Knee Osteotomy

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Definition

What is Knee Osteotomy?

Knee osteotomy is a surgical procedure that your doctor might recommend if you have arthritis damage in just one area of your knee. Osteotomy is also performed in combination with other types of knee surgery, such as cartilage surgery, if your leg is bowed or knock-kneed.

The procedure involves removing or adding a wedge of bone to your shinbone (tibia) or thighbone (femur) to help shift your body weight off the damaged portion of your knee joint.

When is Knee Osteotomy needed?

Slick cartilage covers the ends of the bones in a healthy knee and this allows the bones to move smoothly against each other. Osteoarthritis damages and wears away the cartilage — creating a rough surface.

When the cartilage wears unevenly, it narrows the space between the femur and tibia, causing the knee to bow inward or outward, depending on which side of the knee is affected. Removing or adding a wedge of bone in your upper shinbone or lower thighbone can help straighten the bowing, shift your weight to the undamaged part of your knee joint and prolong the life span of the knee joint.

Precautions

What should you know before undergoing Knee Osteotomy?

Not everyone can safely undergo this procedure. Knee osteotomy is most effective for thin, active patients who are less than 60 years old. Good candidates have pain on only one side of the knee, and no pain under the kneecap. Knee pain should be brought on mostly by activity, as well as by standing for a long period of time. Candidates should be able to fully straighten the knee and bend it at least 90 degrees. Patients with rheumatoid arthritis are not good candidates for osteotomy. Your orthopaedic surgeon will help you determine whether a knee osteotomy is suited for you.

What are the complications and side effects?

As with any surgical procedure, there are risks involved with osteotomy. Your surgeon will discuss each of the risks with you and will take specific measures to help avoid potential complications.

Although the risks are low, the most common complications include:

  • Infection
  • Blood clots
  • Stiffness of the knee joint
  • Injuries to vessels and nerves
  • Failure of the osteotomy to heal

In some cases, a second surgery may be required, particularly if the osteotomy does not heal.

It is important you understand the precautions and know the possible complication and side effects before having this Knee Osteotomy. If you have any questions, please consult with your doctor or surgeon for more information.

Process

How do I prepare for Knee Osteotomy?

Your surgeon will study X-rays of your knee to determine if osteotomy is appropriate and how much correction of the deformity is needed.

Because you’ll be receiving anesthesia, you can’t eat or drink before the procedure. If you take daily medications, follow your surgeon’s instructions on whether to take them the morning of your surgery.

What happens during Knee Osteotomy?

You’ll either be put to sleep (general anesthesia) or be numbed from the waist down (spinal anesthesia). Your surgeon will make an incision over the area of bone to be remodeled.

Depending on the location of the damage, the surgery might involve your shinbone or your thighbone. The most common form of knee osteotomy involves the shinbone.

In the simplest knee osteotomy, your surgeon cuts almost across the bone, opens a gap, fills it with bone graft and fixes the bone in place with a plate and screws. This is called an opening wedge osteotomy.

Another option is to cut the shinbone or thighbone, then remove a wedge of bone. The cut edges of the bone are brought together and held in place with metal hardware. This is called a closing wedge osteotomy.

The surgery typically takes one to two hours.

What happens after Knee Osteotomy?

Depending on the complexity of the surgery and how well you recover, you’ll go home the same day or stay one night in the hospital. You’ll need to use crutches for approximately two months for your bone to heal properly.

Rehabilitation can take as long as six months. It will include exercises designed to:

  • Strengthen your thigh muscles (quadriceps)
  • Increase your knee’s range of motion
  • Improve your balance

Occasionally a brace is used to support the bone while it heals.

If you have any questions or concerns, please consult with your doctor or surgeon for more information.

Recovery

What should you do after Knee Osteotomy?

  • Pain management. After surgery, you will feel some pain, but your surgeon and nurses will make every effort to help you feel as comfortable as possible.Many types of pain medication are available to help control pain, including opioids, nonsteroidal anti-inflammatory drugs (NSAIDs) and local anesthetics. Treating pain with medications can help you feel more comfortable, which will help your body heal faster and recover from surgery faster. Opioids can provide excellent pain relief, however, they are a narcotic and can be addictive. It is important to use opioids only as directed by your doctor. You should stop taking these medications as soon as your pain starts to improve.
  • Weight bearing. After the operation, you will most likely need to use crutches for several weeks. Your surgeon may also put your knee in a brace or cast for protection while the bone heals. Your surgeon will give you instructions about when weight bearing can begin.
  • Doctor visit. You will see your surgeon for a follow-up visit after surgery. X-rays will be taken so that he or she can check how well the osteotomy has healed. After the follow-up, your surgeon will tell you when it is safe to put weight on your leg, and when you can start rehabilitation.
  • Rehabilitation exercises. During rehabilitation, a physical therapist will give you exercises to help maintain range of motion in your knee and restore your strength.

You may be able to resume your full activities 3 to 6 months after surgery.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: November 12, 2018 | Last Modified: November 12, 2018

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