Realignment / osteotomy
Osteotomy surgery is used to realign the leg around the knee. It shifts the weight bearing area from the arthritic and worn side of the knee, closer to the midline or the other side of the knee. The aim is to relieve pain and improve function. It may delay the need for a joint replacement procedure (arthroplasty) for many years.
It tends to be used in earlier stages of osteoarthritis in the younger, thinner and more active patients who have arthritis on one side of the knee.
While osteotomy has been shown to be a successful procedure, it is not as predictable as arthroplasty surgery for pain relief and the recovery can be longer and more difficult due to a period of non-weight bearing after the surgery.
Most osteotomies are done on the tibia or ‘shin bone’. They are known as an HTO – High tibial osteotomy. In some people the femur or ‘thigh bone’ is osteotomised and this is called a DFO – distal femoral osteotomy. In both cases, a wedge of bone can be removed or a wedge opened up to change the alignment. If opened up, the gap may be filled with donated ‘allograft’ bone or bone substitute.
The procedure takes between 1 to 2 hours and requires a short stay in hospital of 1 to 3 days.
Pain control will be a combination of simple painkillers and the use of cold and compression therapy.