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Author Topic: HTO Post op pain question, urgent advice please.  (Read 759 times)

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Offline UK86

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HTO Post op pain question, urgent advice please.
« on: November 29, 2015, 09:47:19 AM »
I had a HTO, large closing wedge with tomofix plate.  This is day 4 post op.   I'm struggling massively with pain, right from the recovery room onwards.  I was on a patient controlled analgesia (pain pump) and oral morphine in hospital. 

Now at home I'm on Morphine Sulphate slow release (MST), 20mg x2 daily.  Ibruprofen 400mg x2 daily. Gabapentin 300mg x3 daily.  Paracetamol 1000mg x4 daily.   

This morning  I woke unable to move.  1.5 hours after taking this my pain was still 7/20, going to the toilet was  extremely painful and I could barely think for the pain.  I wentt dizzy and nearly fell over in the bathroom.

I got back to bed and out of desperation I took 30mg codeine I had left from before my surgery.  Pain is now 5/10, can just about distract myself from it for a short while.

 I'm a large guy (120kg) and I was on codeine for 5 years  prior to surgery so I wonder if the dose of meds I'm on is simply too weak for my size and tolerance.

 I'm resting, elevating and icing the knee to try and reduce the swelling but the swelling is still huge.  The pressure within the knee and around the lower leg is almost unbearable.

This is pain on a new level for me.  Is this normal?
Nov 2015 - HTO & Lateral Release

Offline UK86

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Re: HTO Post op pain question, urgent advice please.
« Reply #1 on: November 29, 2015, 10:10:48 AM »
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« Last Edit: December 05, 2015, 07:08:06 AM by UK86 »
Nov 2015 - HTO & Lateral Release

Offline Leena20

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Re: HTO Post op pain question, urgent advice please.
« Reply #2 on: November 29, 2015, 06:10:25 PM »
Hi

I had a femoral osteotomy 6 weeks ago. Your leg looks similar in swelling to how mine was but I really wasn't in much pain. I only needed ibuprofen and paracetamol.

I don't know if your surgeon has recommended one of these? http://www.gameready.co.uk/Wraps.html
I found it far more effective than the pain medication. It cools your leg and helps with the pain and swelling massively. Although everyone is different I found it amazing. 

Offline UK86

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Re: HTO Post op pain question, urgent advice please.
« Reply #3 on: November 29, 2015, 07:56:13 PM »
Hi

I had a femoral osteotomy 6 weeks ago. Your leg looks similar in swelling to how mine was but I really wasn't in much pain. I only needed ibuprofen and paracetamol.

I don't know if your surgeon has recommended one of these? http://www.gameready.co.uk/Wraps.html
I found it far more effective than the pain medication. It cools your leg and helps with the pain and swelling massively. Although everyone is different I found it amazing. 
Hi, thanks for the reply.
I'm using a cryo cuff around the knee but it doesn't cover the whole leg. Unfortunately I'm finding the cold application increasingly unpleasant rather than helpful.

I don't know how anyone could manage with only paracetamol and ibuprofen!  Would you say you have a really high pain threshold? 

Much of the pain is in the knee joint itself, it feels like it is throbbing and about to pop, presumably from the swelling.    I know it is never going to be fun but I hadn't expected to be totally immobilized by pain.

Even sitting is very painful, the only comfortable position is lying on my back, leg totally straight with the foot raised slightly.
Nov 2015 - HTO & Lateral Release

Offline Leena20

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Re: HTO Post op pain question, urgent advice please.
« Reply #4 on: November 30, 2015, 08:29:35 PM »
Hi - I do remember my physio being quite surprised about how few pain meds I used. For about two weeks I really did nothing but sit on a sofa or in bed, and nights were not pleasant at all as I couldn't bend my leg and found sleeping hard. I think after that everything started to slowly get much more comfortable - the aesthetic made me pretty spaced out for 2 weeks so I don't remember things that clearly. My knee definitely was making some strange sounds too that have now gone as the swelling went down (I had a arthroscopy to clean out my knee at the same time). I don't think I ever felt like it would pop but it was catching and not sitting quite right in the joint for a few weeks.