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High Tibial Osteotomy LAman's Recovery to play sports again

LAman

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Hi - thanks! So, I'm told surgery went well, but not entirely to plan. When they got in there, they actually found a 2nd section of my thigh bone damaged, so i ended up with two OATS procedures, and the HTO.

Also, I had a lot of trouble after the surgery. When I came around, I had some pain and the back of my leg (I had a nerve block, so the surgical site on the top of my knee was pain free) - not severe pain, but certainly quite unpleasant/uncomfortable - i'd say about a 7/10. They gave me a shot of dilaudid through the IV. It didn't help, so they did another shot of it. Neither helped with the pain, instead I became dizzy/lightheaded/nauseated, and started randomly and uncontrollably falling asleep.

Trying to control the pain, they then gave me oxycodone, and after about 40-50 mins my pain dropped to a 4-5/10 and they brought my wife through to see me.

After I rested a while, they tried to set me up with PT, using crutches, so i could be discharged - but I think with all the pain meds in me I just couldn't handle it. Every time I'd get up, or try the crutches I'd very quickly become dizzy/lightheaded/nauseated, and start sweating heavily. We tried a couple of times over the course of 2-3 hours, but it just wouldn't have been safe for me to have gone home and trying crutching into my house, so I was admitted for overnight. Note, the plan originally was for me to be leaving the hospital about 2pm day of surgery, with my surgery beginning at 10:30am.

The next day (this morning) my pain had diminished to about a 2, and I worked with the PT on some basic exercises and crutch use, and was told I could go home. At this stage I hadn't had any more pain meds since about 3pm day of surgery, and didn't feel i needed any. Discharge took a few hours, and it was probably about 2:30pm by the time we got home.

About 3:30pm I started getting some pain - probably around 4-5/10. We tried ibuprofen, but after about 30-40mins, my pain had escalated to a 7-8, so I took a percocet. Within 30mins the pain had dropped back rapidly down to 2/10, and 15 minutes later, it had dropped to 0 - which is better than pre-surgery. The percocet really helped. As the onset of the pain was quit rapid and substantial, i think i will plan continuing the percocet on the prescribed 4hr schedule for at least the next 24hrs, perhaps 48hrs, and then let it go longer and see how the pain is at that point.

I had a very very rough 30hrs, but am doing better now, and have had a couple of uses with the CPM machine at 45 degrees also.
 

Celle

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Hello again, @LAman - and :welome: to recovery.

It sounds as if your surgery was a bit more complicated than anticipated. I'm sorry to read that, but I'm glad to hear you're doing a bit better now.

Don't be in a hurry to come off the heavy-duty pain medications. It's better to take them regularly for a while than it is to be playing catch-up with the pain.

Here are the recovery guidelines we give to people with a replaced knee. Even though that's not what you had done, you should still use them as a guide for your recovery.
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!)​

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. Try to 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.


.
 

Helizabug

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Glad the pain is better controlled. Let that medicine do its thing for a while. Pain can get in your way, so sometimes a heavy hitter is the only way to have a fair fight.

Looking forward to hearing more about how it’s going.
 

InkedMarie

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Sorry you had to endure more than planned but glad you’re home and I hope better this morning.
 
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LAman

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thanks folks. I'm on a 4hr interval for the percocet. I took one at midnight, but when i woke for my 4am alarm, pain was already around a 5. Actually quite surprised the pain hadn't woken me sooner. So, it was a heavily disturbed night, as I had to wait a solid 50mins for the pain to drop back down etc before i could try for sleep. And then i had to pee a couple of times, and it's just such a pain in the butt to pee. Getting up is exhausting and takes me a long time, and I don't want to risk doing so at night on the pain meds, so I have a couple of those urinal tubs from the hospital, which are great, but I have some sort of mental block (I think..) using them, and it takes a long time to get the job done. Normally a good 15-20mins. So, lots of on-off sleep. possibly about 5hrs total.

