What is an Osteotomy?
An osteotomy refers to cutting the bone. In the knee, the tibia (shin bone) or femur (thigh bone) can be cut in order to reshape the leg to take pressure off the painful or arthritic side of the knee. This is similar to performing an alignment of your car. If the inner part of your tires are wearing out, an alignment will make sure the tread of the tires wear more evenly.
Types of Knee Osteotomy:
A high tibial osteotomy (HTO) refers to cutting the upper part of the tibia (shin bone). This is performed when someone has worn out the medial (inner) compartment of the knee due to having a bow-legged knee. A distal femoral osteotomy (DFO) is for patients that have a knock knee and have worn out the lateral (outer) compartment of the knee. This can also be done for patients with instability of the patella or kneecap with an excessive knock knee. A DFO is when the lower end of the femur (thigh bone) is cut to straighten out the leg.
Who is a candidate for an osteotomy?
People are usually less than 65 years of age and want the ability to preserve their activity level after surgery. Pain is only one side of the knee and patients do not have pain behind the kneecap. Patients should have full motion of the knee, do not smoke, and do not have to be on medications that may slow bone healing.
What are the advantages of an osteotomy?
Unlike a partial or total knee replacement, an osteotomy allows people to not have to limit their activities once the bone heals and they are fully recovered. Patients can participate in high impact activities and heavy lifting after an osteotomy. This surgery can also delay the need for a knee replacement by several years. An osteotomy can allow a younger active person to continue with their active lifestyles and not be limited by the restrictions after a knee replacement.
Recovery from an osteotomy:
This is an outpatient surgery and most people can go home the same day of surgery. Patients will require the use of crutches initially and limit the weight bearing on the knee for 6-8 weeks until the bone heals. Physical therapy (PT) will begin immediately after surgery to start regaining full motion of the knee and building the strength of the thigh muscles. It can take up to 4-6 months for complete healing of the bone. Following recovery, most patients exhibit no pain on the side of their knee that bothered them prior to the surgery.
For more information, please consider the following link that was produced by the AAOS.