Osteotomy

What is Osteotomy?

Osteotomy is a surgical procedure that involves cutting and reshaping a bone to relieve pain and improve alignment in joints. It is commonly performed in the knee and hip but can be done on other bones as well.

Purpose

Correct bone deformities
Shift weight from damaged joint areas
Delay need for joint replacement
Improve joint function

Common Conditions Treated

Osteoarthritis (especially of the knee)
Bowlegs or knock knees
Hip dysplasia
Malunited fractures
Avascular necrosis

Types of Osteotomy

1. High Tibial Osteotomy (HTO)

Done on the shinbone to realign knee joint

2. Distal Femoral Osteotomy

Done on the thighbone for knee deformities

3. Periacetabular Osteotomy

Done on the pelvis for hip dysplasia

4. Spinal Osteotomy

Corrects spinal deformities (e.g., scoliosis)

Diagnosis and Pre-Surgical Evaluation

Physical exam
Imaging (X-ray, CT, MRI)
Gait analysis
Joint mobility and function testing
Blood tests and anesthesia clearance

Procedure

Performed under general or spinal anesthesia
A precise bone cut is made
A wedge of bone may be added (opening wedge) or removed (closing wedge)
Bone is fixed in new position with plates, screws, or rods
Bone grafting may be used to fill gaps

Duration: 1–3 hours

Recovery and Rehabilitation

Hospital stay: 2–4 days
Partial weight-bearing with crutches for 6–8 weeks
Physiotherapy starts early
Bone healing: ~3 months
Full recovery: 6–12 months

Benefits

Pain relief
Improved joint alignment
Preserved natural joint
Delay or avoid total joint replacement

Risks and Complications

Infection
Blood clots
Nerve or blood vessel injury
Incomplete bone healing (nonunion)
Need for future surgery

Frequently Asked Questions

Q: When is osteotomy preferred over joint replacement?
A: In younger, active patients with early-stage arthritis or deformities affecting one side of the joint.

Q: Is the correction permanent?
A: Yes, but arthritis may progress, eventually requiring joint replacement.

Q: Will I need metal implants removed later?
A: Not always. Only if they cause discomfort or complications.

Q: Can I run or exercise after surgery?
A: Low-impact activities are encouraged after recovery. High-impact sports depend on healing and doctor’s advice.

Q: Are there non-surgical alternatives?
A: Bracing, physical therapy, medications—but these won’t correct bone alignment.

Q: Is osteotomy covered by insurance?
A: Usually, yes—if medically necessary and not cosmetic.