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.

Maintaining an exercise routine under COVID-19 lockdown

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.

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

The last 4 weeks has forced all of us to live in the ‘new ‘ world and having to adapt to social distancing. For me, work is no different as I mainly worked from home and used tools like Skype for Business and Teams for meetings anyway. If anything, the working hours have started to get longer.

To exercise and to keep muscle strength at a decent level has been a challenge as my Gym has been closed for 4 weeks now. I have been doing some basic weight training and keeping the strength in the knee. I have started to feel the pain in the knee though and do miss the gym. It never goes away completely.

I did fix up my mountain bike ( got a decent TREK 6500 MTB from 2011) and have been cycling every other day and am able to clock up about 60km per week. I only have 45 minutes for lunch but fewer cars on the road does make cycling more relaxing.

In addition to the cycling, taking yoga classes (via Youtube) is helping with the stretching and muscle building. If folks are thinking Yoga is lame, I urge you to have a go, you will use and stretch muscles you never knew were weak. For stretching muscles in the legs and simply doing the breathing exercises does help relieve knee pains. I may start to do Yoga every morning (starting next week!)

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.

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!


Positive change post Tibial Osteotomy – 6 months on…

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.

I did get the chance to visit Chicago in the summer. Perfect weather!

By June 2018, I was signed off my Physio. He felt I made good enough progress to get my life back to a normal state and gave me some tough exercises to continue with. This was coupled with my surgeons recommendation to return on the 12 month operation anniversary (Jan 2019) to have the metal plates removed. This is a big deal as it means the cycle of pain in the knee could be reaching its end point. A weird part of me wanted to keep the metalwork in my leg as its a great conversation opener or filler (“I have a bionic leg”) however I was experiencing the odd skin irritation or swelling where the plates were located. Mr Chatoo (Surgeon) did mention a number of patients having the same experience. I set my mind to return in January for the final operation.

The gym workouts were going well. I was able to run 5k on the treadmill, lift and pull leg weights that was a clear improvement to pre-operation. I kept to a routine of fitness as well as cutting down on my alcohol intake and losing as much weight as possible, through healthier eating.

In July, I had to take time out from work to help my parents. My dad went into hospital to undergo a Quadruple Heart Bypass operation.

My dad is doing well 12 months on but it was a very tough time for my immediate family. Thank you to the NHS!

At the end of August and as a family, we decided to spend our 10 day summer vacation in Chicago, Illinois. For a Brit living under the cloud of Brexit some destinations were becoming very expensive and we felt that Chicago was a great location and is excellent value for money. Also we booked at the last minute and found a great value deal.

I felt much more confident in travelling and doing more outdoor activities; a real turning point as I felt my confidence was coming back.

Yes, there are some great beaches on the lakeshore. Fresh water also!

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’

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