An osteotomy is an operation to re-align a bone. At Castleview Clinic we perform osteotomy to relieve the pain of knee osteoarthritis, or to provide a more favourable environment for cartilage repair and ligament reconstruction around the knee.
An osteotomy is an operation to re-align a bone. At Castleview Clinic we perform osteotomy to relieve the pain of knee osteoarthritis, or to provide a more favourable environment for cartilage repair and ligament reconstruction around the knee.
Pre-op and Post-op Osteotomy showing change in the weight-bearing line away from the damaged part of the knee.
When standing, the weight of the body usually falls in a straight line from the centre of the hip to the centre of the ankle, passing through the centre of the knee. Due to trauma or arthritis the knee may become progressively more bowed (varus) or knock-kneed (valgus). Occasionally bowed or knock-knee deformity develops in adolescence without an apparent cause.
In a bowed knee the bodyweight falls through the inner side of the knee. In an arthritic knee this creates a vicious cycle in which there is more wear on the inside of the knee, which increases the deformity and so on. The wear is more advanced on the outside of a valgus knee.
The osteotomy involves making a saw cut approximately 95% of the way across the bone. This is usually at the top end of the tibia (high tibial osteotomy) or lower end of the femur (distal femoral osteotomy). After making the cut, the bone is opened on one side creating a triangular gap (opening wedge). Alternatively a triangle of bone may be removed creating a triangular gap which is then closed (closing wedge). The opening or closing of the wedge corrects the alignment of the bone. In all cases, after correction, the bone is stabilised with a metal plate and screws which the Castleview surgeons implant using a minimally invasive technique and xray guidance.
Pre-op and Post-op Osteotomy showing change in the weight-bearing line away from the damaged part of the knee.
When standing, the weight of the body usually falls in a straight line from the centre of the hip to the centre of the ankle, passing through the centre of the knee. Due to trauma or arthritis the knee may become progressively more bowed (varus) or knock-kneed (valgus). Occasionally bowed or knock-knee deformity develops in adolescence without an apparent cause.
In a bowed knee the bodyweight falls through the inner side of the knee. In an arthritic knee this creates a vicious cycle in which there is more wear on the inside of the knee, which increases the deformity and so on. The wear is more advanced on the outside of a valgus knee.
The osteotomy involves making a saw cut approximately 95% of the way across the bone. This is usually at the top end of the tibia (high tibial osteotomy) or lower end of the femur (distal femoral osteotomy). After making the cut, the bone is opened on one side creating a triangular gap (opening wedge). Alternatively a triangle of bone may be removed creating a triangular gap which is then closed (closing wedge). The opening or closing of the wedge corrects the alignment of the bone. In all cases, after correction, the bone is stabilised with a metal plate and screws which the Castleview surgeons implant using a minimally invasive technique and xray guidance.
We carefully calculate the angle of correction, and the size of the triangle to be opened or closed, in advance of the surgery. Our calculations are bases on an xray of your whole leg, and computer software which simulates the correction and works out the most desirable correction to the nearest millimetre.
The operation is typically performed under general anaesthetic and usually involves a one-night stay in hospital. In most cases it is safe for our patients to stand on the keg immediately after surgery. A brace is required for 8-12 weeks from surgery, but does not limit range of movement. Crutches are used initially, but our patients are usually walking without crutches by 2 weeks from the surgery.
We think the most striking advantage osteotomy is that it preserves the patient’s own knee joint. This is particularly relevant to our younger patients with knee arthritis, and those for whom running or other high impact sports are important.
Osteotomy is effective in providing pain relief to patients with malalignment and arthritic pain on only one side of the joint. In approximately 75% of these patients it may delay the need for knee replacement by ten years or more.
We carefully calculate the angle of correction, and the size of the triangle to be opened or closed, in advance of the surgery. Our calculations are bases on an xray of your whole leg, and computer software which simulates the correction and works out the most desirable correction to the nearest millimetre.
The operation is typically performed under general anaesthetic and usually involves a one-night stay in hospital. In most cases it is safe for our patients to stand on the keg immediately after surgery. A brace is required for 8-12 weeks from surgery, but does not limit range of movement. Crutches are used initially, but our patients are usually walking without crutches by 2 weeks from the surgery.
We think the most striking advantage osteotomy is that it preserves the patient’s own knee joint. This is particularly relevant to our younger patients with knee arthritis, and those for whom running or other high impact sports are important.
Osteotomy is effective in providing pain relief to patients with malalignment and arthritic pain on only one side of the joint. In approximately 75% of these patients it may delay the need for knee replacement by ten years or more.