22 days post op: High Tibial Osteotomy (open wedge)

To let us know how you are getting on for the first days and first few weeks after your operation or injury. We would be interested in knowing about pain levels and meds, dressings, using the CPM machine, swelling, icing regimes, mobility, exercise regimes, bathing and travelling issues, etc.
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meljoh
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22 days post op: High Tibial Osteotomy (open wedge)

Post by meljoh »

Well, today is day 22 since having a high tibial open wedge osteotomy done (say that fast 3 times ;D). A plate and 4 screws were put in along with them doing a bone graft. I think out of all the ops I have had, a fulkerson TTT included, this ranks up there as a crappy one. The hospital stay made me miserable. Not so much because of the pain or what have you, I did not like some of the post op regimens that they attempted to force on me. And of course being the stubborn, aggressive scorpio that I am, I rightfully declined several things ;D

I have read some people's posts on this site who have had the same procedure as I. I have yet to find anyone who has had it done for the same or similar reason than myself. Basically, while being treated and evaluated for medially subluxing patella (was formerly laterally, but that was fixed), one of the docs noticed what appeared to be compression on the medial section of my knee. So before we could go in to fix the medial subluxing, he had to determine if the compression issue was bone on bone or soft tissue. If the latter, only 1 surgery would be needed to fix all. But if bone on bone, that needed to be fixed first. So had a bone scan done. Unfortunately showed significant bone on bone compression in the medial compartment. That was leading to lateral stretching and my gait mechanics being all out of whack. So fast forward to now.

The hospital stay was only 2 days. I was expecting more but was certainly happy with less! For the surgery, they were able to go through my TTT scar instead of making a whole other one. they started this incision about an inch or so from the bottom and extended it over and to the medial side of my patella. Straight and then crescent shaped on my knee. 27 staples held me togther for 2 weeks. i was glad to have those annoying little suckers removed. In the hospital, before surgery, I made it very clear that if post op pain management included a morphine drip, I wanted absolutely NO part of it. I had the drip with my fulkerson and was horribly miserable. Not only did it have no effect whatsoever on my pain, the side effects made it worse. So whatever they did give me intravaneously, wasn't too shabby. Knocked me out within 30 minutes or so. Can't complain about that.

In recovery they attempted to put these boot things on my feet I believe in an effort to help prevent blood clots. That hurt. VERY VERY bad. Like every couple seconds (alternating each foot) it's like a burst of air into this boot. Basically bursts in at the bottom/heel of the foot. It hurt, I cried. The nurse was understanding and removed them. Later after being moved and settled into my room, all hell broke loose. Doctor and nurse placed them on my feet again. Meanwhile I had some other bozo nurse trying to give me neb treatments. Why I have NOOOO idea. I think it's because I am a smoker, and I am just laying in bed?! Needless to say this time did not go well. I was screaming at the doctor and the nurse that these boots hurt. This pressure, the feeling of impact on the bottom of my foot hurt tremendously at what I learned very quickly to be the point of where the work was done during the surgery. So little nursey nurse starts shooting me up with pain meds thinking its going to help just like that. They kept these boots on, completely disregarding the fact that I was crying and in between breaths I was telling them how much the f-ing boots f-ing hurt (I don't mince words). All the while bozo nurse is trying to shove the neb mask on my face. Told her to get the hell away from me with that s*^t. After some time, the nurse and doctor left, with the boots still going. Pain meds doing nothing for me. So I slyly pull the blanket over my legs, use my right foot to undo the straps on my left foot. Then I watched TV. everytime someone came in the room they could hear the little machine going. Unfortunately the time came when I needed to go potty. Nurse came in with a bedpan. HAHA told her I didn't think so. I'm using a toilet. Get me a walker or crutches cause bedpan ain't happening. At this point of the day I was so frustrated, something WAS gonna go my way!!

