Osteotomy is a surgical procedure whereby a wedge of bone is removed/added near a damaged knee joint and the remaining bone is trimmed and realigned. The surgery aims to ease pain and restore function to the affected joint by off-loading damaged areas of the joint and loading well preserved areas. This can delay and sometimes avoid the need for joint replacement.
Osteotomy is recommended when conservative treatments fail to relieve pain in joint diseases and other bone deformities.
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 side of your knee and the aim is to take pressure off the damaged area and shift it to the other side of your knee with healthy cartilage. During the surgery, your surgeon will remove or add a wedge of bone 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).
A high tibial osteotomy is the most common type of osteotomy performed on arthritic knees. After general anaesthesia is administered, your surgeon will map out the exact size of the bone wedge to be removed, using an X-ray, CT scan, or 3D computer modelling. A 8-10cm cut is made down in front of the knee, starting below the kneecap and running below the top of the shinbone. Guide wires are drilled from the lateral side to the top of the shin bone. A conventional oscillating saw is guided along the guide wires and the bone wedge below the healthy cartilage is removed. The cartilage covering the top of the outside of the shinbone is left intact. Then the top of the shinbone is reduced and fastened with surgical staples or screws. After the procedure is completed, the surgical site is then sutured usually with absorbable sutures and closed in layers.
Complications following high tibial osteotomy may include infection, skin necrosis, non-union (failure of the bones to heal), nerve injury, blood vessel injury, failure to correct the varus deformity, compartment syndrome and deep vein thrombosis or blood clots.
Osteotomy is a safe and effective procedure that relieves joint-related pain. When treated successfully, it may delay the need for a total joint replacement.