Anyone have a knee osteotomy and still running?

Isn't that for DJD?

Seems to me that by the time your knee was in bad enough shape to be considering an osteotomy, you'd be far removed from your running days...

marijuologist wrote:

Isn't that for DJD?

Seems to me that by the time your knee was in bad enough shape to be considering an osteotomy, you'd be far removed from your running days...

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My assumption is that 1) IF it's done right (and this is not an easy procedure to do correctly) and 2) IF your articular cartilage is in good shape after microfracture, ACI, etc. (if this was the reason for the osteotomy to begin with) and 3) IF you've recovered fully from the surgery (which can take over a year) THEN yes, you should be able to resume running.

But it's likely to be a real challenge.

I had a patella realignment back in 1980. My knee was never the same. Now I just had my fourth knee surgery (all on same knee), and will not be able to run again. Make sure that you really need this procedure!

I'm no doctor but my understanding is that osteotomy is used primarily for DJD and not for the types of injuries (focal defects) that microfracture and ACI are used for. You get an osteotomy not because you have a focal defect, but because you've lost so much cartilage on the entire surface of your knee that the distal femur drops down at an angle- but by that time, you're most likely far beyond being able to run, or at least being able to run safely.

Where are you from Brian? If it's anywhere near Pittsburgh you should check out Dr. Fulkerson if it is the right option for you. Read more on his method for correcting patellar subluxation here:

http://sports.espn.go.com/oly/trackandfield/columns/story?columnist=assael_shaun&id=3179223&lpos=spotlight&lid=tab7pos1

I had a female friend who had hers done by him and resumed running fairly quickly from a rehab standpoint, and has been doing longer distances 1/2 marathon, plans for marathon, without problems. Actually was very successful in the way of elimination her symptoms.

also, Please clarify why you need this surgery (curiousity)

I have articular cartilage damage medially in one knee. My alignment is off, but my knee has not collapsed. I have had 2 meniscus surgeries, 1st one in 2000 and then last March. I started running again after the 3/07 (with my Orthopedists blessing) and my knee blew up in July with edema. Had Synvisc done, did not help much. At this point my knee prevents me from just running down the driveway. I was running pain free up to 70 miles a week with speed until I tore it in 12/06. I was told in 2000 at the time of my scope then that I had articular damage in the this knee, but never had any pain.

I am still exploring my options, but curious as to if anyone has personal experience.

I should have been more specific. I am a Podiatrist with a sports background, so I am pretty familiar with the ins and outs of all the knee surgeries.

I live in Sleepy Hollow, NY

marijuologist wrote:

I'm no doctor but my understanding is that osteotomy is used primarily for DJD and not for the types of injuries (focal defects) that microfracture and ACI are used for. You get an osteotomy not because you have a focal defect, but because you've lost so much cartilage on the entire surface of your knee that the distal femur drops down at an angle- but by that time, you're most likely far beyond being able to run, or at least being able to run safely.

It's used for both. Really depends on the surgeon, some are much more conservative than others.

Doctor Truth wrote:

marijuologist wrote:

I'm no doctor but my understanding is that osteotomy is used primarily for DJD and not for the types of injuries (focal defects) that microfracture and ACI are used for. You get an osteotomy not because you have a focal defect, but because you've lost so much cartilage on the entire surface of your knee that the distal femur drops down at an angle- but by that time, you're most likely far beyond being able to run, or at least being able to run safely.

It's used for both. Really depends on the surgeon, some are much more conservative than others.

Interesting thread, fwiw:

Putting myself in your shoes, I would probably try Hyalgin (similar to synvisc, but a different option) first to try before having the surgery done. With two cartilage repair/cleanings already done, and the adverse reaction to resuming running, I would be apprehensive to say you would be able to return to a level of running you would enjoy, but I would likely go through all the options you are before hanging it up as well. I hope the best for you and recommend starting off in the pool for recovery, followed by adding in biking and hopefully returning to running with a solid mix of biking and running to reduce impact but maintain a high fitness level. A new master's level runner required a partial meniscectomy in early summer and worked his way up to 200 mpw on the bike (he was starting to bike before surgery since the pain prevented him from running). He was running 1640's to 1650's 5k for the past few years....ran a race this past December in the 1610's after sticking running back into his program (not sure how many months he has been back running). Hope this helps

April 15th on

https://www.letsrun.com/forum/posts/2297614/reply

I had a High Tibial Osteotomy 10 weeks ago

This was my 4th knee surgery in 23 years. The first 3 were for Osteochondritis Dissecans and the HTO was because there is almost no cartilage on the lateral side of my knee.

I had to stop jogging 5 to 6 months ago and could only do boxing when wearing a custom metal knee brace with 3 to 4 lighter knee braces under the metal one.

The HTO was my 8th surgery overall (4 for left knee, 2 for bone spurs (both shoulders), 1 for sleep apnea, 1 vasectomy) so my pain tolerance is quite high.

All 7 surgeries before the HTO were day surgeries but for the HTO I had to stay overnight for pain management with strong opiate meds (Demerol I think) and there is a lot of metal in my tibia now.

After the first 3 OCD knee surgeries I could walk a few feet on occasion the same day I had the surgeries (no crutches) and start running after a few months but after the HTO I had to use crutches for 6 weeks.

Its been 10 weeks post-HTO and I can walk (slowly while wearing a knee brace) and go up and down the stairs but both activities are painful. My knee hurts every day all day long and my sleep is still poor.

Full HTO recover is supposed to be 6 to 12 months but with all the rehab, physio, bodyweight stretching and strengthening exercises I am doing my plan is to start jogging and boxing again in 3 to 4 weeks.

