Quickfire questions – 1.5 years after Tibial Osteotomy

In January 2018, I underwent a Tibial Osteotomy operation at the One Hatfield Hospital in the UK. I had been suffering from the onset of arthritis on my right knee and needed a solution that would avoid a knee replacement operation and get my life back to some level of normality.

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Was having the Tibial Osteotomy worth it?

No doubt there have been some days recently where I have been questioning myself on the same point. I have started to feel some of the pre-operation pain from time to time in the last few months. As I had the metal plated removed 6 months ago, there is still some pain and swelling as the bone re-grows- I may confusing this pain with what I experienced a few years ago. I need to see in another 6 months.

The Osteotomy is not a miracle cure: rather it has halted the arthritis and its pain giving the patient many aspects of an active lifestyle back.

The inevitable action of a knee replacement is just deferred and on that point I would say yes, it has been worth it.

What would have happened if you didn’t have the operation?

It would have been expensive physio sessions and Cortisone steroid injections while I wait for a knee replacement (partial or full). I am still in my 40’s so what happens after 15 years ? Knee replacements are meant to last between 15-20 years right?

What changes have you noticed?

My leg is a lot straighter than it was before. I am more active now and travelling is back on the agenda.

I am losing weight but its not fast enough. I guess I am more cautious in not pushing myself too much and I need to rest up more.

What lifestyle changes have you made since the operation 1.5 years on?

  • Eating a healthier diet and trying to lose weight.
  • Keeping to the physio strength exercises as a regular routine
  • Building strength and stamina around the knee (I never did this before and has made a big difference)
  • Knowing my limits and resting more

Would you have the same operation on the other knee?

I am experiencing pain in my left knee but it is not as painful as my right knee. I am 50/50 at the moment as the operation/ recovery time/ adjusting to work is not easy and takes a lot out of a person. Maybe a question to ask next year.

If you have any questions, drop me a question in the comments boxand I will be happy to share my experiences with you.

Returning to the operating table – removal of metal work. Osteotomy concluded

In January 2018, I underwent a Tibial Osteotomy operation at the One Hatfield Hospital in the UK. I had been suffering from the onset of arthritis on my right knee and needed a solution that would avoid a knee replacement operation and get my life back to some level of normality.

If you enjoyed reading my blog entry, don’t forget to like, follow, share and comment!

Returning in 2019 to remove the metalwork

The osteotomy had given me a lot of improvement. The physio work and muscle built around my knees in the gym has given me 90% of my life back. The knee issue hasn’t gone away but I feel so much stronger, some pain does remain but this differs from day to day – that’s just the ageing process!

RHS shows healed bone

As the metalwork in my leg did irritate me from time to time, I took my surgeons advice and booked myself in to have the metalwork removed on 27th March 2019. Mr Minhal Chatoo would be my surgeon again. He was brilliant.

The metal work extraction procedure would be a day case. The procedure would take up to 1 hour to remove the screws and plates. Due to the nature of the operation, I would be under general anesthetic, meaning the time in the operating theatre increases to allow for the time to recover as well.

Upon arrival and being allocated a room at the hospital, one of the nurses came in and read my BP, went through standard paper work, handed over a gown, pants and socks – I’m not sharing any pictures of that!

Shortly after, the anesthetist came round as well and confirmed that Mr Chatoo would be operating on me as the first patient of his day.

Mr Chatoo came in to mark my leg before the operation and we had a light hearted conversation. He mentioned the operation is very quick and low risk so was happy to proceed.

Once he left, I was taken downstairs to the operating theatre. As I walked down someone talked me through the procedure again and kept me assured.

Once I was asked to lay down on the bed, I was connected to the ECG and given the anethestic. In seconds, I was out.

Coming round after the operation

I felt groggy after the operation. It was about 10:20 am as I noticed the clock. They showed me the metalwork that was removed from my leg – 2 pins 4 inches long, 3 screws 3 inches long and 6 other smaller screws. They told me I was unable to keep the screws due to protocol; though I wish I could have kept them as a souvenir…

The pain was unbearable and the nurses gave me strong pain killers. 20mins later, it still felt bad so they gave me more – but I think it was codeine. 

