Following a medial high tibial osteotomy (HTO) in September 2018, Amanda gives an update on the removal of hardware from her knee

Amanda feels very positive about the whole procedure and above all is glad to have avoided a partial knee replacement.

AmandaDid you know at the time that you would need a follow up operation?
“Yes, you are extremely well informed at the time of the consultation with Professor Wilson.”

When did you have the hardware removed?
“My hardware was removed in September 2019, however, the estimated timescale given is 1 – 2 years after depending on how quickly the bone union progresses. The main reason for removing it is should you at some time (many years) in the future require a further knee revision e.g. total or partial knee replacement, a much better outcome is achievable when they don’t have to “dig” out the hardware many years later which makes for a more difficult operation.”

What did that second operation involve?
“A further general anaesthetic is required, the original HTO scar is used for the removal of the plate and screws and the remaining bone holes are filled, a revision of scar tissue. The removal of the hardware is nowhere near as painful/uncomfortable as the HTO and recovery is really quick, your knee feels fine, the only discomfort is from the incision site and perhaps a little stiffness from minor swelling.”

How long were you in hospital?
“One night, intravenous antibiotic drip, compression stocking on lower “good leg” and intermittent pneumatic compression device on both to encourage your blood to flow more quickly around your body by inflating at regular intervals to squeeze your legs and encourage blood flow to avoid the risk of deep vein thrombosis. This is noisy so you don’t really get much sleep!”

What was the recovery period and how did it go?
“You walk straight out of hospital, no need for crutches etc. minimum amount of pain killers (I only took paracetamol for 3 days).The recovery period is very short, you really only need a couple of weeks if that to get back to normal. If you work, you probably should take the first week off being careful to rest your leg (RICE protocol) and not do too much straight away but you can easily manage stairs, walking etc. and make sure you do your physio exercises. By the second week it’s pretty much getting on with life, driving, back to work and continue your physio if needed. You need to keep the incision/wound area clean and dry until stitches are removed. It is advisable not to do any high impact sports straight away.”

How are you now?
“It’s now 3 weeks from the removal of hardware, 2 weeks from follow up consultation and stitch removal by Professor Wilson and my wound is fully healed with a very neat small scar. Unfortunately, I do have a small area of muscle numbness on my shin but Professor Wilson advised that this should improve over the coming weeks/months but my knee feels really good. I feel very positive about the whole procedure from start to finish and above all really like having my own knee still.”

Does it feel different without the hardware in your knee?
“You definitely notice the difference when the hardware is removed as you can feel the screw heads and the edge of the plate when in place which causes a bit of irritation when your knee bends and this disappears immediately which feels great.”

Amanda’s advice to patients prior to having hardware removed:
“I decided to work out a little more a few weeks before the op to strengthen my supporting knee muscles e.g. squats, long walks, swimming, stretching, core work and I’m sure this was well worth the effort and really helped with the speed of recovery as I didn’t feel I had any muscle loss/weakness post op.”

October 2019