Boy, little things are just such a chore. I went to get a cup of tea, and realized I couldn't go anywhere with it, had to stand there and drink it, but standing too long is uncomfortable so i just left it in the end. It's gonna be a long 6 weeks....
 

sondrals

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I bought a travel mug for tea. I ran into the same thing, either I had to stand there and drink it or try to carry it and sloshed it all over the place on my way.
 

Jamie

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It's gonna be a long 6 weeks....
I'm curious about this comment. You aren't expecting to be healed from this procedure in 6 weeks, are you?

This is a very major surgical procedure with a lot of work done that disrupts both bones and soft tissue. You're going to hurt and keeping the pain minimized will be important. Use whatever pain meds work best for you on a set schedule so you're not chasing the pain. And don't overdo any exercise or therapy. You need to move about, of course, but this is not the time for anything related to "strength training." Be sure and maximize your use of resting, ice and elevation for pain and swelling. The ice especially can be quite comforting and can even be used at night when you're sleeping.

Don't worry about sleeping through the night right now. Just nap when you can for as long as you can. Things will improve, but it will be slow.
 
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LAman

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Thanks for the tips, I am icing now, and boy does that help. Sorry, part of my story is in the pre-op section, the 6 weeks I'm referring to is my time on crutches, no weight bearing. I know full recovery is a long way away - estimating at 8-10 months, and am hopeful of playing soccer again at that point. Really hoping.
 

Jockette

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Here’s something for you to consider as you go through your recovery and PT:
 
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LAman

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Hi Folks - just thought i'd check in. 5 days since surgery. Post surgery has really all been about pain management, which hasn't always gone well. I have percocet 5/325, and was told one every 4hrs. My experience is now that it takes 45-50mins to take effect, but that the pain control lasts anywhere from 3hrs-4:20hrs. A couple of times i've been caught sleeping at night when it ended at 3hrs and woke in some pretty unpleasant pain, and then had to wait another hour or so in pain for the next pill to take effect, which is very disruptive to sleep.

The last 24hrs i've also started getting a pretty severe pain in the middle of my shin bone - which happens almost every time i try and get up on my crutches. The pain is quite intense even when i'm in the middle of a percocet cycle. Perhaps that pain is specific to my HTO? Anyhow, it has made getting up on crutches very painful, and thus going to the toilet is a real challenge, as its not only painful to get there, but I find it very hard to actually go when i'm feeling that much pain.

Not allowing any weight bearing has made me thoroughly reliant on my family for almost everything - not sure how a single person would deal with this on their own. Icings go ok, although I have major swelling, and there is so much dressing on my knee and shin, i don't really get any cold sensation penetrating to my leg, it does help a little though, and ice packs on my ankle, which is horribly swollen, are very soothing.

I use the CPM machine daily, and don't really have any significant pain doing so - i'm up to 75 degrees, and am well on course to hit the 90 degrees the surgeon wanted by post-op (Wednesday).

I had hoped pain would have reduced more by now - but really all that's happened is the pain has changed. Whereas for the first few days, when the pain came on it felt like a truck had run over my leg - intense pain across the whole stretch of my leg from the knee to a few inches above my angle. Now the pain is concentrated in a couple of places - immediately to the left of my knee cap, which I know was the surgery site for my femur surgery. And then smack bang in the middle of my shin, which gives me the most frequent and severe pain - that shouldn't be a surgery site, but perhaps has something to do with the locations of the screws in my shin bone from the HTO. Anyhow, hoping things get better soon.....
 
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LAman

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Hey - anyone ever develop quite bad calf muscle pain - almost like constant cramp - while walking on crutches after knee surgery? It's in my surgery leg. I had it mildly yesterday, and it seems to be getting more pronounced and constant today. thx.
 

sistersinhim

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Is it hot and red? If so or if it continues to get worse contact your doctor. You want to make sure it's not a blood clot.