At my 2nd post-operative appointment (6 weeks after surgery) the doctor who did my HTO said I could start jogging and boxing in 8 weeks. By then it will have been almost a year since I could jog 5-10 kms about 3-4 times weekly. I really miss jogging.

I have all the conditions that require an osteotomy - patellar femoral bone on bone arthritis, large area of missing cartilage from that joint, all due to a poor Q angle and wear over the years because of it. For a while (a few months), before I saw a couple of surgeons, I was in a lot of discomfort walking and rest did no good. I started managing the problem conservatively and devised my own exercises, which mainly focussed on strengthening what were very weak VMO muscles and shaped my own inserts in my shoes (podiatrists kept giving me orthotics which didn't properly tackle the problem, which was relatively straightforward - I had to land more central and get off that outside edge). I also take a lot of supplements. Glucosamine is the main one that benefits.

Getting back to running was a bit like being a new born foal and it took 2- 3 months to feel natural. I do however now run without any pain. As a near 50 however my speed is nowhere near what it was in my thirties except that I can sprint without any issues at a good pace. I generally only run 3 miles a day and supplement it with cycling, but I was a middle distance runner and never did high mileage. I run 5 days per week, sometimes slowly, I am nowhere near as good as I was but whether this can be attributed to the knee or just general wear and tear from years of racing, I do not know. I can run enough to keep my fitness levels high and do the odd race and my knee now doesn't bother me in the slightest.

Both surgeons told me I'd never run again, would never do all sorts of sports again, thankfully I ignored them. I was shocked that there is little research and little protocol into rehabbing this type of condition conservatively, although what research there is indicates that it is just, if not more, effective than surgery. Apparently I was to cycle, swim and row instead, but cycling more than 2 or 3 days per week at any reasonable mileage actually irritates this condition more than running! I often wonder what speed they think people cycle at. It was as if they had no idea how to deal with a patient with reasonable fitness and motivation. Dealing with those surgeons was way more mentally challenging than dealing with the condition itself and I honestly felt pretty traumatised after seeing them.

Not one surgeon said "look , lets consider what muscles aren't working optimally because of your poor fitting femur and try strengthening them to avoid surgery", it was all "ok, you have to learn to live with never running again". I had a month off running in total and many runs where I was running slowly with a sort of limp for 6 weeks but I felt better when I ran as my supporting muscles atrophied when I didn't.

I should think that an osteotomy would be beneficial in a lot of cases as it does tackle the problem, but conservative management should be tried first. Also look into replacing the missing cartilage with lab created cartilage - it is difficult to plug large gaps. Don't bother with PRP - research indicates its a waste of time.

My knee is great - lets just say I have no problems repeatedly hopping up and down on that one leg if I choose, running up and downstairs. That's the sort of result I would expect from an osteotomy if done well. Otherwise, whats the point in getting it done?

I had an osteotomy 7.5 weeks ago. I was really grateful to read your post, because I, too, am still in daily and constant pain and thought that must signal something wrong. I was cleared to "wean off" the crutches and brace last week, but when I tried to walk on my own (with a severe limp), my PT insisted I use one crutch all the time until my quad strength returns and my gait mechanics improve. It is difficult to not feel disheartened at the moment. I have decided to put faith in this process, but when I try to imagine running again on this leg, it seems out of the question. Prior to my surgery, I had been running regularly for 21 years. I've done 2 marathons, dozens of halfs, and more shorter races than I could count. I was never super fast -- but boy, did I love running. I would love to hear from someone who had an osteotomy and is more than 6 or 12 months out and has successfully returned to recreational running.

In the meantime, thanks for this forum. This surgery feels very lonely. So many people have PKR or TKR, but I've not met anyone who had what I did -- Fulkerson osteotomy, OATS, and lateral release. I trust my surgeon and PT (mostly b/c I have no other choice), but also really need to hear from real-life patients who have gone through it.

Any thoughts on the age this might be done?

I've got a bad knee, which has turned into two bad knees over time, and a bad foot, bad back, bad neck, all from one bad knee. I'm 55, and wondering if the recovery/potential complications are worth it, or if simply managing at this point is the better course.

Seeker of knee wisdom wrote:

Any thoughts on the age this might be done?

I've got a bad knee, which has turned into two bad knees over time, and a bad foot, bad back, bad neck, all from one bad knee. I'm 55, and wondering if the recovery/potential complications are worth it, or if simply managing at this point is the better course.

I've got a bad ankle (torn tendon & OA), two bad knees (degenerative ACL tear & torn patella tendon), bad hip (OA), bad back & a bad shoulder.

I'm 58 and miserable most of the time. With the exception of the back & shoulder (MV accident), all these injuries occurred in the name of running and being physically active!

Acute injuries become chronic, wear & tear only gets worse as you get older. All the rehab & glucosamine in the world doesn't due much. Surgical intervention doesn't have the best outcomes either for us older cats. The sports medicine system doesn't really have much to offer except pain management through drugs.

Running is gift for middle-agers who don't have a significant injury history.

☝️ What do you call a competitive runner over 50?

? LUCKY!...as in damn lucky!

DK

My history is identical to yours. Would

Love the opportunity to speak to you off line.

Hi! Yes, but I do not know how to share information without posting it publicly?

Sorry for the delay; I just returned today to see your reply. I am feeling slightly more optimistic today than when I wrote that but I will also say that was far from my low point of feeling discouraged. I hope you're doing well with your surgery!

Hi,

I am not interested in how your recovery is going? I may benefit from and hto and aci for an isolated cartilage defect on my femoral condyle. I’m still trying to decide if this is right for me. Any information would be helpful.

Thanks

Eric

Whoops, I am interested in how your surgery and recovery has progressed.

Eric