Post-Surgery Knee Pain: What to Expect After High Tibial Osteotomy - Orthopedics

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After undergoing a high tibial osteotomy (HTO), it is common for patients to experience a range of symptoms, including pain, stiffness, and swelling in the knee. Your concerns about persistent pain and limited range of motion are valid, and it's important to understand what to expect during the recovery process.

Firstly, it is essential to recognize that healing after an HTO can take time, and the recovery process varies significantly among individuals. Generally, the initial phase of recovery can last several months, and it is not uncommon for patients to still experience discomfort and limited mobility two months post-surgery. The knee joint is complex, and several factors can influence your recovery, including the extent of the surgery, your overall health, and adherence to rehabilitation protocols.

Regarding your specific concerns:
1. Pain and Hardness in the Knee: The sensation of hardness in the knee and pain can be attributed to several factors, including swelling, scar tissue formation, and the healing of the bone and soft tissues. After surgery, the body goes through a healing process that can result in inflammation, which may contribute to pain and a feeling of tightness around the knee and ankle. This is a normal part of the healing process, but it should gradually improve with time and appropriate rehabilitation.

2. Limited Range of Motion: Your ability to extend your knee only about 20 degrees is concerning, as full extension is crucial for proper knee function. While flexion (bending) seems to be satisfactory, extension is equally important. It is essential to continue with physical therapy, focusing on exercises that promote knee extension. Your physical therapist can provide specific exercises to help improve this range of motion, such as heel slides, quadriceps sets, and stretching exercises.

3. Tightness in the Ankles: The tightness you feel in your ankles may be related to compensatory movements due to the knee pain and stiffness. When the knee is not functioning optimally, other joints, including the ankle, may become tense as they compensate for the lack of mobility. Stretching and strengthening exercises for the ankle and calf muscles can help alleviate this tightness.

4. Pain During Rehabilitation: It is normal to experience some discomfort during rehabilitation, especially when pushing the limits of your range of motion. However, if the pain is severe or worsening, it is essential to communicate this with your healthcare provider or physical therapist. They may need to adjust your rehabilitation program to ensure you are progressing safely.

5. Concerns About Surgical Success: It is natural to worry about the success of the surgery, especially when experiencing ongoing pain and limited mobility. However, it is crucial to remember that recovery from HTO can be a lengthy process, and many patients see significant improvements over time. Regular follow-ups with your orthopedic surgeon will help monitor your progress and address any concerns.

In conclusion, while your symptoms are not uncommon two months post-high tibial osteotomy, it is vital to stay proactive in your rehabilitation efforts. Continue working closely with your physical therapist, adhere to your prescribed exercises, and maintain open communication with your healthcare team. With time and consistent effort, you should see improvements in your knee function and a reduction in pain. If you have any concerns about your recovery or if symptoms persist, do not hesitate to reach out to your surgeon for further evaluation.