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Can 54 year old women walk with full body weight after open wedge osteotomy surgery of 19.5 degree correction in 13 Weeks . Also Taking calcium , vitamin D and Hadjod for 11 weeks
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open wedge osteotomy weight bearing recovery tibial
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open wedge high tibial osteotomy large correction 19 degree full weight bearing 13 weeks bone healing
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open wedge high tibial osteotomy large correction bone healing weight bearing
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https://pmc.ncbi.nlm.nih.gov/articles/PMC10782265
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Cissus quadrangularis hadjod bone fracture healing osteotomy
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Can a 54-Year-Old Walk Full Weight After Open Wedge Osteotomy (19.5°) at 13 Weeks?
Short Answer: Possibly yes - but only if X-ray confirms adequate bone healing. This is a large correction that requires surgeon confirmation before full weight bearing.
Why This is a High-Demand Case
A 19.5° correction places this firmly in the "large correction" category (most protocols define large as ≥10°). Large corrections create:
- A wider osteotomy gap - more bone has to fill in
- Higher risk of lateral hinge fracture during surgery
- Greater load on the fixation plate before bone heals
- Delayed callus maturation compared to small corrections
At 54 years old, bone healing is slower than in younger patients due to lower bone turnover and likely post-menopausal status.
What the Evidence Says About Timing
| Protocol / Study | Full Weight Bearing Timeline |
|---|---|
| Campbell's Operative Orthopaedics (2026) | Full weight bearing allowed by 12 weeks, as healing progresses |
| Ohio State University HTO Protocol | Weeks 6-8: Weight bearing as tolerated with crutches. Large correction (>10°) delays this progression |
| PMC Study (early FWB in OW-HTO) | With TomoFix plate, some patients achieved FWB at 8-10 weeks; cane use until week 11-12 is common |
| Allograft + large correction study (PMC 2024) | Large correction group (≥10°) achieved good healing at final follow-up; hinge fracture cases had delayed weight bearing |
At 13 weeks, full weight bearing is within the expected window for standard cases - Campbell's Operative Orthopaedics states full weight bearing by 12 weeks as healing progresses. However, 19.5° is nearly double the "large correction" threshold, so the timeline should be confirmed with an X-ray.
The 3 Things That Must Be True Before Full Weight Bearing
-
X-ray shows bridging callus / cortical continuity - The osteotomy gap (which is wide at 19.5°) must show adequate bone formation on at least 3 cortices. This is assessed using the modified RUST score on plain films taken at 6, 12, and 24 weeks. A 13-week X-ray is the key test.
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The fixation plate and screws are intact - No signs of hardware loosening, screw cut-out, or correction loss.
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Lateral hinge is intact (or healed) - Large corrections have a higher rate of lateral hinge fracture. If one occurred, healing must be confirmed before full weight bearing.
About Her Supplements
| Supplement | Dose/Status | Role in Bone Healing |
|---|---|---|
| Calcium | 11 weeks | Provides raw mineral substrate for new bone matrix. Essential, especially post-menopausal |
| Vitamin D | 11 weeks | Improves calcium absorption and bone mineralization. Deficiency significantly impairs osteotomy healing |
| Hadjod (Cissus quadrangularis) | 11 weeks | Traditional Ayurvedic fracture remedy. Has shown in animal and some small human studies to promote callus formation and reduce healing time. Likely beneficial and is low-risk |
Taking all three for 11 weeks is a positive sign. Adequate calcium and Vitamin D are especially important in a post-menopausal woman undergoing a large-gap osteotomy - deficiency of either can lead to delayed union or correction loss.
Red Flags That Would Delay Full Weight Bearing
- No clear callus / cortical bridging on X-ray at 13 weeks
- Pain or tenderness directly over the osteotomy site
- Hardware failure or correction loss on recent X-ray
- A lateral hinge fracture noted at surgery that has not healed
- Ongoing swelling, warmth, or wound issues
Practical Recommendation
Do not start full weight bearing without a recent X-ray (ideally taken at 12-13 weeks). The surgeon must review it and confirm callus formation before discontinuing crutches. If the X-ray looks good - which is plausible at 13 weeks given her supplements - full weight bearing is reasonable. If the gap still looks unfilled, protected weight bearing (20-30 kg) with crutches should continue until re-evaluated at 16-18 weeks.
Important disclaimer: This is general clinical information. The treating orthopaedic surgeon who performed the surgery and has access to the X-rays is the only person who can safely clear full weight bearing. Do not make this decision based on time alone.
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