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High Tibial Osteotomy
An osteotomy is performed to correct a joint deformity, like X- or O-legs or a hip dysplasia, that has caused osteoarthritis. The procedure includes evening out pressure on the joints, and can, for example, involve a wedge being cut out of the upper thigh bone to align the knee joint. The upper thigh bone is then stabilised with a metal plate.
About the procedure
Tibial osteotomy is usually performed under general anaesthetic and takes one to two hours. The surgeon will make a small incision just below the knee to cut and remove part of the healthy bone from the outside of the tibia. A metal plate or pins will be used to bring together the remaining healthy bones, allowing more space for the damaged part of the knee to move so you carry your weight comfortably.
A cast or brace may be given to you to protect your knee as it heals, and you may be required to remain in a hospital for a couple of days after the procedure. A physiotherapist will be assigned to give you gentle exercises to get your knee moving around and crutches will need to be used for the first couple of weeks.
Why is osteotomy used?
You are likely to undergo osteotomy if you become aware that your leg has bowed. Although this procedure does not return the knee to normal, it does prevent the injury from causing further damage by preventing your weight from being carried on the inner part of the knee. This can result in a walking impairment and lasting pain in the knee. For many patients, an osteotomy delays the need for a total knee replacement.
Advantages of osteotomy
Benefits of osteotomy include:
- Delays knee replacement surgery
- Not as much risk of infection
- Can remain active for longer
During your time in the hospital, your leg should be elevated to reduce swelling and you should be given antibiotics for 24 hours through an intravenous drip. Any movement should be supervised by a physiotherapist and assistance should be provided where necessary. You will be discharged from hospital when the physiotherapist is confident you can support yourself on crutches.
An appointment will be made for two weeks after your surgery, but if you have any problems before then, it is important you speak to your GP or the clinic where your surgery was performed.
Healing usually takes up to six months and it will take up to a year to feel the full benefits of the surgery.
Risks of osteotomy
As with most surgical procedures, there are general risks to be wary of. This includes the dangers of general anaesthesia, which should be discussed with you before your operation, and the side effects of surgery, including bruising, swelling, tenderness and stiffness. However, there are certain risks related to osteotomy - this includes:
- A curved scar on your leg about 10cm long
- One leg being shorter than the other (although this is usually unnoticeable)
- Pain in the knee
- Damage to nerves or blood vessels
You should always be asked for consent before undergoing any kind of surgical procedure.
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