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Personal experience of High Tibial Osteotomies (HTOs) for arthritis of the knee.

By Hugh Stewart December 18, 2017 Leave a Comment

Living with one bad arthritic knee and the other moderately so for a year and a half, I had them both corrected as per the title, at one sitting. After 9-10 months I could walk 10+ miles over rough hills and after two years have done 15+ in the Cairngorms. I was able to cycle indoors at 8 weeks, outdoors at 3 months.
This operation involves cutting the Tibia (shin bone), across below the knee, opening a wedge shape gap, inserting a bone graft and plating top to bottom parts. The idea is to straighten deformed legs, in mine and most cases bow legs (medically called varus), so that the line of force goes through the centre of the knee, or slightly to the outer side, as opposed to through the arthritic inner side before the operation. The same can be done in the lower thigh for knock knee (valgus) arthritic knees, but note both operations can only be done if it is only one side of the knee that is arthritic and has been destroyed to cause the deformity (or worsen a pre-existing one), not if the whole knee is involved.
These procedures are ideal for the younger and/or active person, avoiding knee replacement and thus avoiding the possibility of being one of the unfortunate 5-10% of people who are not improved by replacement, and also avoiding being a hostage to fortune forever.
I was in a wheelchair for five weeks (two chairs actually, one upstairs) and crutches then for a month. Off work 4.5 months. You have to have something (or someone, or both!) to keep you sane during this time. I occupied myself writing half the book you can see on the website.
Definitely worth it! These procedures are making a comeback (I used to do them in a much less scientific way, and gave up), and at present not many centres are doing it, but things will change.

Both Knees Pre-Op, showing loss of joint space on the inside (medial) joints, and bow legs.
Left Knee Post-Op, as for the Right.
Right Knee Post -Op, showing a wedge bone graft and plate.

Filed Under: Orthopaedic

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Hillwalks from the Settle to Carlisle Railway Stations

24 walks into the hills surrounding the historic and iconic Settle to Carlisle railway, based on the stations between Settle and Appleby. The area has some of the finest walking of the north Pennines: the Craven district around Settle; the Three Peaks area; Dentdale, and Mallerstang and the upper Eden valley.

£12.95 (P&P may apply)

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Mountain Biking Adventures: Multi-day Routes in Northern Britain

Over the last two decades, mountain biking has developed enormously as a “sport”. We greatly admire the technical and athletic capabilities of modern day mountain bikers and recognise that many excellent guides have been written and custom-built trails set up. In this guide we try to reopen a sense of adventure and wilderness to mountain biking, providing multi-day routes with a remoteness, continuity and “arc” missing from many modern guides with their focus on day and half day outings.

UK £13.95 ( inc. P&P)

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Settle to Carlisle – Hill Walk with Return by Classic Train Route

With over 22,000 ft of ascent in 105 miles set out over 8 days, this walk sets out from Settle, taking in the classic summits of the North Yorkshire Dales, Howgills, Eastern and Northern Lakeland Fells, to arrive at Carlisle. The return journey to Settle by one of the classic train journeys. Illustrated with photographs and route maps.

£12.95 (P&P may apply)

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Alternative route from Tebay to Shap

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An Upper Swaledale round from Muker

This lovely 8 mile walk is best done in early to mid-June when the Muker meadows, and to a lesser extent the Ivelet to Muker meadows, are full of wildflowers. Starting in Muker, find the path through the village which leads onto the meadows. It is not signed so be careful. Go through the delightful

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Scafell Pike from Wasdale, without the crowds. (Mostly.)

A glorious friday in early June, the last weekday of the Whitsun holidays. I wanted to see what Piers Gill was like, as my late mother told me once that she had been cajoled by my father to take me and my one older and one younger brothers (aged maybe 3 to 7) up the Pike, but went wrong in bad

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