High Tibial Osteotomy Help 7 days post surgery pain is excruiating

SQUISHY

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South Africa South Africa
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Hi everyone I am 48. Just had a HTO on 14 Sept. Pain seems to be getting worse. I am in South Africa and only been given one painkiller - Synaleve - which doesn't help.

I had closing wedge HTO to correct opening wedge HTO done in error in 1987. Also had bone grafts into old ACL tunnels. My leg was 22 degrees skew hence the ACL going all time. It was corrected 19 degrees.

This is my 2nd HTO on right leg as well as 15 other ops since 1984. As soon as this heals I am having 3rd ACL reconstruction.

Pain is actually making me nauseous. I want to hear from anyone what their pain levels were 1 week post op. Thanks
 
Hi and Welcome to Bonesmart!

I am going to tag @Josephine
our forum administrator and nurse director to address your concerns.
 
@SQUISHY Welcome to BoneSmart! So sorry you are in pain. I see Jockette has already tagged our medical expert here. She should be along soon. What is the dosage of your medication (how much and how often)?
 
2 tablets every 8 hours. They are not helping at all. I am fine lying down. Minute try mobilizing on crutches the pain is unbearable. Feels like leg gonna explode.
 
only been given one painkiller - Synaleve - which doesn't help.
Well, Synaleve contains three main ingredients, namely acetaminophen (paracetamol), codeine phosphate, and meprobamate. Can you tell me what dose of each of these your tablets contain, how many you take and how often during the day?

This must be quite and old drug as the meprobamate has been replaced with benzodiazepines which are incredibly addictive.

I think you'd be better off taking Tramadol and paracetamol. Do ask which ever doctor is in charge of your pain meds (GP or surgeon) if you can have them instead and if you're successful, take them according to this chart

aa Tramadol routine 1.JPG


I must also ask you if you are icing and elevating your leg because that is also a good way to manage pain.

Here are our Knee Recovery: The Guidelines

2. Control discomfort:
rest
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)
don't overwork.
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

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Elevation is the key
Ice to control pain and swelling

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

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 a 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 history before providing advice.



I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?
 
Josephine thank you so much for info and reading your recovery thread helped.

I have hired a icing machine for 2 weeks and using it about 20 hours a day.

Each synaleve capsule contains:
Mephrobumate 200mg
Codeine 8mg
paracetamol 400mg

I have been taking every 8 hours or 10 hours to make them last but by then the pain so bad I almost pass out.

I am on a blood thinner so scared to take any other pain killers.

And ask away with questions please.
 
I have been taking every 8 hours or 10 hours to make them last but by then the pain so bad I almost pass out.
That's not enough. You really need to go back to your prescribing doctor and discuss this with him in regard to the fact that this drug isn't controlling your pain adequately.
I am on a blood thinner so scared to take any other pain killers.
What other pain killers were you referring to? The Tramadol? It won't have any impact on the anticoagulants. Besides which, I suggest you get Tramadol instead of Synaleve not in addition to it.
 
Thank you Josephine. Will ask my doc for Tramadol on Monday. Synaleve now finished so just taking Betapyn (paracetamol + codeine)
 
Hope you are feeling better. I had my HTO 27/11/18. Each day gets better. Keep on the Tramadol. It helped me a lot. If you ever want to talk I’m here xx
 
Hi Purr I had my ACL and MCL reconstructed on 27.11.2018. No more pain from HTO but have 7 new cuts and doc tells me I have bone on bone. Why did you have an HTO? Take it you a kitty person by name? Squishy one of my 8 cats.
 
Hi Squishy
Yea love cats
When did you have your HTO ?
My surgeon told me it would be better than a TKR at my age, he did explain it takes longer to recover but I will have normal knee movement and be able to kneel. Which is important in my job. Must admit first week I was wishing I hadn’t had it done
What’s ACL and MCL ?
 
Anterior Cruciate Ligament and Medial Cruciate Ligament. And she means they were damaged and had to be repaired.

If you ever see an acronym anywhere again, you will very likely be able to find the definition in this abbreviations and acronyms
 
I had my HTO 14/09/2018. In my accident I snapped my Anterior Cruciate Ligament so they cut part of my quad tendon out and made me a new ACL. That shortened my MCL and shaved some excess bone growth from HTO. Sadly he also discovered my knee is bone on bone so not sure how long till I need a TKR. I feel he should have done it now.
 
Yes definitely seems to be putting you through so much pain when TKR would solve every thing. How is your pain now
 
Sadly he also discovered my knee is bone on bone so not sure how long till I need a TKR. I feel he should have done it now.
Oh my gosh yes! He should have abandoned the HTO and done the TKR instead. That's outrageous because you are now committed to at least 12 months of recovery from this surgery before anyone will consider doing a TKR. I am astonished!
 
This my 17th op on this leg since 1984. At the moment pain through roof and I look like a shark bite victim. 7 cuts for ACL and MCL. I am a bit down in dumps.

Purr how is your pain?
 
I feel like a shark attack victim

squishy.jpg
 
That looks painful babe can you weight bear on it. Is that a fixed brace or can you bend your knee. Yep can see the look a like shark attack victim there . Sorry your feeling down in the dumps pain lack of sleep takes it toll doesn’t it. Pain killers still not working ? Did you manage to get your G.P to change them ? . How are you managing all them cats lol.
My pain last few days been bad. Pain killers work for a few hours then it starts again. Now my left knee really hurts due to taking all my weight god knows what I’ll do if that gives out.
Hope you feeling a little brighter and here when ever you want a chat. Not like either of us will go far for a while xx
 
Not seen any chat for a while. Hope every thing is ok. Let’s us know xxx
 

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