Osteotomy surgery is a controlled break of the bone to allow realignment of the limb. The aim of osteotomy surgery is to correct the alignment of the leg and transmit weight through the central part of the knee joint.
The benefits of Osteotomy Surgery
This surgery can improve knee function and reduce pain by relieving pressure on the damaged surface. In turn this can slow or even halt arthritis and preserve the natural knee joint for longer. It is a useful alternative for people who are young and active and do not want to consider a joint replacement.
Conditions that benefit from osteotomy
Osteotomy surgery is an ideal option for patients who present with malalignment of the knee joint caused by either a deformity in the femur or tibia or both. Each deformity has to be carefully analysed in order to decide what type of surgery would give the greatest benefit to the patient.
Varus Deformity (Bow Legs)
This type of deformity results in arthritis and pain on the inside of the knee joint. Most commonly the correction is made in the lower leg (high tibial osteotomy).
Valgus Deformity (Knock Knees)
This deformity results in arthritis and pain on the outside of the knee. Most often this needs to be corrected in the thigh bone (distal femoral osteotomy).
Complex Deformity Correction
Occasionally the deformity arises in both bones. It is also possible to develop such a significant deformity that correction in one bone is not feasible. In these cases we may need to perform a double osteotomy in order to correct the alignment.
What happens before Osteotomy Surgery?
We usually obtain an MRI scan and several x-rays. These images help us to carefully plan the osteotomy. Often patients are given an off-loader brace to try prior to considering an operation. We will discuss the benefits and risks of surgery and fill in a consent form.
We recommend Don Joy knee braces. Patient information leaflets can be found on the Don Joy website: https://www.djoglobal.eu/en_UK/Patient_Leaflet.html
Patients must stop smoking at least 3 months before surgery as this has a significant effect on bone healing. The pre-assessment team will conduct tests to check you are fit for the procedure.
All patients will be invited to join the UKKOR secure database. The questionnaires you fill in help us develop greater understanding of osteotomy surgery.
What happens on the day of Osteotomy Surgery?
You will be admitted on the day of your surgery. We give you detailed instructions on fasting at home. You will be given some medication before and after the operation to help reduce the pain and swelling.
Most patients have their surgery with spinal anaesthetic and sedation which involves a needle in the back. This type of anaesthetic helps with pain control after the operation. We call this enhanced recovery. You will also be given a Cryocuff (cold pack) to wrap around the knee. Most patients stay in hospital for one night.
Recovering from Osteotomy Surgery?
You will be given crutches for support. Most patients can walk as pain allows without restriction. However, you should rest at home for the first 2 weeks.
You should practice straightening and bending the knee without walking great distances. We will supply you with medication to reduce the chance of blood clots while your mobility is limited. You will attend outpatient physiotherapy.
It is variable how long it may take to return to full activity. You shouldn’t drive your car until you have a full range of movement in the knee and are able to walk confidently without crutches.
We will see you back in clinic at regular intervals to take new x-rays and check your leg alignment and bone healing.