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
. 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: Reduce painImprove movementDelay further damage to the jointPostpone the need for total knee replacement surgery
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like: InfectionPoor healing of the boneExcess bleedingSwellingBlood clotsShortening of the legInjuries to nerves or blood vessels
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as: SmokingDrinkingChronic disease such as diabetes or obesityPoor nutritionThe use of certain medications
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: Physical examBlood testsX-rayMRICT scan
Before surgery, you will need to: Arrange for a ride home.Arrange for help at home while you recover.Talk to your doctor about any allergies you have.Ask your doctor about assisted devices you will need.If you are overweight, lose weight. This will help to decrease the amount of stress on your new joint.Install safety equipment in the bathroom, shower, and on the stairs.Prepare a bedroom on the first floor if possible. Climbing stairs will be difficult at first.
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: Aspirin and other anti-inflammatory drugsBlood-thinning drugs, such as warfarinAnti-platelet drugs, such as clopidogrel
Do not eat or drink anything after midnight the day before your surgery, unless told otherwise by your doctor.
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: Pain medicationAntibiotics to prevent infectionMedication that prevents blood clotsPlace padded bandages over the incision sitesApply ice to reduce swellingA splint or brace to hold the knee in the right position
During your stay, the hospital staff will take steps to reduce your chance of infection such as: Washing their handsWearing gloves or masksKeeping your incisions covered
There are also steps you can take to reduce your chances of infection such as: Washing your hands often and reminding visitors and healthcare providers to do the sameReminding your healthcare providers to wear gloves or masksNot allowing others to touch your incisions
To help ensure a smooth recovery at home, take these steps: Apply ice or a cold pack to the area for 15-20 minutes four times a day. Wrap the ice in a towel. Do not apply it directly to your skin.Elevate the injured leg to reduce swelling.If you have a cast, follow the doctor’s instructions for taking care of your skin.Use crutches or a walker. Avoid putting weight on your injured leg until your doctor gives you permission.Keep the incision area clean and dry.Ask your doctor about when it is safe to shower, bathe, or soak in water.
Place a plastic covering over the incision areas if your doctor recommends keeping it dry.Start working with a physical therapist once you are instructed to. The therapist will focus on balance, range-of-motion, and strength training.Maintain a healthy weight after surgery.Follow your doctor's instructions.
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: Signs of infection, including fever and chillsRedness, swelling, increasing pain, excessive bleeding, or discharge from the incision siteSwelling, redness, or pain in your legs, calves, or feetPain that you cannot control with the medications you have been givenNausea and vomitingCough, shortness of breath, or chest painYour leg, foot, or toes appear chalky white, blue, or blackNumbness or tingling in your leg, foot, or toes
If you think you have an emergency, call for medical help right away.
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http://www.hopkinsmedicine.org/healthlibrary/test_procedures/orthopaedic/knee_replacement_surgery_procedure_92,P07673/. Accessed May 6, 2013.
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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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