Knee Osteotomy

Osteoarthritis (OA) is a progressive, chronic, degenerative disease. It is a disease of aging often called wear and tear arthritis that wears away the articular cartilage at the ends of the bones. The articular cartilage functions to help the knee glide smoothly. Degeneration can cause popping, locking and pain.

When the knee loses cartilage, the bone grows in an attempt to repair the damage, but this abnormal growth of bone makes things worse, creating misshapen bone, and altering bone alignment. Knee OA makes it painful and difficult to perform the normal functions of daily life like kneeling, climbing stairs and walking.

A knee osteotomy is a well-established surgical procedure that can significantly reduce pain and improve function for patients with moderate OA in one area of the knee (single compartment).

Called a High Tibial Osteotomy (HTO), this procedure involves changing the poor alignment of the knee caused by OA by cutting the bone and using screws and plates or a bone graft to hold the bones together while they heal.

Restoring alignment shifts weight bearing to the healthy part of the knee. The result is pain relief, improved function, and slowed cartilage deterioration which can potentially delay the need for a future knee replacement. Studies report that knee replacement can be delayed for about a decade, but this depends on patient factors.

Typically, the patient will spend about one day in the hospital and several weeks using crutches.  Physical therapy beings immediately and will focus on restoring range of motion and assist in reducing pain. It can take up to six months to fully recover after an osteotomy; and up to a year to return to high impact activities like running.

This procedure is usually reserved for patients with early-to-moderate OA on one side of the knee joint. Patient selection is vital to a good outcome.  Several techniques are available. The exact technique is determined by the degree and location of the damage and malalignment.