Well I had to get clearance from a PT doctor before I could use the bathroom. That wasn't a challenge. But he did discover what I had done with the boots. I told him I refuse to wear them anymore. He was like fine, but you HAVE to do ankle pumps every hour. I said no problem, I was very good about doing the pumps, almost constantly. Later on doctor came in and my husband asked him if it was normal to experience so much pain from those things. Earlier a doctor and the nurse kept saying they dont hurt like that. This one told my husband, no they generally don't cause so much pain. But considering what I had done, and the fact this was the same day as surgery, he wasn't surprised I was feeling so badly. From there, things were relatively uneventful. I think 2 or 3 more times the respiratory people tried to come in for the neb treatments. I faked it the next time. The following morning they came the same time as my nurse. I held out my arms so nursey could do what he needed to do. Not being a morning person, I had the sheets pulled over my face hehe ::) The resp. guy was like you ready for your next treatment? Said nope going back to sleep leave me alone. He was like well I already scanned your barcode and the meds so the system shows it was administered. I told him too bad, you should have asked first or better yet don't come back again. I said until you people start letting me go outside to smoke I'm not doing your stupid breathing treatments. I'm not some 80 year with emphysema who just had her hip replaced. Leave me alone...

PT began the morning after my surgery. Wasn't too bad. Painful but did everything nonetheless.

Now 3 weeks later, I have unlocked my brace (in a Breg) because I have enough consistent ROM to walk while bending it. I have been PWB from day one, which actually surprised me. As of this past Tuesday my ROM was up to 129 degrees which is only 11 shy of full ROM. I am about 3 degrees shy of full extension. I just cant straighten it all the way even if I force it. Was able to do full revolutions on the bike Tuesday at PT. Therapist was surprised I could do it. Didn't really hurt either, was actually relieving like i was stretching and breaking up that stiffness.

Pain level has tapered off quite a bit, although yet to experience at least a minute pain free. I was given Vicodin for pain management and am also on blood thinners. I have to get my blood drawn weekly to monitor that. No biggie.

Other than all that, feeling ok I suppose. Ready to be done with this. First Post op appointment is next week. Had the staples removed last week. Just going bonkers sitting at home.

Hope all is well with everyone and their knees!

~Melly
3/93 scope torn meniscus, 10/00 sched for LR but remvd exc. scar tiss 11/01 LR,  repair  degen men. tear 10/02 TTT with agg. trauma since 12/04 screw rem. dlng w/bone mass loss in knee, medial subluxg 9/05 open wedge HTO. More to come...
shadehawk

Re: 22 days post op: High Tibial Osteotomy (open wedge)

Post by shadehawk »

Melly,

Sorry that you had problems at the hosp, but aside from that things are looking really good so far. I am also surprised that you were allowed to be PWB right away, that has to be so much easier for you to get your ROM back.

Keep up the good work,

Shade
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Re: 22 days post op: High Tibial Osteotomy (open wedge)

Post by stgiles16 »

OMG Melly, we had the same nurse with the bed pans LOL. I finally got her goat. My hubby CARRIED ME to the potty,,,,,,, she comes back in the room feeling smug and asked me was I ready for that bedpan now? LOL NOpe, all taken care of, she was not happy. I sucked it up and took the neb treatments. They dont hurt and I didnt fight them. As for the smoking, I didnt exactly ask, hubby went and got a wheelchair and off we went, no one ever said anything about it. I had the boots too but luckily, they didnt hurt. Did you meet that horrible british lady in pt? EWWW she was evil when I was there. She doesnt like me either because I didnt mince words with her ;D I am sorry that you didnt like the hospital. I have always had good care there.

You seem to be doing really well. I am happy for you. I will send you a pm soon, have been gone all day.
get well soon
missy
2 ligament recons right ankle
2 arthroscopic,
5 open knee procedures
2 Plica removals
bone spur removal
2 microfractures
4 debridements
2 open LOAs all on left knee
Arthritis,both knees, ankles, shoulders, elbows, hands,spine
Fibromyalgia
Arthrofibrosis
LOA & PKR 2/15/06
RA
in pain mgmt
TKR JAN 2012
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meljoh
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Re: 22 days post op: High Tibial Osteotomy (open wedge)

Post by meljoh »

Thanks for the thoughts you guys. Today is day 25, so far so good. Friday had PT again. It um SUCKED. My ROM went up another 3 degrees to 132, so 8 more and I'm at 100%. Extension is still a problem. So she decided to uh MAKE it extend further. At first, she put a l ittle wedge thing under my thigh and placed a hand on either side (top/bottom) of my knee. And pushed it down. Then switched the wedge to under my calf and did the same thing. Holy crappers did I pay for that the rest of the day!! :o All this and my extension increased by 1. So I am still 2 degrees shy of full extension. Told her next time I come she should just sit on my leg or better yet let my daughter just jump up and down on me for crying out loud!! But really, she is a cool therapist. This past week I had to bring my 3 year old with me. Told her to bring books and stuff to keep her busy. My therapist will read to her while I am doing some of my exercises.

