Knee pain . realignment operation . osteotomy

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For many years I have had problems with both knees... clicking, grinding and pain... now after many wasted years trying physio and other fixes i have finally been refered to a knee specialist, who wuickly diagnosed my problem... seems my knees are facing outwards and are out of track... not an issue that can be fixed with physio (I.e. build up vastus medialis to pull knees straight). An mri scan will confirm the extent of the problem, but looks as though I have a problem which ive had since birth and an osteotomy will have to be performed on each knee to realign them... Obviously this will require a long period off work for recovery after surgery, which comes with it's own issues.. at least 12 weeks off work will put a massive dent in my non existent savings.... but my question now. . Is what do I do to manage the pain I am in before I have the surgery?.... will exercise benefit me or have a negative impact? My left knee hurts the most, it grinds and clicks and even just walking leaves me in pain!... will it just get worse or can I improve this in the meantime? ... any suggestions will be appreciated. smile

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  • Posted

    So are the doctors suggesting that they break the femur and re set it?

    What job do you do, are on your feet all day? Self employed or employed by a company? 

    The 12 weeks sounds a lot, but perhaps that is a graded return to activity and work.

    As for medications and exercise, what do you take for the pain now.

     

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  • Posted

    hi, I know this is an old post but if you are still around can you update on how this operation went?

    My doctor is recomemnding something very similar and I'm not sure if I should go ahead or not. 

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    • Posted

      Hey Guy,

      I had a patella realignment (osteotomy), a lateral, release and arthroscopy on my left knee in December last year. My recovery has been relatively pain free, with my only real concern being sensitivity around the incision and numbness around the lateral side of the knee, both of which should improve over time (although I may never be completely free of the numbness).

      If I had a desk job I would have been back at work by the end of January (around 8 weeks), but I'm a remedial massage therapist and I found that standing for long periods wasn't really viable until about March.

      If you have any questions I may be able to help.

      Good Luck!

      Jodi

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    • Posted

      Hi Jodi, thanks for the reply smile

      So is it fair to say you had surgery in December but were not back to normal until March?    

      I was told no weight bearing for 8 weeks and total 9 month recovery eek 

      I'm not completely sure what they want to do, but basically something about breaking my thigh bone and putting some plates and screws in, then having a knee arthroscopy at the same time. 

      If you don't mind I would really be interested to know:

      Did you have a plaster cast?  

      Were you able to bend your knee immediately after surgery? 

      How much physiothreapy did you have?

      What pain killers did you need to take?

      How long before you walk distances (30 mins+) and could drive? 

      Thanks

       

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    • Posted

      Hey Guy,

      Wow, your surgery sounds a lot different to mine. My knee caps also point outwards, but my realignment involved cutting into the Tibial tuberosity (top of shin bone), shifting it medially and screwing it back onto the Tibia; which shifts the Patellofemoral Tendon (and kneecap) medially. They also cut the Lateral Retinaculum tissue, which anchors the kneecap and did an arthroscopy to clean out the joint.

      It's probably easier if I list this as a timeline (bear with me it's exciting stuff):

      4 Dec: 90 min surgery

      5 Dec: Out of hospital on caliper crutches with leg in removable straight leg brace.

      Painkillers: Endone – I took 1 or 2 x fast acting per day and 1 x slow release at night  before bed (didn’t want to take too much as it’s very addictive and I wasn’t in much pain). Was advised to try gentle weight bearing with crutches as often as able.

      6-7 Dec: On couch feeling sorry for myself with leg elevated and iced. Took half a teaspoon of coconut oil each day to avoid constipation from a combination of surgery, lack of appetite and painkillers (degrading enough getting onto the loo with one leg stuck out on a little stool without being constipated as well!)

      I can't even begin to explain the 'joy' of the toilet experience!

      8 Dec: Day four post op, first day of physio. Mostly massage and Tens machine, also a bit of weight bearing walking without crutches (physio supported as required). Took Endone prior to session.

      9 Dec: Stopped taking Endone completely; two paracetamol (Panadol) every six hours was enough.

      14 Dec: 10 days post op; stopped taking regular Panadol, but sometimes needed after physio.

      15 Dec: First post op appointment, Doc said I could ditch the brace. Virtually no bend in the knee; could begin gentle flexion exercises, bearing in mind that the bone would still need a few weeks to knit completely.

      Physio was three days per week till about the end of February. Initially I went to one Physio who took me through range of movement exercises, treadmill, cycling, very gentle Muay Thai boxing sessions (for stability), manipulations and massage. Towards the end of February I also went a second physio who took me through massage and forceful flexion work. 

      At three weeks post op I was getting around the house without using crutches (or one if tired) and only used one when out for short trips. Longer trips to the shops required one or both crutches depending of length of time walking. Could finally bend knee enough to sit in the front seat of the car again!

      Four weeks post op and scar was healed enough to start swimming.

      Five weeks post op, ditched crutches completely and started driving again!

      10 Jan: Five weeks post op: Moved house and helped carry some of the lighter boxes up stairs (could only manage one step at a time). I could have started work at this time if I’d had a desk job. Knee got swollen pretty easily, still iced regularly.

       27 Jan: Post op appointment: Doc advised I could pretty much do anything within reason. Advised to get stuck in to knee flexion; gave me the ok to start GENTLE jogging on grass only. Moving around pretty normally, but knee gets tired and stiff fairly quickly. Still icing as required, but also used heat packs to release stiffness.

      End of January I could walk up stairs slowly, but normally. Downstairs was still one step at a time as excessive flexion was still uncomfortable.

      20 Feb: 11 weeks post op. Began to see second Physio; knee at 110° flexion (made me cry to get there though!). Walking downstairs normally, but slowly, and still with a bit of a hitch in the hip.

      End of Feb: Knee still stiff after standing for too long. Regular 30 min walking. 115° flexion.

      Early March: Off the stationary bike and onto the mountain bike. 2 km ride on flat track. Started doing massage work again!

      20 Mar: 8km on bike

      26 Mar: 15 km on bike

      5 Apr: 5 km walk

      12 Apr: 8.5 km walk

      15 Apr: 9 km walk

      Mostly back to normal as of begining of March, so about 3 months.

      I had my final visit with my surgeon today and he advised that it would be a few months till my quads were back to full strength and till I would have full knee flexion. I will really need to push both aspects.

      Sorry it's a bit long winded, but most people on here have had total knee replacements and I would really have liked to see someone else's experience with a surgey like mine, so I hope this helps you.

      Jodi

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