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Joint Preserving Surgery

The knee joint is a highly complex structure and with careful attention can heal parts of itself. Joint replacement although highly successful in the selected patient is an irreversible step and does come with some rare but potentially serious complications. Part of our clinic philosophy is to always consider whether the joint can be saved.

Osteotomy is a procedure that realigns the leg very slightly to change the weight distribution through the knee.  This can take the weight off the injured or arthritic area and transfer it to a part of the knee that is still functioning. This will improve pain, potentially allowing haling on the arthritic side and preserve the life of the joint and put off the need for joint replacement.

Medial compartment osteoarthritis is the most common pattern of disease in the knee causing the knee to bow outwards. If the knee movement is well preserved and the lateral side is healthy we recommend an opening wedge high tibial osteotomy. This involves making a cut across the shin bone (tibia) and opening a wedge with a plate and screws.

When the problem is on the other side of the knee and the knee has bowed inwards (knock-kneed) the osteotomy is usually performed on the thigh bone (femur) to close a wedge and once again transfer the weight, this time to the inside of the knee.

The procedure involves a one or two night stay in hospital and 6 weeks on crutches after the surgery. Time off work in a physical job is usually 8 weeks.