Knee Osteotomy

What is it?

When you are in the early stages of knee osteoarthritis, the articular cartilage protecting the ends of the bone starts to wear away. The result is pain and stiffness in your knee.

A knee osteotomy is a surgical procedure that involves cutting the thighbone or shinbone to transfer weight from the parts of the knee damaged by arthritis onto the healthier parts of the joint, and to slow the development of osteoarthritis and prolong the lifespan of your knee joint. It is especially beneficial for younger patients, allowing them to lead a more active lifestyle for many years and delaying the need for a knee joint replacement.

Who might need it?

You are most likely to be offered a knee osteotomy if you are below the age of 60 and are fairly physically active. Ideal candidates for this type of surgery experience knee pain during activity or if they stand for long periods of time. The pain normally affects only one side of the knee and is not felt below the kneecap. You will not be offered a knee osteotomy if you have rheumatoid arthritis or if you are unable to bend and straighten your knee. Your orthopaedic surgeon will discuss your individual symptoms and advise you if you are suitable for knee osteotomy.

What to expect

A knee osteotomy is normally performed under general anaesthetic, which means you will be asleep throughout. In some cases, however, you may be given an epidural which means you will be awake during the procedure but numb from the waist down. Knee osteotomy surgery normally takes between one and two hours. The orthopaedic surgeon will make an incision at the front of your knee, starting just below your kneecap. They will remove a wedge of bone using an oscillating saw, using guide wires to show them precisely where to cut. A plate and screws will be fixed inside the joint to hold the bones in place while they heal. Once the incision site has been closed, you will be taken to the recovery room where you will be closely monitored as you recover from the anaesthetic.

Benefits of knee osteotomy

A knee osteotomy can relieve the early symptoms of osteoarthris by correcting poor knee alignment and transferring your weight away from the arthritic compartments of your knee towards healthier parts of the joint. It preserves your natural knee joint and can delay the need for knee replacement surgery. Once you have healed from your knee osteotomy, you will be able to enjoy a full range of movement again and even participate in high impact sports. It normally takes a few weeks before you can put weight on your knee joint, during which time you will need to use crutches. You will need to do regular exercises as prescribed by a physiotherapist to support your knee to make a good recovery. Most people can resume the full range of day to day and sporting activities three to six months after surgery.

There are some disadvantages to the procedure, however, and orthopaedic surgeons may not recommend it in some cases. It takes around six weeks to heal from a knee osteotomy and unlike with a knee replacement, you will not be able to put weight on your operated knee straight away. Also, pain relief is less predictable after a knee osteotomy than it is after a knee replacement. And, if you do need to have knee replacement surgery in the future, it can make it more complex if you have previously had a knee osteotomy.

As with any type of surgery, there is a small risk of complications, including infections, blood clots or failure to heal. In rare cases this can lead to the need for further surgery to correct the problem.