What is a knee osteotomy?

A knee osteotomy is an operation that surgeons use to treat the pain and instability that can occur when there is damage or arthritis in part of the knee joint. Doctors may recommend an osteotomy instead of a knee replacement when only one area of the knee has damage.

During this knee surgery, a surgeon repositions the bones in the tibia (shin bone) or femur (thigh bone) to realign the knee. This new positioning shifts your body weight from the damaged part of your knee to a healthy part.

A knee osteotomy can help slow deterioration of cartilage in the knee and may delay your need for knee replacement surgery for many years. Osteotomy of the knee has been used for decades to improve pain and function.

Why is a knee osteotomy done?

All joints, including the knees, have cushioning tissue called cartilage where bones meet. Some people develop osteoarthritis when cartilage wears away in a joint, which can cause the tibia and femur to rub uncomfortably. This pressure can cause pain and stiffness in your knee.

Doctors perform knee osteotomy to shift pressure from the damaged part of the knee to an area with healthy cartilage and cushioning. This shift can reduce pain and improve mobility in the knee. A doctor may also use a knee osteotomy to repair a broken knee that did not heal properly.

What are the types of knee osteotomy?

The two main types of osteotomy are opening wedge and closing wedge.

During a closing wedge osteotomy knee surgery, the surgeon cuts a wedge of bone from the leg and brings the sides of the opening together to close the space.

In some cases, the surgeon opens up a section of bone, rather than closing the bone. This procedure is called an opening wedge osteotomy. Sometimes a graft is used to hold the space between the ends of the osteotomy gap.

What should I expect from a knee osteotomy?

You’ll have knee osteotomy under anesthesia. Your doctor will recommend the best anesthesia option for you, including:

• General anesthesia: Your doctor gives you medicine that puts you to sleep during the surgery.
• Spinal anesthesia: You receive an injection in your back that numbs your body from the waist down.

Your doctor has several options to hold the osteotomy in place during healing. This includes metal screws and a plate or a biocomposite material to hold the realigned bone in place while it heals. Knee osteotomy surgery usually takes one to two hours.

After a knee osteotomy, your doctor will closely monitor you while you recover from the anesthesia. Most people who have a knee osteotomy leave the hospital one to two days after surgery. Some patients leave the same day of surgery. While healing from the surgery, you will likely need to use crutches or a walker for several weeks to avoid putting too much weight on the knee while it heals.

What are the risks of a knee osteotomy?

Complications associated with a knee osteotomy are rare, but can include:

• Blood clots
• Infection
• Injury to surrounding nerves and blood vessels
• Failure for the osteotomy to heal, or delay in the healing
• Irritation from the implanted hardware or failure of the hardware

What is the prognosis (outlook) for people who have a knee osteotomy?

Most people who have a knee osteotomy experience relief from pain and increased function in the knee, which leads to an improved quality of life. In most cases, people do not need to limit their physical activity once they heal from the procedure.

People who have a knee osteotomy can typically return to their usual activities three to six months after the surgery.