Osteotomy

Arthritis of the knee is a common condition. When the bones of your knee are not properly aligned, this can put extra stress on either the inner (medial) or outer (lateral) side of your knee. This pressure can wear away the cartilage that protects the bones. The result is pain and stiffness. If only one side of the joint is damaged, an osteotomy can redistribute pressure on the arthritic side to a healthier area. This can allow you to return to normal activities without pain.

How it happens

Arthritis is generally due to “wear and tear” of cartilage. Some individuals may be more susceptible to knee arthritis than others, possibly due to their genetic makeup. Poor knee alignment can worsen the arthritic damage on one side of the knee joint.

How it feels

Arthritis pain in the knee is generally felt as a deep, dull ache. The knee pain is usually worse with activities such as walking. When knee arthritis pain is very advanced, running will be impossible. After increased activity, such as a long walk, knee arthritis pain will usually be more severe. Generally, knee arthritis is easily diagnosed with plain x-rays.

How it is fixed

Knee arthritis is treated initially with non-operative management. This includes medication, such as non steroidal anti-inflammatory drugs, as well as Tylenol. Chondroitin (joint supplement that helps reduce osteoarthritis pain) and glucosamine (joint supplement that helps reduce osteoarthritis pain) have been proven to be effective for alleviating pain related to knee arthritis. Physical therapy is a very valuable non-operative management option to improve the pain related to knee arthritis and increase function. Injections may also be useful including cortisone or visco-supplementation (injection of sodium hyaluronate). A brace may help some patients with advanced knee arthritis. A cane can also be of assistance to patients with knee arthritis. If non-operative management does not sufficiently improve the symptoms, surgery may be required. If the arthritis is in its early stage and limited to one side of the knee, an osteotomy may be chosen over a knee replacement. During the procedure, a wedge of bone is removed from the outside of the tibia (shin bone) or femur (thigh bone). The surgeon then closes the wedge, straightening the leg. In some cases, the wedge is “opened” instead of “closed,” and the surgeon adds a bone graft to fill the space.

Recovery/Post-Surgery

In most cases, patients stay at the hospital for 2 days after an osteotomy. Most patients require crutches for 6 to 8 weeks. Rehabilitation includes range of motion and strength exercises. The recovery period for an osteotomy usually lasts between 3 and 6 months.

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