Wednesday, August 1, 2012

High Tibial Osteotomy

The meniscus in my right knee tore while walking in 2009 probably because of osteoarthritis.
That year, I received a series of Synvisc (rooster juice) injections which brought some
relief. In 2010, I was given a course of Orthovisc injections which did not help. I was then fitted with a knee brace. I was not compliant in wearing it often enough because of its bulk. I didn't have any problem bicycling but walking was increasingly difficult. Limping for three years was getting to me. It was time for me to consider arthroscopy or something more involved.
The operation I underwent is called Microfracture + High tibial osteotomy (medial opening wedge technique using distraction osteogenesis.
The operation went well. There was hardly any pain post-op. For the first week, ice water circulated around the wound using a machine that we purchased. I had to keep my leg in a Continuous Passive Motion machine for a few hours a day to continually move it back and forth pivoting around the knee. Starting with week 3, I also need to use a stationary bike for about an hour each day. My leg is still not allowed to bear more than 10% of load so I have to use crutches to get around.
The tubes attached to an ice water machine. (6 days post-op)

During surgery, an external fixator was attached to my leg using 4 pins:

It may make you cringe but, honestly, it did not hurt much.  The scars on the knee are where  cartilage was accessed.  (17 days post-op)

My wife helps me take a shower and dresses up my wound each morning. While sitting in the shower, I clean the pins of the external fixator that stick out of my leg and knee with a toothbrush soaked in soap every day to prevent infection. Starting with day 6 post-op thru day 33 post-op, 
a screw was turned 180deg, three times a day using a wrench
that was given to us to move my tibia. The vertical load line was being
shifted. Every week my leg was x-rayed and there was good progress
in the desired direction. On day 33 post-op, the fixator was locked in
place for 5 weeks. The following week, I was allowed to put 50% load on
that leg.

We don't have a bed downstairs. I stay in the main family room
downstairs and sleep on a sofa there, My wife sleeps on another sofa
in the next room. A week ago, we tried sleeping upstairs. I had bought
a walker for use upstairs. I get up the stairs by sitting on the
second step and sliding up a step at a time. Coming down is just the
reverse. I made about 3 round trips a day. I have found that sleeping
in the confined space of a sofa is easier on me than moving around in
a bed with the load of the fixator around my leg and its sharp
protrusions.

When no one else is around, I can drag a chair to a place near the
coffee maker and make a mug of coffee. I drink it sitting in that
chair because I can only carry very small, non-liquid, items while on
crutches.
Other than the weekly visits to my doctor, I have not gone anywhere else.
My wife took a lot of time off from work to clean my wound, dress
it and help me shower. My kids have filled in any gaps and provided a lot of support.
The long period of recovery should end around day 77 post-op and then I
will undergo physical therapy.
[The three products from Amazon are the ones that I purchased. I needed one bandage roll/day and 1 gauze pad(sponge)/day.]

No comments: