During the High Tibial Osteotomy (HTO) Surgery
In the Operation Theatre Complex:
Dr. Amyn Rajani prefers to operate early in the morning and hence the patient will be wheeled in to the operation theater at about 7:45 am
The anesthetist will evaluate the patient and make him/her comfortable. After which the fluid drips will be started,
During Anesthesia:
We use a combination of Spinal and Epidural Anesthesia for High Tibial Osteotomy Surgery. The patient sits with his/her back facing the anesthetist so that the back can be cleaned and draped before injecting the anesthetic injection.
Our team of anesthetists are very well trained and hence when the Spinal and Epidural injections are given in the back, other patient may feel minimum or no pain at all. The epidural catheter is left in the epidural space and is connected to a pump externally, which gives pain medications at regular intervals. The catheter is normally removed after 48 hours.
As soon as Spinal Anesthesia is given the patient's limbs become numb and the patient is made to lie down.
Catheterization:
Urinary Catheterization is done to monitor the urinary output during as well as after the HTO Surgery. The catheter is removed at 48 hours after the High Tibial Osteotomy Surgery.
Preparation of the limb before the surgery:
Inflatable cuffs attached to electronic tourniqet machines are applied to the thigh as they prevent intraoperative bleeding by increasing the pressure. Limbs are then scrubbed thoroughly by an assistant surgeon to prepare it for painting and draping.
The donor site for the bone graft (usually it is the same side iliac crest) is scrubbed and prepared as well.
Limb scrubbing
Limb scrubbing
Donor site for Bone Graft
Surgeon's Preparation:
After giving the position, the surgeon scrubs up before wearing sterile gloves and gown.
Painting and Draping:
The knee is painted and draped in sterile fashion so as to keep the leg free.
Image Intensifier:
The image intensifier is adjusted so that a clear view of the osteotomy site is provided.
The Surgery:
The High Tibial Osteotomy Surgery is described in the procedure page.