Knee Osteotomy

Overview

Knee osteotomy is a surgery that is performed to reduce chronic knee pain caused by arthritis. 

There are two common types of knee osteotomy:

High tibial osteotomy. During a high tibial osteotomy, your doctor will reshape your shin bone.

Femoral osteotomy. During a femoral osteotomy, your doctor will reshape the thigh bone.

Knee osteotomy candidates

You may be a candidate for a knee osteotomy if:

• You have damage to one side of the knee joint.
• You can straighten your knee and bend it to 90 degrees.
• Your pain does not extend under the kneecap.
• Your pain is most severe when you are active, or you stand for an extended period.

Typically, patients who are between 40 and 60 years old and live an active lifestyle are the best candidates for a knee osteotomy.

Risks associated with knee osteotomy

While a knee osteotomy is generally a safe procedure, complications can occur including:

• Limited pain relief.
• Bone or soft tissue infection.
• Pieces of the bone do not grow together.
• Nerve or blood vessel injuries.

Preparation for knee osteotomy

To determine if you are a candidate for a knee osteotomy, your doctor may recommend you wear a leg brace that mimics what the alignment of your knee will be after surgery. If you experience relief with the brace, your doctor may recommend a knee osteotomy for you. 

Your doctor may also recommend strengthening exercises to help build strength and improve your knee range of motion before surgery.

Other recommendations before surgery include:

• Avoid sunburn, scrapes, poison ivy, and other problems that may affect the area around the surgical site.
• Stop taking medications such as NSAIDs that may make it difficult for blood to clot and steroids that suppress the immune system.
• Stop smoking two weeks before surgery.
• Reduce or eliminate alcohol consumption.
• Report any illnesses such as fever to your doctor before surgery.

What to expect during knee osteotomy

A knee osteotomy is performed under general anesthesia or through a spinal anesthesia to numb you from the waist.

Your doctor will make an incision either in the shinbone or thighbone depending upon where the damage is located.

Using guide wires, he or she will determine the size of a wedge that is needed. He or she will then remove a wedge of bone, fill it with a bone graft, and close the bones to fill the space left by removing the wedge. Plate and screws will be inserted to hold the bones together while the osteotomy heals. This is called an opening wedge osteotomy.

In a closing wedge osteotomy, your surgeon will remove the thigh or shin wedge, bring the edges of the bone together and hold them in place with metal hardware.

A knee osteotomy will take approximately one to two hours.

You will likely spend a couple of days in the hospital after the procedure. 

Duration of knee osteotomy recovery

Recovery after a knee osteotomy is a lengthy process. You will be required to spend several weeks on crutches and undergo physical therapy for several months. 

You will also need regular doctor check-ups to ensure you are healing properly.

While most patients are walking unaided eight to 12 weeks post-surgery, it will take six months to a year for a full recovery.
The length of your recovery will depend upon a variety of factors, including:

• Your overall health.
• Any surgical complications you experienced.
• Type of hardware used and where it was used to secure the osteotomy.
• The size and where the wedge of bone was placed in the knee.