An osteotomy is a joint-preserving procedure (one that is used to prevent/delay the need for a joint replacement) used when there is arthritis confined to one part of the knee, the inner or medial side or the outer or lateral side. The aim of the osteotomy is to realign the knee so that weight is transferred away from the painful arthritic side onto the painless arthritis-free side.
Inner (medial) side arthritis
In such cases we perform a medial opening-wedge high tibial osteotomy. The operation is performed high up on the inner side of the shin bone through a 10-12cm surgical incision. A plate is placed on the bone under the skin to hold the newly aligned bone in place until the osteotomy heals. This takes as long as a broken bone usually takes to heal (12 weeks) but, unlike previous plates, the plates that we use allow patients to put full weight on the leg as soon as they are comfortable. Crutches are recommended for 6 weeks.
Opening-wedge tibial osteotomy
Outer (lateral) side arthritis
In such cases we perform a lateral opening-wedge distal femoral osteotomy. The operation is performed low down on the outer side of the thigh bone through a 10-12cm surgical incision. A plate is placed on the bone under the skin to hold the newly aligned bone in place until the osteotomy heals. This takes as long as a broken bone usually takes to heal (12 weeks) but, unlike previous plates, the plates that we use allow patients to put full weight on the leg as soon as they are comfortable. Crutches are recommended for 6 weeks.
Opening-wedge distal femoral osteotomy