High Tibial Osteotomy 3 months post op

rissa20012002

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Hello, I’m a newly 33 year old and I had a closing wedge HTO on September 22nd 2022. I had tried conservative methods and for 3 years and had previously had an arthroscopic surgery to clean up the cartilage. In less than 4 months the cartilage has already gotten torn up again. My leg was also unstable. Unfortunately no ortho was willing to do a knee replacement due to my age. Recovery has been absolutely awful. ROM is barely past 90 degrees, I am finally walking without crutches at home but using at least one crutch while out for stability. The biggest issue besides the constant ache is that my tibia feels uncomfortable, especially if I don’t have a compression bandage such as an ace bandage wrapped around it. Is this something anyone else has experienced? Does it get better? Do you ever get used to the new way your leg feels?
I know I still need to work on the skin/nerves and helping them stop being so sensitive. The skin around the incision is highly sensitive, but I guess I didn’t expect for the inside of my actual leg to feel so different. I thought having a cervical disc replaced was bad…that was a walk in the park in comparison.
 
Hi and Welcome!

HTO can be a really tough recovery. Quite a bit of work was done inside your leg and healing takes time, an average of a year, so 3 months is still early in recovery. Yes, it will get better, but it will take a while.


I will leave you our Recovery Guidelines. Even though they are for a TKR, they will also apply to HTO. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Just keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

Knee Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary

2. Control discomfort:
rest
ice
take your pain meds by prescription schedule (not when pain starts!)​
If you want to use something to help heal the incision,
BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.​

3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you​
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​
4. PT or exercise can be useful BUT take note of these

5. At week 4 and after you should follow this

6. Access to these pages on the website

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in the majority of BoneSmart’s forums, we ask that each member have only One Recovery Thread. This policy makes it easier to go back and review the member’s history before providing advice, so please post any updates or questions you have right here in this thread.
 
Here are some other members who‘ve had an HTO:

 
Hello, sorry you’re having such a hard time. Just curious, what is an HTO? I had many procedures before my first LTKR when I was 45. Had a cementless TKR that worked well (cement fails first so cementless is supposed to last longer). 7 yrs later my RTKR did not. At 45 I was also not a candidate but my doctor finally knew there was nothing else he could do. Good luck!
 
Just curious, what is an HTO?

 
Hello, sorry you’re having such a hard time. Just curious, what is an HTO? I had many procedures before my first LTKR when I was 45. Had a cementless TKR that worked well (cement fails first so cementless is supposed to last longer). 7 yrs later my RTKR did not. At 45 I was also not a candidate but my doctor finally knew there was nothing else he could do. Good luck!
An HTO is a high tibial osteotomy. This surgery is where they cut out a wedge of the tibia and either close it or fill it with a graph and secure it with a plate and screws. This realigns the leg and fixes how you carry weight on the knee in order to help preserve it. It’s not a common procedure and typically done as a last resort from my understanding. 3 orthopedists later and the same answer of we can’t replace the knee at your age I didn’t see much of an option. I was on crutches pre surgery since my knee was constantly giving out and I’d had too many falls.
 
3 orthopedists later and the same answer of we can’t replace the knee at your age
I ran into the same problem. I was told in my early 30's that I would eventually have to have knee replacements. Five surgeries later I finally had the RTKR. It is very frustrating to have to hear the words that many of us have heard, that we're too young for a replacement even though we need it.

We are here to help you through your healing from the HTO. I pray that you are blessed that this corrects your problem and there are no more surgeries on this knee for you!
 
Hello rissa20012002
I hope you're doing well this month and enjoying some steady progress. Want to wish you a Happy Three Month Anniversary and hope you enjoy the holidays with those you love!
@rissa20012002
:merry-xmas-smiley-emoticon:
 
Hello all, just wanted to post an updated. Next week will be 5 months post op and I’ve honestly not felt anywhere near close to where I should be. I’ve felt behind every step of the way. I’ve also been having creased pain, hypersensitivity of the skin, my ankle is still “stuck”, I have discoloration/patchy skin on my leg, horrible blanching, and the temperature difference is very noticeable. The leg that got the HTO is always cold all the way down to my toes. Well turns out I have complex regional pain syndrome. It sounds like it’s not a very common then to suffer from in general and even if less in legs. I guess they see it more on hands. It’s apparently a huge factor in why my recovery is going so slow, it apparently doubles the recovery time? Basically I’m adding a few more folks to my care team including a new physical therapist who specializes in CRPS and a pain therapist to help work on desensitization my leg and treating the nerves. It sounds like the sooner we work on it the less likely I’ll be to lose full use of joints (such as my stuck ankle). Also, I’m waiting on a CT scan to see if my plate being too big is causing issues with the soft tissue. So things are…an adventure.
 
@rissa20012002 So sorry you are dealing with CRPS! But I guess the good news is that you now have a diagnosis and can move forward. Yes, this will increase your recovery time. But sounds like you have the right professionals lined up to help you.

Please keep us updated!
 
@rissa20012002 So sorry you are dealing with CRPS! But I guess the good news is that you now have a diagnosis and can move forward. Yes, this will increase your recovery time. But sounds like you have the right professionals lined up to help you.

Please keep us updated!
Thank you! I will say it’s validating in that I’m not some sort of failure or this surgery is not a complete failure. At every appointment it’s been “you’re not where I want you to be” and I haven’t been able to figure out what I’m doing wrong - I feel better knowing it’s not anything I’m doing wrong I’ve just got an extra challenge.
 

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