Comparing Pre and Post Osteotomy scans – a single view of change

Just a short Blog this week. As per last week I wanted to share single point of view on the positive impact of the Tibial Osteotomy can have. The image below was taken from the One Hatfield Hospital’s monthly publication.

You can see in the left hand image the surgical requirements Mr Minhal Chatoo orchestrated pre-operation. On the right hand side you can clearly see the surgical correction.

Accuracy of the surgery has to be at 95-98%. For all the planning it really is up to the expertise and training of the surgeon. I cannot recommend Mr Chatoo enough. There are a number of experts like him in the UK and worth looking into this type of operation as it saves on having a knee replacement operation.

6 month check up after Tibial Osteotomy

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.

So in late April 2018, I went on an overseas business trip to Detroit, Michigan and stopped over at Chicago on both legs of the journey. I would strongly advise to call your airline to explain your condition and request assistance – it takes a lot of stress out of the travel.

After my surgery, I had booked 12 physio sessions with the One Hatfield hospital (https://www.onehealthcare.co.uk/hatfield/) and had completed 10 of the sessions; I tried to keep to a visit every 2 weeks and the physio ensured he pushed me hard with challenging exercises. Here are a few that I still do today:

  • Bosu Ball – hop on and hop off on both legs
  • Strengthen calf muscles – slow raises holding a weight dumbell. Alternate on both legs
  • Strengthen hamstring with leg raises and using resistance from a large (elastic) band
  • Lunge exercises
  • On the treadmill, jog – I am now getting to 5km
  • Cycling
  • All leg weight training in the gym.

It is fantastic that I am exercising a lot more. It helped with the swelling being reduced (not using icepacks as much), stamina and my mental health.

May 2nd 2018 marked the 6 month review with my surgeon Mr Minhal Chatoo. I was booked in to have an x-ray prior to my consultation.

He had received feedback from my physio and so he knew I had been pushing myself. He then took me through some strength tests and was pleased. He then shared the X-ray results (below)

He explained the bone healing was progressing as planned and filling out correctly. He also mentioned the correction was 97% accurate to his planning.

Within the blue circle you can see the faint grey – bone growth.

I shared the following concerns I had over the last 6 months:

  • Swelling does flare up from time to time . RESPONSE – the bone is still healing, it will when tiredness sets in.
  • Feeling pain that feels similar to that prior to the operation. RESPONSE – irritation can be caused by the metalwork and that can swell, so the pain is really where the metal is located on the leg.
  • I had lost sensation from the front of my leg (shin). RESPONSE – the operation is intrusive and some nerves are affected. He recommended I keep track but no action to be taken as it was not affecting my day to day life. Nerve endings need time to heal, so the sensations may eventually come back.

He recommended I should not hold back and get back to full activity (other than playing football and hard surface running) BUT also to lose as much weight as possible, At 6ft tall, I was 110 kg and had dropped to 105 kg – he recommended to get to 96 kg for body longevity.

My surgeon then recommended the following :

  1. book in for a 12 month review
  2. plan for the removal of the metal plates as a ‘day case’

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.

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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!

Tibial Osteotomy photo review – Post op to 6 weeks after. Part 1

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.

For this weeks blog, I am sharing photos taken from pre-op to 6 weeks after. On creating this post, you have to realize the human body has amazing recovery capabilities, the repairs to the bone, muscle, tendons and skin are simultaneous!. When you are going through it on a daily basis it can feel like sh!t – don’t worry, you will get better!

Pre-Op mark up

Pre-op and before the leg shaving, Mr Chatoo marked my operating leg.

Post Op – compression bag on leg to reduce swelling

May be 2-3 hours after i came round from the op, you cannot feel a thing.

After 1 day, compression bag removed

There is a lot of bandage, but where is my other leg?

Day 2 – Getting ready for home, remove the bandages

This is the best part, time to go home.

Looks like I have run out of space, stay tuned the next post will continue the journey.

Putting the Physio advice into action

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.

My blog charts the diary I kept as I went through the rehabilitation process. I am not a medical expert and is only my experiences that I share. Please click through my earlier posts using the menus on the right!.

I applied all the advice from my physio Craig into practice to build my muscles up. Loss of muscle mass and body control after an intrusive operation means getting back to normal needs a lot of work.

Lets keep this in perspective, an Osteotomy is a major operation

Feeling more stable on my feet and better stamina is making the recovery feels more real.

I am now able to walk correctly (with crutches) but the funny thing is ‘relearning walking’…to put the foot on the ground with the heel and moving the foot in a smooth rolling movement is key; I wanted to avoid dragging my foot or worse still, walking like a penguin; I really have to concentrate. At best it will improve posture, avoid back pains as well as ruining my other leg/knee.

I am able now to walk to the coffee shop and walk further without getting tired.
Working is still the pain, as its cold outside, and laying on the sofa – cabin fever, the irritation of medication and mobility just ends up with being negative to people at work. I expect this to subside as well. Just need to keep the routine going.


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.

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.