Osteotomy for osteoarthritis

Surgery Overview

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Osteotomy ("bone cutting") is a procedure in which a surgeon removes a wedge of bone near a damaged joint. This shifts weight from an area where there is damaged cartilage to an area where there is more or healthier cartilage. In osteoarthritis, cartilage breakdown in the knee often is much greater in the inner part of the knee joint, often resulting in a bowlegged appearance.

In knee osteotomy for osteoarthritis of the inner knee, your surgeon removes bone from the outer side of the lower leg bone near the knee. This tilts your body weight toward the outer, healthier part of the knee cartilage and away from the inner, damaged cartilage. Weight is spread more evenly across the joint cartilage. After removing the bone wedge, your surgeon will bring together the remaining bones and secure them, most often with either pins or staples. An osteotomy for osteoarthritis of the outer knee is just the opposite—your surgeon will remove bone from the inner side of the lower leg to shift the weight toward the inner knee.

Osteotomy may be effective for hip and knee joints. Doctors often do an osteotomy to correct certain knee deformities such as bowleg (varus) and knock-knee (valgus) deformities of the knees. Hip osteotomy involves removing bone from the upper thighbone (femur). Osteotomy may allow an active person to postpone a total joint replacement for a few years and is usually reserved for younger people.

What To Expect After Surgery

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Recovery depends on the surgical technique as well as the strength and motivation of the person having surgery. A cast or splint may limit movement of the joint for 4 to 8 weeks.

You will start physical therapy immediately, even if you are in a cast or splint. When the cast is removed, you can put your full weight on the joint 10 to 12 weeks after the surgery. It may take up to a year for the knee to fully adjust to its corrected position.

Why It Is Done

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Doctors use osteotomy if destruction of the knee cartilage mainly affects a single disc of cartilage: the disc (meniscus) either on the inner part or on the outer part of the knee joint.

Osteotomy is an appropriate treatment for younger, active people with osteoarthritis who are able to delay a total joint replacement.

How Well It Works

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If the amount of correction needed to align the knee is relatively small, osteotomy is successful in stabilizing the knee and relieving pain symptoms in about 90% of cases.¹

Risks

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• A failure of the bones to heal or failure to heal properly
• Blood clotting
• Bleeding in the joint
• Inflammation of joint tissues, nerve damage, or infection

What To Think About

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By shifting the weight onto good cartilage, osteotomy may "buy time" for younger or more active people before they need a total joint replacement.

Complete the surgery information form (PDF) (What is a PDF document?) to help you prepare for this surgery.

References

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Citations

1. Sledge CB (2005). Principles of reconstructive surgery for arthritis: The knee. In ED Harris Jr et al., eds., Kelley's Textbook of Rheumatology, 7th ed., vol. 2, pp. 1890–1900. Philadelphia: Elsevier Saunders.

Credits

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Author	Robin Parks, MS
Editor	Kathleen M. Ariss, MS
Associate Editor	Pat Truman, MATC
Primary Medical Reviewer	E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer	Stanford M. Shoor, MD - Rheumatology
Last Updated	April 20, 2007