Osteotomy of the knee

Definition

Osteotomy of the knee is surgery that involves making a cut in one of the bones in your lower leg. This can be done to relieve symptoms of arthritis by realigning your leg.

Alternative Names

Proximal tibial osteotomy; Lateral closing wedge osteotomy; High tibial osteotomy; Distal femoral osteotomy; Arthritis - osteotomy

Description

There are two types of surgery:

During surgery:

In most cases, the procedure will take 1 to 1 1/2 hours.

Why the Procedure Is Performed

Osteotomy of the knee is done to treat symptoms of knee arthritis or for instability. It is done when other treatments no longer offer relief.

Arthritis most often affects the inside part of the knee. Most of the time, the outside part of the knee is less affected unless you have had a knee injury in the past.

Osteotomy surgery works by shifting the weight away from the damaged part of your knee. For the surgery to be successful, the side of the knee where the weight is being shifted to should have little or no arthritis.

Risks

The risks for any anesthesia or surgery are:

Other risks from this surgery include:

Before the Procedure

Always tell your surgeon which medicines you are taking, even medicines, supplements, or herbs you bought without a prescription.

During the 2 weeks before your surgery:

On the day of your surgery:

After the Procedure

By having an osteotomy, you may be able to delay the need for a knee replacement for up to 10 years, but still stay active with your own knee joint.

A tibial osteotomy may make you look "knock-kneed." A femoral osteotomy may make you look "bow legged."

Outlook (Prognosis)

You will be fitted with a brace to limit how much you're able to move your knee during the recovery period. The brace may also help hold your knee in the correct position.

You will need to use crutches for 6 weeks or more. At first, you may be asked to not place any weight on your knee. Ask your surgeon when it will be OK to walk with weight on your leg that had the surgery. You will see a physical therapist to help you with an exercise program.

Complete recovery may take several months to a year.

References

Crenshaw AH. Soft- tissue procedures and osteotomies about the knee. In: Azar FM, Beaty JH, eds. Campbell's Operative Orthopaedics. 14th ed. Philadelphia, PA: Elsevier; 2021:chap 9.

Feldman A, Gonzalez-Lomas G, Swensen SJ, Kaplan DJ. Osteotomies about the knee. In: Scott WN, ed. Insall & Scott Surgery of the Knee. 6th ed. Philadelphia, PA: Elsevier; 2018:chap 121.

Phillips MJ, Nodzo SR. Patient considerations: comorbidities and optimization. In: Mihalko WM, Mont MA, Krackow KA, eds. Technique of Total Knee Arthroplasty. 2nd ed. Philadelphia, PA: Elsevier; 2023:chap 1.



Review Date: 8/12/2023
Reviewed By: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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