Type of Surgery
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Last updated: 02/17/2009
According to Healthy People 2000, Final Review, published by the Centers for Disease Control and Prevention, the various forms of arthritis "the leading cause of disability in the United States" affect more than 15% of the total U.S. population (43...
million persons) and more than 20% of the adult population. Osteoarthritis (OA) is the most common form of knee arthritis and involves a slowly progressive degenerative disease in which the joint cartilage gradually wears away. It most often affects middle-aged and older people. The most common source of ACL injury is skiing. Approximately 250,000 people sustain a torn or ruptured ACL in the United States each year. Research indicates that ACL injuries are on the rise in the United States due to the increase in sport activity.
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Knee osteotomy is commonly used to realign arthritic damage on one side of the knee. The goal is to shift the patient's body weight off the damaged area to the other side of the knee, where the cartilage is still healthy. Surgeons remove a wedge of the shinbone from underneath the healthy side of the knee, which allows the shinbone and thighbone to bend away from the damaged cartilage.
A model for this is the hinges on a door. When the door is shut, the hinges are flush against the wall. As the door swings open, one side of the door remains pressed against the wall as space opens up on the other side. Removing just a small wedge of bone can "swing" the knee open, pressing the healthy tissue together as space opens up between the thighbone and shinbone on the damaged side so that the arthritic surfaces do not rub against each other.
Osteotomy is also used as an alternative treatment to total knee replacement in younger and active patients. Because prosthetic knees may wear out over time, an osteotomy procedure can enable younger, active osteoarthritis patients to continue using the healthy portion of their knee. The procedure can delay the need for a total knee replacement for up to ten years.
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New procedures like minimally invasive procedures are often subject to scrutiny, but I think that one of the biggest problems facing these innovative procedures is for people to understand exactly what we do.
-Dr. Michael Perry, Laser Spine institute
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