Alternatives to osteotomy (HTO/DFO)

damagedPEteacher

Hi all. Looking for some advice/research and questions to use. Recently diagnosed with OA, the initial consultation and X-ray indicated OA and ACL (2nd rupture). Consultant had at this meeting suggested osteotomy was my option to prevent/delay TKR which aged 38 isnt a good option (especially as a PE teacher). Further imaging is under way/booked in. I had to push for suggested alternatives such as knee brace - I was told about Ossur unloader at this point!

Can anyone suggest good counter arguments with research or additional questions I should be asking to avoid surgery. I am aware that surgery can be a good option while young but would be keen to have as many options as possible to discuss as it seemed osteotomy was the only option.

thanks

frogmorton

Shame this isn't an RA question because I know @Arthuritis is my go-to person for research.

Having said that I can see your dilemma you are young to be having joint surgery and it is quite a scary prospect knowing it may need to be repeated. My own youngest had to have shoulder replacement surgery due to cancer treatment at 19 it was a terrifying thought, but at the time she was in so much pain she had no quality of life.

There weren't braces available for her to try, but in your case there are.

There are a few people here who have dodged surgery even though it really needs to happened through the right exercise I am thinking of @jonr

Sorry not to be much help but wish you all the best

Toni

speedalong

Hi , I snapped my ACL (though hospital were economical with the truth.) It was the physio who told me it was just torn but dangling. I went the physio route as like you I didn't fancy the surgery nor the road to recovery following an ACL repair. However, I didn't receive much advice at the time, as I too had OA in my knees (and hip replacements) I don't think I was a priority candidate.

The physio helped, however I had to learn to avoid certain movements that hurt like hell and it was never as good again.

Roll forward lots of years and I have swelling caused by overloading the knee and some severe knee pain.

There is a limited time frame for ACL repair, which is different to a TKR - I would ask about that too.

damagedPEteacher

@frogmorton thank you. It is a minefield

@speedalong thanks for your comments.

I don’t think I was massively helpful in my original post. Too late last night. I had ACL reconstruction and meniscus removal 22 years ago. This reconstruction has failed due to an incident (can’t recall one) or degraded. Having had the surgery at 16 I have given my knee a smashing!

I want to continue to be able to play sport and be active especially in my career. I need to be aware of the prospects for likely future sport post surgery as well as balancing being able to teach for the next 20 years.

any thoughts or suggestions much appreciated

speedalong

Hi @damagedPEteacher I was offered a Periacetabular osteotomy for my second hip and attended appointments down South. However, I deteriorated quicker than anticipated and the damage became too great. Check the window for the osteotomy to be done.

frogmorton

Good to see you Speedy @speedalong well I remember your op in 2010!😊

@damagedPEteacher please do let us know what you decide to do.

Toni x

speedalong

Hi @frogmorton thank goodness for the forum in the lead up and after my op. I'll PM you a proper message, when I feel more like me again.

damagedPEteacher

@speedalong when you say check the window do you mean check how long an osteotomy is viable for? Don’t delay too long??

speedalong

@damagedPEteacher yes that’s exactly what I mean. Might be different for knees (mine was for a hip) but not worth the risk. Insist on regular check ups, an appointment wasn’t sent out to me and I went too long between check ups and that’s why mine deteriorated too much for it to be a viable option anymore. They never explained that to me when the option was offered.