Shortly after I was taken back upstairs to my room and Loiza was sat waiting. 

I remember falling in and out of sleep and still in pain. To me, this felt much more painful than the osteotomy last year. 

It took a while for me to eat lunch (soup and a sandwich), just the tiredness from the drugs and the pain. 

I remember the Physio “Saul” visit . He got me out of the bed and made me go for a walk. We made it to a stairwell and then down a flight of stairs. He did say the pain will be high but I will need to get moving sooner. The recovery period would be :

  1. Next 2 days full rest and some movement
  2. Use crutches for a few days after that
  3. Walk without crutches thereafter
  4. Keep moving and apply icepacks if there is swelling

The recovery period was a lot shorter but I kept in mind that there was a deep cut, stitches and several holes in my tibia that would take time to recover.

I was able to walk however I was very tired due to the drugs. I made it back to the room and then met Mr Chatoo again. I remember him telling me that he placed “wax plugs in the screw holes!” to reduce the bleeding from the bone. 

Mr Chatoo also said the operation was uneventful- this is good news.

I rested again and of course, fell asleep. When I came round again I was still in pain and was given more painkillers. 

The nurse mentioned that I could be discharged once Mr Chatoo comes round at about 5 pm. The discharge was quick and easy and everything was set for me to go home.

I was wheelchaired to the car – We drove home in my Audi. The ride was great as I was glad to be going home. 

When I got home, we took the picture below.

I was exhausted. I slept in Aroon’s room and was out as soon as I hit the pillow. I know I woke up in the middle night and Loiza had to help me to go to the restroom – it was still to early and I was unsteady on my feet – the drugs were not helping and as it transpired I had a bad reaction to the codeine.

Quickfire questions on life before and after Osteotomy procedure.

So this blog is written by Priya. We met with my surgeon Mr Minhal Chatoo at the One Hatfield hospital on 8th May and he recommended Priya interviews me to share how life has changed pre- and post- Osteotomy.

Hi, Priya here. I thought of a bunch of questions to ask my dad about his progress.


This is Hertford Castle, near where we live and where we went for a walk.


How has the pain around your leg changed since the Osteotomy operation?
Every day and every week I notice that the pain is getting less. However I do notice new pains appearing. The swelling in my leg is still there but is gradually reducing. The Osteotemy does entail bone cutting, drilling, cutting deep into flesh, muscle and many nerves. It does take a long time for the healing process to complete.

What life changes have you made since your first diagnosis?

I have made an effort to lose weight and eat the right foods. I have cut down alcohol, sugar and some types of meat. I have had to stop jogging due to the impact on my knees however I have now started going to the gym more where I run on the treadmill, use the cross trainer and lift weights to strengthen my core. If I can lose more weight I may be able to run again.

How has the operation influenced your life now?

To be more aware of long term health. I know I cannot run as much or kick a football about as much, so I need to find new sports/pass times to get involved in. Also life is about longevity so doing the right exercise is key.

How might the operation impact others around you?

As his daughter I have seen a urge in my father to lose weight and really exercise more. The effect this has on me is that as a family we go out and walk in different new locations on a weekly basis. This is a more active effect on my life and it’s for the better, as we are also eating healthier and experimenting more activities.

How do you think you can help others?

If you are young enough and want to continue having an active life, there is an alternative to a knee replacement surgery. The operation does give you the chance to defer such an intrusive operation for a number of years. The psychological impact of getting your life back to a normal balance is very important.

Post Tibial Osteotomy and returning to work as well as starting Physiotherapy

Recovery in weeks 3 and 4 (Feb 2018)
In the weeks surrounding returning to work, I did find it tiring in the afternoon. I was able to work from home for a reasonable period; it helps the sense of things returning to normal.

Trying to balance a laptop, having a bag of frozen peas (to reduce swelling) and laying flat as much as possible does get uncomfortable – be aware. The swelling is getting less and some mobility was returning. I am going out more for a walk around also.

