Osteotomy

Knee osteotomy is used when a patient has early-stage osteoarthritis that has damaged just one side of the knee joint. By shifting weight off of the damaged side of the joint, an osteotomy can relieve pain and significantly improve function in an arthritic knee. normal knee anatomy and osteoarthritic kneeeoarthritis that has damaged just one side of the knee joint.  (Left) A normal knee joint with healthy cartilage. (Right) Osteoarthritis that has damaged just one side of the knee joint. 

Advantages and Disadvantages

Knee osteotomy has three goals:

• To transfer weight from the arthritic part of the knee to a healthier area

• To correct poor knee alignment

• To prolong the life span of the knee joint

Advantages of the procedure is that

• preserving your own knee anatomy, a successful osteotomy may delay the need for a joint replacement for several years. 

• there are no restrictions on physical activities after an osteotomy—you will be able to participate in your favorite activities, even high-impact exercise.

Osteotomy does have Disadvantages . 

• pain relief is not as predictable after osteotomy compared with a partial or total knee replacement. And recovery from osteotomy is typically longer and more difficult because you may not be able to bear weight on your operated knee right away.

• In some cases, having had an osteotomy can make later knee replacement surgery more challenging.

Because results from total knee replacement and partial knee replacement have been so successful, knee osteotomy has become less common. Nevertheless, it remains an option for many patients.

Procedure

a tibial osteotomy 

In a tibial osteotomy, a wedge of bone is removed to straighten out the leg.

Most osteotomies for knee arthritis are done on the tibia (shinbone) to correct a bowlegged alignment that is putting too much stress on the inside of the knee.

During this procedure, a wedge of bone is removed from the outside of the tibia, under the healthy side of the knee. When the surgeon closes the wedge, it straightens the leg. This brings the bones on the healthy side of the knee closer together and creates more space between the bones on the damaged, arthritic side. As a result, the knee can carry weight more evenly, easing pressure on the painful side.

Osteotomies of the thighbone (femur) are done using the same technique. They are usually done to correct a knock-kneed alignment.