As frustrating as it seems, she said for barely over 3 weeks post op, I am doing great. Especially with regaining my movement. I get so excited cause when I am doing heel slides, going down, I can actually SEE my quad. Lil thing poppin up like it wants to be seen, lol. Also, she put me back on the bike, but lowered the seat. So Trying to do full revolutions she thought would have been harder because of course there is a higher degree of ROM involved. Again, did it like it was nothing. Actually went faster too ;D Felt Phenominal, very loosening.

In the end at least I got some massaging out of it though. She massaged the back of my leg and boy howdy was that surprisingly sore. Never realized it til she messed with it though. And right smack on the back of my knee hurt like a you know what. I was like why in the world is THAT so painful?! They did bone work. She said chances are they probably did some manipulating. Which they did. I vaguely remember them telling me about that post op. Hehe, right before the last thing of e-stim and ice, she tied one of those big resistance bands around my thigh so I could do the thighmaster exercise. LMAO told her I was gonna go home and tell my husband I got massaged and tied up ;D ;D

Today got a call from the clinic where I go for my weekly blood draws. Results came back a little too much on a "normal" level considering I am on Coumadin. Doc asked I know what INR (?) level OS wanted to keep me at. I'm clueless. He thinks somewhere between 2 and 3. My results came back 1.5. It's been dropping every week. So gotta double dose tonight and call OS tomorrow. Probably get blood drawn sooner this week. He thinks OS will likely increase my dosage. Asked if this can happen cause body gets accustomed to the med and reduces effectivness. This can be the case, but so could some other things. They might do some other work ups this week too cause I had asked if a common side effect of nausea/throwing up. For the past week and a half I have thrown up every night around the same time. And I told him I know I am NOT pregnant, lol. I've been spayed and I still take the pill. I will so sue the crap out of someone if I ever get pregnant again!!!

Shade~
I am surprised too that I was able to be PWB since day 1. VERY surprised. I remember when I had the Fulkerson done, they were hell bent on not letting me put any weight on the leg. I remember a couple times I slipped up. Not hardcore, totally walking on it, just kinda inadvertently. doctor went off the deep end when I told him ::) I think what has reallky helped me so much in getting back to normal is the fact that I can take off the Breg when I'm lounging at home. Being able to work my leg as I feel comfortable, not always those "written instructions", helps too. Especially mentally. I am always a better person going at my pace, not what others tell me. Don't get me wrong, I do what I'm supposed to do. But doing even more at my pace and comfort I think is a huge boost. Unlocking my brace has helped too. When I wear it that way and then take it off at home to do exercises and what not, I no longer feel like I have taken 2 steps back from where I was. Having it locked made me soo stiff.

Missy~
Dunno about the bedpan nurse, lol. Being the stubborn butt that I am , when I say no I mean NO. I think I was such a butt about the neb treatments because I had reached a boiling point. I am usually pretty good about dealing with pain. And my threshold aint too shabby either. But to have pain basically forced upon me (the boots) and my protests get ignored, it really pisses me off to say the least. When I reach that point, I am not cooperative with too much else. Needless to say, they did finally give up on trying to give those to me hehe ;D Don't mess with a ticked off scorpio...

Hope everyone is having a good weekend. I am off to the kitchen for crippled cooking ::)

~Melly
3/93 scope torn meniscus, 10/00 sched for LR but remvd exc. scar tiss 11/01 LR,  repair  degen men. tear 10/02 TTT with agg. trauma since 12/04 screw rem. dlng w/bone mass loss in knee, medial subluxg 9/05 open wedge HTO. More to come...
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