What is a knee osteotomy?
Osteotomy means "cutting of the bone." In a knee osteotomy, either the tibia (shinbone) or femur (thighbone) is cut and reshaped to relieve pressure on the knee joint. It is most commonly performed on people who have isolated degeneration or arthritis on one side of the joint and are considered too young for total knee replacement. Older patients are often better served by a joint replacement. Many people who undergo knee osteotomy will eventually need a total knee replacement.
Tibial tubercle osteotomy is the most common type of knee osteotomy performed. It corrects the maltracking of the patella (kneecap). The tibial tubercle is cut at an angle and slid into a different position to transfer load to the healthier part of the patellofemoral joint. After the procedure, the patella moves more smoothly in the trochlear groove, reducing pressure and relieving pain.
The knee is the largest joint in the body and one of the most complex. It is made up of the femur, tibia and patella. Damage can result from injury, deformity or arthritis, when the articular cartilage that cushions the ends of the bones gradually erodes. Without this cushioning effect, the bones of the knee joint rub together. The knee can't move easily and becomes stiff, swollen and painful.
Removing or adding a wedge of bone in the upper tibia or lower femur can help shift weight to the undamaged part of the knee and prolong the life span of the joint.
When is surgery recommended?
If you have arthritis or other damage that is limited to just one area of your knee, and all non-surgical methods of treatment have failed – including weight loss, anti-inflammatory medications, cortisone injections and physical therapy – knee osteotomy may be right for you.
Because proper patient selection is critical, it is important that each individual is carefully screened by an orthopaedic surgeon to determine the most appropriate type of procedure.
Osteotomy is usually a stand-alone procedure. But in some cases it is performed in conjunction with other surgeries. It can be an important adjunct procedure when performing cartilage restoration surgery, meniscal transplant or ligament instability in association with a mal-aligned knee.
Many people who undergo knee osteotomy will eventually need a total knee replacement – usually about 10 to 15 years after the initial procedure. In the meantime, the surgery offers a reasonable alternative to replacement in carefully selected candidates.
What is the recovery time?
Recovery time varies depending on the complexity of the surgery, your overall physical condition and other factors. Some patients require a knee brace or cast for protection while the bone heals. And most people use crutches for several weeks following surgery. Typically, patients will spend a couple of months in physical therapy to strengthen the thigh muscles, improve balance and increase the knee's range of motion. The entire rehabilitation process may take as long as six months.