Type of Surgery
Information
Last updated: 02/17/2009
Osteotomy is performed as open surgery to the knee assisted by pre-operative arthropscopic diagnostic techniques. Surgery takes place on the tibia end or the femoral end at the knee according to whether the malalignment to be corrected is varus, or...
inward leaning, or valgus, outward leaning. The surgery involves the gaping or wedging of a piece of bone and its removal to change the pressure points of weight-bearing activity. The cut surfaces of the bone are held together with two staples, or a plate and screws. Other devices may be used, especially in tibial osteotomy where a fracture is involved. After surgery, a small plastic suction drain is left in the wound during recovery and early postoperative hospitalization.
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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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