Starting Physiotherapy (at last!!)

Physio day (at the One Hatfield hospital) was something I was really looking forward to. In the same week, the UK was being braced to abnormally cold weather. Very challenging journey indeed to the hospital!

Loiza was worried on the day to drive. The outside temperature was around -1 to -3 centigrade on the day but snow was very light. In my mind I was completely set on going and would have driven myself to get there. I say this because I had set my mind to get to this milestone-  its where the expert can tell me if my recovery is going well and what i need to do to get better. Having stopped work at 2pm, we set off.

I have to say that just sitting in the car and going for a drive is something i really enjoyed.

We waited for the physio to arrive and sat with a coffee.

We met with the resident physio, Craig. He started by testing my strength, assessed flexibility. He then went over additional exercises. Examples for strength exercises are :

  • Lying on the floor and lifting the leg up 6 inches and lowering slowly
  • Tensing the Quads and pushing the knee down
  • Bring the knee to your body
  • Roll up a towel, rest under the knee and straighten the leg
  • Stand up and hold a ball behind the knee and push the leg back

Craig said he was happy that I had been exercising- he could tell.

The final task was to walk and alternate the walking sticks – aiming to move me off 2 crutches and onto 1.

Having concluded the session, the task was to continue at home on a regular basis and get some core strength back.

Removal of metal clips after Tibial Osteotomy – Feeling lighter!

Check out my #Osteotomy blog. I share the day the metal clips are removed from my leg.

Removal of the clips

3 steps to Osteotomy. Simple!

On the 14th February ( and yes on Valentines day!) we returned to the One Hatfield Hospital for the removal of the stitches/ metal clips.

The resident nurse took us away. I had Loiza and Priya as my support team; or rather for Priya to watch me pass out and make a mess of myself.

The nurse was very helpful and knowledgeable. We didn’t know that Osteotomy’s in the past resulted in patients having their leg in plaster for over 8 weeks. She mentioned surgery now is much more accurate and less evasive. I have to thank the surgeon Mr Chatoo for his expertise.  

Initially I thought the removal of the clips would be very painful, it was the opposite. Using a pair of metal clips, she pinched the clip in the mid point and that forced the clip to bend and pull out. Out of the 17 clips, only 3 hurt when they were removed. I didn’t have any local anesthetic.

The wound feels very raw but the good thing is it is healing without an infection.

Clips now removed. Another milestone achieved

And a closer look where you can see the ink marks from the surgery. External healing is definitely a “work in progress”

As a treat for Valentines, Loiza took us to a well known fast food establishment serving fried chicken- this is payback for when Loiza and I were dating at University and i took her to this place when I was broke. Anyway I loved it!

On going to bed, i asked Loiza to add a bandage to cover the wound as i didnt want it to catch or split whilst i was asleep.

The pain in the knee and ankle remains however the shooting pain on my shin is less painful. Also the red bruising on my calf muscle has almost gone. For the pain, Loiza set up a call with a GP who administered stronger pain killers. This is working, the swelling on the knee is  less so and i am able to walk a little easier. However the ankle pain remains. That will need gravity and ice to give me movement back over the coming weeks.

Q &A How the Tibial Osteotomy became the recommended solution

I thought I would take time out from my diary blog in order to answer a bunch of questions that friends and family have asked me in the past.

Q: Was the cause a Sports Injury?

A: When I was younger, I was very active. Loved Martial Arts so trained 3-4 days a week; did this for over 12 years to a high level. I also played Soccer, Basketball for school, college and clubs. When I got older (into my 40’s) I took on Sprint Triathlons and 10k runs. The training takes its toll. Also I would consider myself overweight (or heavy boned 🙂 )

Q : You had an Arthroscopy and Debridement – thought that was the fix?

A: You would think that, but in effect brought on the pain more, my right leg became bow. (keyhole surgery where they wash lose cartilage from within the knee and shave some bone)

Q: Who recommended you for the tibial osteotomy?

