Type of Surgery
Information

Last updated: 02/17/2009
Osteotomy surgery changes the alignment of the knee so that the weight-bearing part of the knee is shifted off diseased or deformed cartilage to healthier tissue in order to relieve pain and increase knee stability. Osteotomy is effective for patients...
with arthritis in one compartment of the knee. The medial compartment is on the inner side of the knee. The lateral compartment is on the outer side of the knee. The primary uses of osteotomy occur as treatment for:
- Knee deformities such as bowleg in which the knee is varus-leaning (high tibia osteotomy, or HTO) and knock-knee (tibial valgus osteotomy), in which the knee is valgus leaning.
- A torn anterior cruciate ligament (ACL), which is a set of ligaments that connects the femur to the tibia behind the patella and offers stability to the knee on the left-right or medial-lateral axis. If this ligament is injured, it must be repaired by surgery. Many ACL injuries cause inflammation of the cartilage of the knee and result in bones extrusions, as well as instability of the knee due to malalignment. Osteotomy is performed to cut cartilage and increase the fit and alignment of the ends of the femur and tibia for smooth articulation. As one very common knee injury that often occurs in athletic activity, HTO is often performed when ACL surgery is used to repair the ligament. The combination of the two surgeries occurs primarily in young people who wish to return to a highly athletic life.
- Osteoarthritis that includes loss of range of motion, stiffness, and roughness of the articular cartilage in the knee joint secondary to the wear and tear of motion, especially in athletes, as well as cartilage breakdown resulting from traumatic injuries to the knee. Surgery for progressive osteoarthritis or injury-induced arthritis is often used to stave off total joint replacement.
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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.
Other Information
Orthopedic complaints are the most common reason to seek medical care.
From: About.com
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