Should I have the metal plates removed 12 months after the 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.

In December 2018, I was thinking more seriously about going back into hospital to have my plates removed. In the last couple of months I was experiencing more irritation caused by the metal plates in my leg. My surgeon did mention this could happen when during my last consultation. I spent a lot of time thinking the knee pain returned, but simple self investigation by pressing on the affected area, it was clearly in the region of where the metal plates were located. The pain would appear in the following ways:

  1. Swelling beneath the knee area – The remedy was to use ice packs to reduce the swelling.
  2. Itchiness beneath the skin- not much I can do other than trying not to scratch the scar area.

In retrospect I didn’t really feel 100% fully recovered and did experience stiffness and pain in the knee area that was brought on by the following :

  1. Tiredness caused by lack of sleep
  2. Stiffness when sat in the same position in a chair in the office
  3. Excessive exercise such as treadmill running.
  4. Leg pain for standing up too long.

The remedy really was to take painkillers to reduce the swelling and of course, to rest.  In conclusion I saw myself as 70% recovered – still much better than what I was like before the operation. I found my picture below from our family trip to Athens, Greece where I raced my wife on the ancient Olympic track. Who would have thought that Will I run again!

Just the action shot of me running . Ok Loiza beats me at the end

Clearly I can run again!

My thoughts on returning to the hospital were something else….it would be my 3rd operation in 3 years – I was fed up with going into hospital and then taking time out (a good few months) to rehabilitate thereafter. I am softy at the end of the day!

A lot of points to consider…..

Loiza felt I should go ahead with the plate removal. Due to my private health insurance, I would be able to go back to the same private hospital (the OneHatfield) and have the operation done on a day that is convenient for me. It would be silly if I did not do do this.

Well thats it for now….I need to find a simple view/photo of my Tibial Osteotomy showing pre-operation planning and the affects of the surgery. As soon as I find it, I will post it.

Thanks for stopping by!

Coping with Tibial Osteotomy months 8 to 12

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 our family holiday in August 2018 was amazing, we ate, shopped and visited many attractions around the Chicago lakeside area. Going for a bike ride on the lakeside was my favourite experience.

We were lucky that our hotel had an indoor basketball court ( well, Chicago is home of the Bulls) so I was really able to test out the progress of my recovery and it was a success! I was able to play 1on1 with my son – run, jump, turn and shoot and it felt great!. We were in Chicago for 10 days and we played every other day. It had been over 2 years since I was able to engage in a physical sport in that manner, so this was a massive achievement for me.

In terms of strength building I was able to spend longer in the gym and I felt stronger than possibly 2 years ago. I was making a real effort to lose weight and to change my diet. Over the summer I did notice that if I drink alcohol, I do felt aches and pains the day after – so the message here is to drink sensibly ! 🙂

As the UK weather in autumn/ early winter changes to being colder and damp, I noticed the metal work causing me pain in the areas where the plates and screws were.

Sometimes there was swelling in the area and soreness around the scar but taking ibuprofen eased the pain.

Oh and in October, we decided to have a short holiday in Athens, Greece. Strong recommendation from me and the family!

To get to the Acropolis you negotiate a steep climb and in places, over uneven surfaces. Great fun!


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.

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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.


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.

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