High Tibial Osteotomy surgery
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1 Golden Jubilee National Hospital NHS National Waiting Times Centre High Tibial Osteotomy surgery Patient information guide Agamemnon Street Clydebank, G81 4DY (:
2 Introduction This booklet will provide you with useful advice and general guidance to help in the recovery following your high tibial osteotomy surgery. What is High Tibial Osteotomy surgery? High Tibial Osteotomy is a surgical procedure to correct the position of your leg and reduce the pain you have in your knee. There are a variety of approaches to carrying out this procedure and your surgeon will discuss the best option with you. One of the most common procedures carried out in this hospital is a wedge osteotomy. A wedge osteotomy involves taking a wedge of bone from the outer side of the tibia (the bone beneath the knee). This helps to position the bone and allow weight to pass through the outer, undamaged, part of the knee. 2 High Tibial Osteotomy Surgery
3 Why do I need High Tibial Osteotomy surgery? Damage to the inner-knee can cause osteoarthritis. Such damage may be the result of; a sporting injury; rickets; poliomyelitis; direct trauma to the knee. Osteoarthritis can be painful, limiting the function of your knee and quality of life. The aims of High Tibial Osteotomy surgery are to; correct poor alignment of the knee; prolong the life of the knee joint, delaying the need for Total Knee Replacement surgery; reduce pain; improve function; improve quality of life. What happens at your clinic appointment? You will be examined by a surgeon who will discuss the planned procedure with you. At this time you will have an opportunity to ask any questions you may have and asked to sign a consent form stating that you have understood what is involved and are you are willing to go ahead with the surgery. You may also be pre-assessed on the same day, however on occasion you will be asked to return to the hospital for another appointment. Your pre-assessment will be carried out by nursing staff but you may see other healthcare professionals during this appointment, such as ward doctor, anaesthetist, specialist nursing staff or physiotherapist. High Tibial Osteotomy Surgery 3
4 The nurse will check your temperature, blood pressure, pulse, height and weight. A sample of urine will be requested when you arrive. Swabs will be taken for MRSA testing. Additional tests may be required, such as: blood samples; an x-ray; an MRI scan; a tracing of your heart. What happens when I come into hospital? You will usually be brought in early on the morning of your operation. You may be seen by the anaesthetist before surgery who will answer any concerns you may have and explain what will happen. You will usually be asked to stop eating at midnight on the morning of your operation and stop taking fluids two hours before you go to theatre. You will be told your fasting instructions before admission. The procedure lasts for about an hour, after which you will remain in the theatre recovery area until you are ready to go back to the ward. What can I expect after surgery? The day of surgery Once you are back on the ward the staff will continue to monitor your progress. You will be able to eat and drink on return to the ward. Some patients are able to get up with the physiotherapists later in the day; others stay in bed until the following morning. The day after surgery and onwards You will be assisted out of the bed to sit in the chair, usually using a Zimmer Frame with the assistance of two members of staff. You will not be able to take any weight on your operated leg. You will have a wash and change your clothing. You will be visited by a member of the pain control team to ensure you are on adequate analgesia. 4 High Tibial Osteotomy Surgery
5 You will be assessed by the physiotherapist to ensure you are walking safely, progressing from the Zimmer Frame onto elbow crutches; you will not be able to take any weight though your operated leg. The physiotherapist will also teach you some exercises, as shown below. Arrangements for your discharge home will begin. Discharge from hospital You will have a blood test and an x-ray on the first or second day after your surgery. The physiotherapist will have completed your exercises and shown you how to go up and down stairs safely. You will have seen the pharmacist, who will explain any changes in your medication. You will be given a letter to be taken to your General Practitioner (GP). An appointment to be seen at clinic will be posted out to your home. When at home, if you have any issues relating to your surgery, wound or rehabilitation that you wish to discuss please do not hesitate to contact us on: Monday Friday 9am 5pm Arthroplasty Team or and ask to be put through to the Arthroplasty page holder. General advice All information provided in this booklet is for guidance only and is not exhaustive. Detailed, individualised instruction will be provided by your surgeon, physiotherapist and multi-disciplinary team. High Tibial Osteotomy Surgery 5
6 Stairs Technique First take a step up with your healthy leg. Then take step up with your affected leg. Then bring your crutches up on the step. Always go one step at a time. First put your crutch one step down. Then take a step with your affected leg. Then take a step down with your healthy leg, onto the same step as your affected leg. Always go one step at a time. 6 High Tibial Osteotomy Surgery
7 Physiotherapy Exercises Lie on your back with your legs straight. Bend your ankles and push your knees down firmly against the bed. Hold for five seconds and relax. Repeat 15 times, four times a day. Lying on your back. Bend your knee as far as is comfortable, and then straighten your knee again. Repeat 15 times, four times a day. Lying on your back. Put a rolled up towel under your knee. Pull your toes up towards you, tighten your thigh muscle and straighten your knee (keep your knee on the towel). Hold for five seconds then slowly lower your leg. Repeat 15 times, four times a day. Lying on your back. Straighten your leg by pulling your toes up and pushing your knee down. Lift your leg a few inches off the bed. Hold for five seconds then slowly lower your leg. Repeat 15 times, four times a day. High Tibial Osteotomy Surgery 7
8 (: Please call the above number if you require this publication in an alternative format Review date: September 2015 Version 1 OR07
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