If it isn't hot and red, then more than likely it's the muscle. Many of us have had the same thing. Mine actually hurt worse than my knee for at least a week or so. I was told the soreness came from the movements of my leg during surgery.
 

Celle

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If your calf pain doesn't improve today, @LAman, it would be wise to get it checked out by your surgeon. Probably, it's not a blood clot, but it would be wise to make sure of that.
 
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LAman

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thx folks - I msg'd my surgeon, and he had the same concerns as mentioned (blood clot). I think in my case, as I don't have any significant pain to touch, redness, or heat coming from it, it should be ok, and is probably just a muscle issue. He said to immediately alert him if I get any of those symptoms tho. Also, my post-op is tomorrow morning, so that's good timing to make sure all is well.

Things continue to improve from a general pain perspective. In fact I've just now passed 6hrs since my last percocet (originally scheduled for every 4hrs) and have no significant issues. I've gone to 5 1/2hrs a couple of times, and get some pain back, but get a strong feeling of nausea also, which is very unpleasant. I'm not sure if that is pain connected, or a side effect of not taking the percocet. I will address that with the surgeon also.

Looking forward to the post op tomorrow. Most issues now seem to be a general discomfort from the brace (locked permanently at 0 degrees) making sleeping awkward, and the general feeling of usefulness that comes with no-weight baring crutches and how reliant i am on my family for really even some of the smallest tasks. Today is one week since the surgery, which already feels like a couple of months ago. 5-7 weeks left on crutches seems like a life sentence!
 

Celle

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I'm glad you contacted your surgeon, @LAman .
I hope your appointment goes well tomorrow.
 
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LAman

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thanks! If anyone has any particularly good post-op questions I can fire in, let me have'em!
 

Joha123

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Will they be taking the staples out already? My post op appointment is three weeks after my surgery and then they will remove the staples. I think that’s too long. I want them out!
It’s been two weeks for me today and it feels like forever! I did go outside for a walk today. Small victories!
 
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LAman

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I'm not sure about staple/stitches removal - I've only ever had stitches once before, and those were for a wound on my arm - those were taken out too early and the wound burst open a few hours later, so I won't be too upset if they want to wait a little longer before removal! I do hope the giant, wrapped-around-my-leg-1000-times bandage comes off tho!
 
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LAman

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post-op today. Went well. They removed the 'first stitch' from each of my incisions, and i'm told the rest will dissolve. Bandages came off - wasn't the frankenstein I'd worried about, although the two incisions are certainly substantial, but whoever did the stitching is a true artist, and it should all heal up nicely. I'm allowed flat-foot touching now, but still no weight bearing, and obviously continue with the crutches. I asked the doc for a realistic target to play soccer again - he said end of August. Will be starting PT next week - 2x per week from here on out, until complete recovery. Got some gnarly pictures of the inside of my knee during surgery, showing the damage, and successful bone/cartilage plugs in place. And a nice xray of the metal plate in my shin bone.

Haven't had a percocet since yesterday 7:30am, so I think i'm basically done with them. The time I normally got nausea (around 5 1/2 hrs after taking a percocet and not having another) coincided with lunch, I ate lunch and I just never got nausea and never got pain above 3/10, so I'll just take ibuprofen occasionally from here. Discomfort is now a bigger concern than pain, as I have to continue to wear and sleep in the brace locked at 0 degrees.

Things are def. much better over the last 48hrs. Still, long road ahead.
 

Helizabug

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I remember that brace so well from my previous surgeries. Ugh.

Stay hopeful about returning to soccer. My crusty old husband tore his quad, 100 percent across, a couple of years ago. Big surgery. Long recovery. And he got back to basketball three times a week. One day, one of his arms is just going to come clean off his shoulder and go through the basket with the ball and he’ll keep playing. He won’t notice until he realizes that the player he’s supposed to guard is still at the other end of the court.
 

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