Knee osteotomy is re-alignment surgery of the bones around the knee. It can be performed on the femur (thigh) bone, known as distal femoral osteotomy or the tibia (leg) bone, known as high tibial osteotomy.
Osteotomy was a popular procedure prior to the arrival of knee replacement and has had a resurgence in use due to the development of digital planning and precision instruments which allow very accurate corrections to be made. Changing the alignment of the knee allows the weight of the patient to be moved from the arthritic part of the knee to a healthier part of the knee, which improves pain.
Osteotomy is a good treatment option for patients with arthritic knees who are too young for knee replacement or who wish to maintain high levels of exercise, including impact sports.
Before high tibial osteotomy, alignment X-ray shows weight-bearing axis from the hip to ankle (in red) passing through the inside part of the knee. Close up of the knee shows arthritis (femur bone touching tibia bone) outlined in yellow
During surgery, an osteotomy (bone cut) is made across the tibia and the angle of the bone is adjusted.
High Tibial Osteotomy - The bone is held in the new position with a plate.
After high tibial osteotomy, alignment X-ray shows the weight-bearing axis from hip to ankle (marked in red) now passes through the unworn outside part of the knee, improving pain.