Knee Osteotomy Surgery
Knee Osteotomy is a surgical procedure in which the upper shinbone (tibia) or lower thighbone (femur) is cut and realigned. It is usually performed in arthritic conditions affecting only one part of your knee and the aim is to take load off the damaged area and shift it to the other parts of your knee with healthy cartilage. During the surgery, your surgeon will remove a wedge of bone or add a wedge either below or above the knee joint depending on the site of arthritic damage.
Knee Osteotomy is commonly indicated for patients with osteoarthritis that is isolated to a single compartment (unicompartmental osteoarthritis). It may also be useful in those patients with instability due to ligament damage.
A high tibial osteotomy is the most common type of osteotomy performed on arthritic knees. Pre-operative planning will be undertaken. After general anaesthesia is administered, your surgeon will check the exact size of the bone wedge to be removed/opened, using an X-ray, CT scan, or 3D computer modelling. An incision is made in front of the knee, starting below the kneecap and running below the top of the shinbone. Guide wires and an oscillating saw are used below the unhealthy cartilage to realign the leg and off-load the damaged joint. The cartilage covering the top of the outside of the shinbone is left intact. Fixation is achieved with a plate and screws in the corrected position. After the procedure is completed, the surgical site is then sutured usually with absorbable sutures and closed in layers.
The rehabilitation is important and will involve protection of load with crutches and possibly a brace. Physiotherapy and a graduated return to function will be required over the first few weeks and months.
Risks and Complications
Complications following high tibial osteotomy may include infection, wound breakdown, non-union (failure of the bones to heal), nerve injury, blood vessel injury, failure to correct the deformity to the exact plan, compartment syndrome and deep vein thrombosis/blood clots.