Knee Osteotomy

Knee

Overview

A knee osteotomy is an operation that surgeons use to treat the pain and instability that can occur when there is damage or arthritis in part of the knee joint.

Doctors may suggest a knee osteotomy to treat instability and pain caused by knee joint damage or arthritis in a specific area of the knee. Rather than replacing the entire knee joint, an osteotomy shifts body weight from the affected part of the knee to a healthier area, which may slow the deterioration of cartilage and delay the need for knee replacement surgery. The procedure has been used for many years to improve knee function and alleviate pain.

Diseases treated with Knee Osteotomy

Knee osteotomy is a surgical procedure used to treat specific knee conditions, mainly osteoarthritis and certain knee deformities, such as genu varum (bow-legged) or genu valgum (knock-kneed). In these cases, knee osteotomy can help realign the knee joint, redistribute the load on the knee, and relieve pain and other symptoms. Knee osteotomy is typically considered for patients who are younger and have early-stage knee arthritis or deformities that affect only one side of the knee joint. It may delay the need for a knee replacement and help the patient maintain an active lifestyle

Types of Knee Osteotomy

There are two primary forms of knee osteotomy: closing wedge and opening wedge. During a closing wedge osteotomy, a wedge of bone is removed from the leg, and the sides of the opening are joined together to close the gap. In an opening wedge osteotomy, the surgeon opens up a section of bone rather than closing it. In certain situations, a graft may be used to maintain the gap between the ends of the osteotomy.

Preparation for Knee Osteotomy

To prepare for a knee osteotomy, the patient should follow their doctor’s instructions, which may include:

  1. Providing medical history: The patient will need to provide information about their medical history and any medications they are currently taking.
  2. Fasting: The patient may need to fast for a certain period before the surgery.
  3. Quitting smoking: If the patient is a smoker, they should quit smoking before surgery to help with the healing process.
  4. Physical therapy: The patient may be advised to undergo physical therapy before surgery to strengthen the knee and improve mobility.
  5. Discussing medications: The patient should discuss any medications they are taking with their doctor, as some medications may need to be stopped before surgery.
  6. Arrange for help at home: After the surgery, the patient may need assistance at home, so they should arrange for someone to help them with daily tasks.
  7. Follow pre-surgery instructions: The patient will be given specific instructions to follow before the surgery, such as not eating or drinking anything after midnight the night before the surgery. It’s essential to follow these instructions to ensure a successful surgery.

Knee Osteotomy Procedure

During a knee osteotomy, you will not feel any pain as you will be given spinal or epidural anesthesia or general anesthesia to make you unconscious. The surgeon will make a cut of about 4 to 5 inches (10 to 13 centimeters) on the area where the osteotomy will be performed. There are two types of osteotomy: the closing wedge osteotomy, where the surgeon removes a wedge of your shinbone from underneath the healthy side of your knee, and the opening wedge osteotomy, where the surgeon opens a wedge on the painful side of the knee. Depending on the type of osteotomy, staples, screws, or plates may be used and a bone graft may be necessary to fill in the wedge. The procedure usually lasts for 1 to 1 1/2 hours. By undergoing an osteotomy, you may be able to postpone the need for knee replacement for up to 10 years, while still keeping your own knee joint active. A tibial osteotomy may result in a “knock-kneed” appearance, while a femoral osteotomy may cause a “bow-legged” look.

After the knee osteotomy surgery, a brace will be placed on your knee to restrict its movement during the recovery process. The brace may also assist in maintaining your knee in the right position. You will need to use crutches for at least 6 weeks and might be instructed not to place weight on your knee initially. You should consult your doctor to determine when you can start to put weight on the leg that had surgery. A physical therapist will work with you to create an exercise program. Full recovery may take anywhere from several months to a year.

Benefits of Knee Osteotomy

A knee osteotomy can provide several benefits for patients, including:

  • Pain relief: Osteotomy can help relieve pain caused by osteoarthritis, meniscal damage, or other knee conditions.
  • Delayed need for knee replacement: Osteotomy can help delay the need for a knee replacement for up to 10 years, allowing patients to stay active with their own knee joint.
  • Improved joint function: Osteotomy can help improve knee joint function and mobility, allowing patients to perform activities that were previously difficult or impossible.
  • Reduced risk of complications: Compared to knee replacement surgery, osteotomy carries a lower risk of complications such as infection, blood clots, and nerve damage.
  • Preservation of natural joint: Osteotomy preserves the natural joint and can avoid the need for total knee replacement surgery