Osteotomy Scar update, 2 years on

In January 2018, I underwent a Tibial Osteotomy operation 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.

Oh, the memories of the metal plates supporting my tibia. I keep forgetting, its major surgery

With Covid-19 lockdown restrictions still in play in the UK, I have tried to keep up my fitness and exercise regime. Getting back on to my mountain bike and cycling on quiet roads on a sunny day, are great! I have been logging my activities on Strava and have covered 250km per month since march; not bad considering I cycled 200km in total between 2018-2019.

The activity I miss the most is weight training. The loss of muscle mass around my knee is telling and some pain has returned. At least the gyms reopen in July. I guess I lack motivation of weight training at home as I really want to get out of the house for a change of scene; especially when working from home.

I wanted to share the status of my operation scars. If you are part way through your recovery journey, it may serve useful to set some expectations.

My initial tibial Osteotomy was in January 2018, and in March 2019 I went back to hospital to remove the metal plates and screws.

As a reminder, this is my leg post operation:

metal pins applied where incisions were made below the right knee

What the scarring looks like today

Scarring shows up in the summer but not as prevalent

I am left with a 7.5 cm scar and using Bio Oil (or similar products) has helped in hiding some of the blemishes. The a vertical cut (as seen in the previous picture) and is barely visible. I am still experiencing loss of nerve sensation on my shin, but you get used to it.

Until my next post – I wont leave the next post too far away.

2020 and finally seeing the difference after my Osteotomy

In January 2018, I underwent a Tibial Osteotomy operation as I had been suffering from the onset of arthritis on my right knee and needed an alternative to a knee replacement operation.

In 2019, I went under the surgeons knife again to have the metal plates removed from my leg. I am writing this blog to help others who may be starting their own recovery journey

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

Its been a while since my last post in December 2019. The rubbish winter in the UK has been extremely wet and damp, I did miss the snow. 2020 is my year to be surgery free and to get stronger.

At work my role changed to become the regional lead for the Microsoft Azure Professional Services practice for DXC Technology (large American IT systems Integrator). This does mean longer hours but at least I am able to work from home.

Working from home has allowed me to visit the gym more frequently and for 2 -3 days a week, I focus on weight training and it really has helped. The key exercises that made a difference are shown below.

Hamstring building
Leg extension

I did have to take my time and build up strength gradually.

Prior to my operation, I never focused on leg weight training and it was only when I went through Physiotherapy the physio explained the impact of muscle mass improving stability and stamina.

For me it has helped with better leg movement, reduction of swelling and increased stamina. As the months have elapsed I have noticed the difference.

I am probably at 75% mobility in my knee and the pains have substantially decreased (but still not gone)

Cycle or Running event ? decision made…

In January 2018, I underwent a Tibial Osteotomy operation 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.

It has been a long time since I posted a blog, recovering from an umbilical hernia and then getting mad busy at work have caused distractions.

This is the second year of operations for me and requiring time to recover (removal of metal plates from leg and then an umbilical hernia repair) just makes things look shitty as you are forced to make life adjustments to make sure recovery is good. Now I have clear runway to do more challenging things..

I met with a good friend this week who wants to do a few triathlons, 10k runs and cycle sportive in 2020 and he got me excited – however a reality check is needed.

So…I have been scratching around on what I can do physically….I’d love to take part in running. I can run on a treadmill but road running is painful. Also my knee is still suspect to heavy workouts…if I walk more than 8km, I feel swelling and pain. I have been adding muscle mass to compensate but the pain is still there.

Cycling it has to be !

Maybe a few 30 and 50 Mile events in the UK for starters that commence in March. At least there is a target and a training plan to make up; from now until then..

Later in the year, would be great to take part in the UK Coast to Coast cycle, a few days on the road on a MTB. See here

Some days I feel like I can swim, bike and run, other days it feels like I need to get an electric bike and pretend to burn the calories.

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.

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

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.

Flying post Osteotemy and managing pain in the USA

In January 2018, I underwent a Tibial Osteotomy 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.

In April 2018 I traveled on business from London, UK to Detroit, USA – a journey with 2 connecting flights and over 15 hours of combined travel time.

I do like the F250 type truck, this one will do also!

In my previous blog, I forgot to mention that I continued taking pain killers such as standard Ibuprofen, Paracetamol (when needed) and calcium tablets. The purpose was to manage the pain; after 3.5 months, the swelling and pain was still prevalent, advice from the Physio was to take the tablets when needed; pain management is key, you cannot be a hero as the healing process is still ongoing.

So on the flight over, I did not sleep, I kept moving on the aircraft. I decided to work on my laptop standing up and it really worked. When I landed in Chicago (1st stop) I was able to walk OK and the swelling was not bad. I did get some assistance from ground staff, which was great. At my next check in for my flight to Chicago, I boarded first, placed my crutch in the compartment above my seat and rested up. The rest of the journey from the Airport to the hotel was uneventful.

As soon as I did get to my hotel room (around 2pm), I crashed for a few hours and then drank a lot of water. Again, no pain!

A fancy head, in a restaurant!

As I adjusted to the timezone and to the extended work day, pain management and rest was key. The key thing was not to slack off but to keep to the routine to date. I was also conscious of not acting like I was a special needs case – If I needed to use the crutch I would otherwise I would try to walk and ensure my posture was correct. Its so easy to get back pains, impact the good knee or develop hip joint pains; a symptom of overcompensating.

I have seen this building in a movie shot in Detroit, the city is changing by the way; more gentrified

Tibial Osteotomy photo review – Post op to 6 weeks after. Part 2

In January 2018, I underwent a Tibial Osteotomy 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.

This image has an empty alt attribute; its file name is knee.jpg

As a follow on from last weeks blog, I am sharing photos taken from pre-op to 6 weeks after. During the process of finding the pictures after 12 months and knowing that I am much better now, it does bring memories back of the journey of recovery and change. When you are in the moment, it is tough but as I noted in a previous blog, the human bodies capability to repair is incredible. The is light at the end of the tunnel!

Day 3- 5 Swelling and bruising

#After 3-5 days, expect bruising and discoloring to appear – the healing process

Days 6-8 I want to remove the bandaging!!

So in total I have 16 metal clips. Awesome!

Days 14 Metal Clips are out

Removal of clips are not that painful. Now I can think about Physiotherapy

Week 5-6 and the wound is healing well!

Healing in progress and Physio kicking in.

I hope the helps you out there. If you have any questions shoot me a message. See you next week!

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.