I’ve blogged previously on high tibial osteotomy (HTO) knee surgery and MRI studies showing that the surgery does take pressure off overstressed cartilage (at least in some patients who are bow legged or knock kneed). This invasive knee surgery involves sawing a wedge of bone out of one side of the tibia to allow the knee to be straight again. Usually plates and screws are inserted to hold it all in place (see picture above). However, can you return to physical activities if you have a knee HTO surgery? Can you return to running, hiking, or skiing despite a prolonged recovery time due to tibial osteotomy surgery? A recent study sought to find this out by looking at 41 women and 98 men with a mean age of 59 years who were 4 years post tibial osteotomy surgery. The study is retrospective (looking backward) so it’s not as good as a prospective study (looking forward). 63% of the patients felt like their knee was “normal” after tibial osteotomy surgery, but 62% of patients still felt that their activities were limited by their knee (for example I don’t run at all or as much because of pain). Among patients younger than 75 years, only 28% were participating in regular sports after HTO knee surgery-a fairly low number, but one that could be impacted by pre surgery cartilage damage. To determine who really wanted to return to sports versus who didn’t, the researchers separated their patients into those who were motivated to return to high levels activities such as running, hiking, skiing, etc.. and those who weren’t motivated. Of the “motivated” patients, about 2/3rd’s did return to sports. While the quality of the data is much less than high level, it does suggest that if you’re motivated to return to impact activities after a tibial osteotomy, it’s more likely than not that you will return to sports. However, most patients still feel that their knee limits their activities despite having a high tibial osteotomy, so you may be competing with some pain. The upshot? HTO knee surgery looks like it may be a useful adjunct to get some patients back to high levels of activity, with a few caveats. However, it should be noted that this is an invasive surgery that should only be considered if there’s a significant side bend to the knee (knock kneed or bow legged).
This blog post provides general information to help the reader better understand regenerative medicine, musculoskeletal health, and related subjects. All content provided in this blog, website, or any linked materials, including text, graphics, images, patient profiles, outcomes, and information, are not intended and should not be considered or used as a substitute for medical advice, diagnosis, or treatment. Please always consult with a professional and certified healthcare provider to discuss if a treatment is right for you.
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Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications.
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Regenerative procedures are commonly used to treat musculoskelatal trauma, overuse injuries, and degenerative issues, including failed surgeries.
Shoulder
Many Shoulder and Rotator Cuff injuries are good candidates for regenerative treatments. Before considering shoulder arthroscopy or shoulder replacement, consider an evaluation of your condition with a regenerative treatment specialist.
Many spine injuries and degenerative conditions are good candidates for regenerative treatments and there are a number of studies showing promising results in treating a wide range of spine problems. Spine surgery should be a last resort for anyone, due to the cascade of negative effects it can have on the areas surrounding the surgery. And epidural steroid injections are problematic due to their long-term negative impact on bone density.
Knees are the target of many common sports injuries. Sadly, they are also the target of a number of surgeries that research has frequently shown to be ineffective or minimally effective. Knee arthritis can also be a common cause for aging athletes to abandon the sports and activities they love. Regenerative procedures can be used to treat a wide range of knee injuries and conditions. They can even be used to reduce pain and delay knee replacement for more severe arthritis.
Many spine injuries and degenerative conditions are good candidates for regenerative treatments and there are a number of studies showing promising results in treating a wide range of spine problems. Spine surgery should be a last resort for anyone, due to the cascade of negative effects it can have on the areas surrounding the surgery. And epidural steroid injections are problematic due to their long-term negative impact on bone density.
Hand and wrist injuries and arthritis, carpal tunnel syndrome, and conditions relating to overuse of the thumb, are good candidates for regenerative treatments. Before considering surgery, consider an evaluation of your condition with a regenerative treatment specialist.
Hand and Wrist Arthritis
Carpal Tunnel Syndrome
Trigger Finger
Thumb Arthritis (Basal Joint, CMC, Gamer’s Thumb, Texting Thumb)
Hip injuries and degenerative conditions become more common with age. Do to the nature of the joint, it’s not quite as easy to injure as a knee, but it can take a beating and pain often develops over time. Whether a hip condition is acute or degenerative, regenerative procedures can help reduce pain and may help heal injured tissue, without the complications of invasive surgical hip procedures.
Foot and ankle injuries are common in athletes. These injuries can often benefit from non-surgical regenerative treatments. Before considering surgery, consider an evaluation of your condition with a regenerative treatment specialist.
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