A: I was undergoing Physiotherapy for my arthroscopy at the time and I complained the pain was getting worse. At this time, the physiotherapist recommended me to arrange a consultant session with a specialist, Mr Minhal Chatoo. He was doing some great work in surgeries that avoid having a knee replacement. I was referred to Mr Chatoo.

Mr Minhal Chatoo, Consultant Surgeon

Q: What happened during the first meeting with Mr Chatoo

A : Prior to meeting with Mr Chatoo, I went for an MRI scan and a full leg X-ray (starting from my hip down to my foot – 2 X-rays merged to 1). Mr Chatoo analysed the X-ray.

On meeting with Mr Chatoo, he shared his diagnosis and then outlined the course of correction that an Osteotemy would provide and more importantly deferring a knee operation. He also shared success stories of his previous patients. He considered me as a candidate as I was young and capable of making the right recovery.

Q: At high level, what would the surgery entail?

A : I am no expert so can only share my recall…….Mr Chatoo used software to outline where a line of gravity should pass after surgery (A line should move from the hip, down the middle of the knee and to the middle of the ankle). There was a lot of wear and tear on the inside of my right leg/knee. As my leg was bow he showed me where the line of gravity was passing versus where it should be. To achieve this, he will cut my tibia and remove enough bone (in a triangle) to allow correction. Steel plates will be applied to allow the bone to grow back and straighten my leg and to conclusively reduce the pain caused the rheumatism. I was a borderline candidate but Mr Chatoo was confident of success.

Q: Why did you proceed with the Surgery, sounds painful

A: The surgeon, Mr Chatoo was the reason. He was caring, knowledgeable, confident and human. He has a great success rate and convinced me of a decent recovery.

Right, that’s it for now, I’ll post more in a few weeks. If you have questions, post them to me and I’ll add them to another post.

Living with the Osteotomy – venturing out of the house!

After my Tibial Osteotomy, its times to get moving again. Read my blog for my diary entry

The next 4 days

Hello there! I took a few days off from blogging as the weather in the UK is just amazing.

Shoreditch, London. Keeping the rich out of our common places

Forcing a routine of getting up and resting is just something that has to be done. As Loiza and others tell me when I become impatient, the importance is for a full recovery of :

(1) the soft tissue beneath the skin

(2) the bone that is missing coupled with the metal work

(3) tendons and muscles that are affected by the surgery

It is so important to recover well in order to have the right level of mobility, otherwise the surgery will not be as effective.

The overarching pain at the moment is the joint pain. My knee is still stiff and swollen. Slowly movement is coming back but I am conscious of keeping my muscle mass however it will be noticeable that I am losing muscle. My ankle now is the most painful. The swelling (and blackness of the bruising) is more painful and keeping my knee above the rest of my body is easier said than done.

I am now negotiating the stairs and taken showers by sitting on the stool – the stair climb is painful as pain is felt on the outside of the knee (as the alignment takes effect).

On the 12th February Loiza took me out for a walk and I covered the longest distance (ok it was about 20 metres there and back). Compared to the last time I went for a walk, I have trebled the distance. The issue is the continued pain in the knee.

Get some loose clothing and get some exercise.

The pain in the evenings is interesting, I get shots of pain from the top of the tibia to half way down. A throbbing pain as well as the area around the stitches. If this is the healing process then great but they are heavy bursts of contracting pain. I really cannot wait for the clips to be removed, I won’t miss the protruding metal clips i can feel within the bandage.

Revealing the staples after Osteotomy

After 7 days, it was time to see the stiches and the healing process after the Osteotomy. Read on!

February 7th (day 7)

Nothing to do with my operation, but a snap from my holiday to Langkawi, Malaysia in 2017.

When you are unable to walk and get out of the house for a number of days, it does drive you a little crazy. There is only so much daytime you can take before insanity sets in. I also noticed that my swelling from the leg has traveled to my ankle. Late in the morning, I was sat on a stool in the kitchen in the sunshine as my mother lunch. I must have been sitting for 30 minutes. After I sat back at the sofa, my ankle did begin to hurt.

Additional bruising, the case for gravity.

