A knee osteotomy is the removal of a wedge of bone from the tibia to reshape and realign the leg. The tibia is the shinbone. Recovery time will depend on certain factors, such as your overall health.
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This procedure aligns the knee joint so the healthy part of the knee surface is able to do more weight-bearing. This takes pressure off the damaged part. Damage is often due to osteoarthritis . This surgery may be done instead of a total knee replacement. It may also be done to correct poor knee alignment for other reasons.
While osteotomy does not cure conditions like osteoarthritis, the surgery may:
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:
Your risk of complications may be increased if you have a history of blood clots.
Prior to the surgery, the doctor will order tests to confirm the diagnosis and decide how much bone to remove.
Tests may include:
Before surgery, you will need to:
Talk to your doctor about any medications, herbs, or supplements you are taking. You may be asked to stop taking some medications up to one week before the procedure, like:
Do not eat or drink anything after midnight the day before your surgery, unless told otherwise by your doctor.
Anesthesia will keep you pain-free and comfortable during the procedure. Anesthesia methods include:
There are many methods that can be used to perform an osteotomy. In one method, the doctor uses imaging technology to measure the piece of bone that will be removed. A cut is made in the skin from the knee cap to the top of the shinbone. Several thin wires are placed in the knee to serve as guides, showing where the bone should be cut. The doctor uses an oscillating saw to remove the bone wedge. The remaining parts of the bone will be held together with staples, screws, or a plate and screws. The doctor will stitch the tissue together and close the area.
Anesthesia will block pain during the procedure. You will have pain after the procedure. Ask your doctor about medication to help manage pain.
You may need to stay in the hospital for 2-3 days. If you have any problems, you may need to stay longer.
Right after the procedure, you will be taken to recovery and monitored closely. The staff may give you:
During your stay, the hospital staff will take steps to reduce your chance of infection such as:
There are also steps you can take to reduce your chances of infection such as:
To help ensure a smooth recovery at home, take these steps:
You will need to return to the doctor to have your cast removed or to have x-rays taken. Full recovery can take six months.
Call your doctor if any of the following occurs:
If you think you have an emergency, call for medical help right away.
American Academy of Orthopaedic Surgeons
American Orthopaedic Society for Sports Medicine
Canadian Orthopaedic Association
Canadian Orthopaedic Foundation
Degenerative joint disease of the knee. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated May 3, 2013. Accessed May 6, 2013.
Frequently asked questions: high tibial osteotomy. New England Musculoskeletal Institute website. Available at: http://nemsi.uchc.edu/clinical_services/orthopaedic/sportsmedicine/faqs/faqs_hto.html. Accessed May 6, 2013.
Knee osteotomy. The Knee Society website. Available at: http://www.kneesociety.org/web/patienteducation_osteo.html. Accessed May 6, 2013.
Knee replacement surgery. Johns Hopkins Medicine website. Available at: http://www.hopkinsmedicine.org/healthlibrary/test_procedures/orthopaedic/knee_replacement_surgery_procedure_92,P07673/. Accessed May 6, 2013.
Marti R, Verhagen R, Kerkhoffs G, Moojen T. Proximal tibial varus osteotomy. J Bone Joint Surg Am. 2001;83-A(2):164-170
Wilson A. Knee osteotomy and painful osteoarthritis. Knee Guru Information Hub website. Available at: http://www.kneeguru.co.uk/KNEEnotes/node/2153. Published May 13, 2010. Accessed May 6, 2013.
6/6/2011 DynaMed's Systematic Literature Surveillance http:/www.ebscohost.com/dynamed: Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.
Last reviewed February 2014 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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