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Knee Osteotomy Surgery

Knee Osteotomy

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Updated April 17, 2014

How is an osteotomy done?
An osteotomy uses is a procedure where the surgeon cuts the bone and then reorients the bone. There are two basic types of osteotomies: closing wedge, where a wedge of bone is removed to change the alignment of the bone; and, opening wedge, where bone is gapped open on one side to realign the bone. Depending on the type of deformity and the location of your osteotomy, your surgeon will choose one of these options.

Once the bone is cut and subsequently realigned, your surgeon may choose to use a metal plate and screws to hold the bones in the new position.

How long is the recovery from a knee osteotomy?
The recovery from a knee osteotomy can be difficult. Because the bone is cut, it needs time to heal. The total healing time is at least 8 weeks, and can take longer. Most patients need physical therapy to regain their knee motion.

What are the complications of knee osteotomy surgery?
The most common problem with this surgery is that it almost always fails over time. Now, if you can feel better for nearly a decade, and delay knee replacement surgery, it may be well worth it. However, it is not uncommon for patients to require conversion to knee replacement within a few years of the surgery.

Orthopedic surgeons also face the problem of performing the surgery in a manner that will not make a subsequent knee replacement surgery more difficult. Finding a doctor experienced in this procedure is a good idea.

Other potential complications include problems with healing of the osteotomy (a nonunion), continued pain from arthritis, blood clots, and infection.

How successful is this surgery?
When done in the right patients, knee osteotomies are usually successful at decreasing pain caused by arthritis. They surgery tends to last about 8 to 10 years, and after that time, many patients will require total knee replacement. In a large group of patients, knee osteotomy gives good to excellent results in about:

  • 80% of patients for 5 years
  • 50% of patients for 10 years
  • 30% of patients for 20 years
Because of this, knee osteotomy is generally reserved for young, active patients, who want to delay the time until knee replacement.

References:
1. Naudie, D et al. "Survivorship of the high tibial valgus osteotomy" Clinical Orthopaedics and Related Research; 1999; 367:18-27.

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