One of the more consistent pains I am experiencing is the pain of standing up. The shin area of my leg is really tender and when I stand up, that area becomes overbearingly painful for a few minutes. So much that I am unable to walk. Do watch out for this after your op.

Loiza planned to replace the current bandages and so we took off some of the tape around the wound to see if we could proceed. Unfortunately the replacements provided by the hospital were too small so had to wait. What we did see (as below) are metal clips. The points where the skin are pinched together still look raw and I can understand why I have so much pain in my shins.

Markings made by the Surgeon and the staples appearing. Too soon me thinks.


February 8th (Day 8)

My nights sleep was very uncomfortable, a combination of heartburn and leg pain. I also felt that I was coming down with the flu. I did go back to sleep after a warm glass of milk but felt rough in the morning.

My breakfast routine of tablets, porridge, fruit juice and fybrogel continues. Today my mother took over as Loiza went to work early,

My parents were going to leave to day, a little sad but i think my dad was getting a little tired. I will miss them as they helped me during the day and kept me company.

Today I found walking even more painful than normal, walking by sliding my foot just made it easier for a short time. Unbearable today. Also I fell asleep on the sofa with my leg resting above my head; i jerked my leg for no reason and woke me up. The pain was a 9 out of 10 – right on the stitch lines on my leg. It took 5-10 minutes for the pain to die down.

Once Loiza returned from work, we removed the bandages and had a chance to look at the stitches. There was also blood on one of the stiches – may have been a result of knee moving while I was asleep earlier

Ok, so it is a major operation guys!. Recovery will be gradual.

I didnt want to speak much for the rest of the evening; also the pain and swelling from my ankle was at a 8 out of 10. Loiza gave me a salt bath to soak my ankle. Helped a bit


Osteotomy recovery on days 3 , 4 and 5

After my Osteotomy surgery @OneHatfield, recovery continues, slowly. Don’t panic if bruising appears

The bruising appears

February 3rd (Day 3)

I may have woken once last night for painkillers and so felt well rested. The pain was less and felt like I had some more mobility. I was able to wash and change by myself however Loiza did helped me. I sat in the day room and watched Priya get ready for her Saturday league football match. Aroon was going to stay with me for the morning and keep me company. I felt a lot stronger today and walked a little with the crutches. The exercises and movement are so important and really helps psychologically. Having watched The Punisher on Netflix (which is just awesome) I fell asleep for an hour – tiredness hits you and comes in waves. I know it helps with the healing.

The key thing is to remain mobile and to keep the joints moving. I have started doing ‘light weights’ to keep the upper body muscle mass although need to be careful as not to pull any tendons in the leg.

I stayed up until 10pm and then was helped to bed.

February 4th (day 4)

I only woke up once last night for painkillers (3:42am) and I could feel the pain. Waking up at 7:20am thereafter and I was really thirsty. I did drink ¾ of the water bottle but could not go back to sleep. This morning the pain level was very high.

The length of my tibia was painful. Loiza also noticed that I had new bruising on the back of the knee. Also the swelling is more prevalent this morning and appeared purple and red towards the bottom of my leg.

Red bruising appearing after the operation

I did get a chance to walk more. Distance and frequency is improving but the stiffness around the ankle and knee is still there.

February 5th (Day 5)

Monday morning and I woke up at 7:20am. I was able to sleep on my side although felt uncomfortable when i woke up. Loiza still had to help me out of bed and had to take the day off; it was the right thing to do. I cannot manage by myself just yet.

I think i have one more day of the co-didromel pills afterwhich i am on 400mg ibuprofen and the paracetamol.

Sitting with Loiza today and i am continuing with the icepacks on the leg. I did notice that my knee is stiff and getting new pains in the knee. Also as the picture below, more new bruising is appearing and this time in the back of the knee.

Further bruising appearing on the back of the leg

I was able to walk a little more than yesterday so at least my mobility is improving however by lunchtime I am exhausted. I know that movement is still needed otherwise mobility in the joints reduces and becomes harder.

My parents arrived at 3pm and so i sat, chatted and stayed awake until about 10pm.