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Orthopedic Surgery
Orthopedic Procedures

Knee Osteotomy

Knee Osteotomy is an alternative to knee replacement surgery.

In patients with degenerative arthritis, or osteoarthritis, of the knee joint, deformities of the knee are common. These deformities include a bow-legged or knock-kneed appearance. More technically, these deformities are called genu varum (bow-legged) or genu valgum (knock-kneed).

The idea of an osteotomy is to shift the weight-bearing forces to "unload" the worn out side of the joint, and place the forces on the healthier side of the joint.

The problem with knee osteotomies is that finding the right patient is very difficult. Knee replacement surgery is very successful, and unless there is a good reason not to perform a replacement the total knee replacement is usually favored. Some patients, however, are not good candidates for knee replacement, especially patients who are young. Because knee replacements wear out over time, younger patients should be evaluated for alternative procedures.

The ideal patient for a knee osteotomy is a young, active person, who has arthritis limited to one side of the knee joint. The patient must have significant pain and disability such that surgery is warranted. The patient must understand that rehabilitation from this surgery is lengthy and difficult. Finally, osteotomies around the knee, tend to last less than one decade--then something more, usually a knee replacement, needs to be done. Some patients may find lasting relief with an osteotomy, but the majority of patients use a knee osteotomy surgery as a means to delay eventual knee replacement surgery.

Good candidates for this surgery must fit the following criteria:

  • Significant pain and disability
  • X-rays showing involvement of only one side of the knee joint
  • The ability to cooperate with physical therapy and rehabilitation