to do physio and time on the cpm machine and I am now 10 degrees off the same bend (135 degrees ) as my good knee. The wound has healed very well, and is looking good. I have moved from struggling around on two crutches with a stiff leg to walking on my own around the house, and on one crutch when outside (also when I have done too much during the day and my knee is aching). Still struggling with stairs, but this is due to lack of strength (and maybe some confidence!!). Sleeping very well, too well in fact. Painkillers are only being taken during the evening and/or before bed so I have cut out most tablets now, and this is because I need to wean myself off them slowly so I do not get side effects. The only pain I get is when I have over done it, and when I do some of my physio, but it is not unbearable and nothing like the pain prior to the operation. It also feels great to find out that I will not have to have any metal plate taken out later on due to the wonderful technology my OS has used on my leg. I have an implant in my leg to hold it open and not any metal. I have had to explain to quite of few people about the implant as it does not appear to be very commonly used yet.

I would like to say “Thanks” to my OS for his knowledge and understanding, also to my physio for his patience and world of exercises. Best of all I would say a huge “Thanks” to my husband for his pampering and continued support, and that I will be back to enjoy walking the coastal paths before long.

I would like to finish this reflection by saying that I am glad that I have had this operation and would not hesitate to recommend it even though the recovery is a long haul but worth it.

WD

Offline WonkeyDonkey

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Re: WonkeyDonkey's High Tibial Osteotomy - Open Wedge Diary 11/11/11
« Reply #29 on: January 21, 2012, 09:52:02 PM »
Day 71 Sat

Yesterday I had a really good day. I had an appointment with my GP, I walked there and back, also walked around the supermarket with my husband, even if I was on my crutch.
The highlight of my day was that I went swimming. Sounds sad that it was a highlight but I love swimming and haven’t been able to go for quite sometime. I managed 20 lengths front crawl of the pool, could have done more but didn’t want to over do it on the first time back! Think using the crutches have strengthened my arms. I alternated two lengths kicking with my legs with two lengths using a pull buoy. Made me feel good as I could still manage to overtake some of the other swimmers. My knee felt quite stiff to start with but by about 15 lengths it was just about bending a little on its own. I am going to ask my physio if there are any exercises I can do in the pool to help. 

Got letter today from the hospital which, is a copy of what my OS Registrar has written to my GP. It said that I am doing extremely well following my op, ROM has improved markedly, wound is well healed and some callus forming in Osteotomy site. I have been advised to avoid high impact things, particularly jumping for a year or so.

To me the future looks promising.

WD















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