Knee Osteotomy

Knee Osteotomy – Bone Realignment for Knee Health

Overview of Knee Osteotomy Surgery

Osteotomy, or reshaping the bone, is a surgical procedure to reduce stress on the knees and reshape only one area of the knee joint. If you have an early diagnosis of osteoarthritis affecting one side of the knee, then it must have caused a misalignment for the knee bones. For such people, doctors perform an osteotomy, where the body weight is redistributed away from the damaged location to ensure pain reduction and improved knee function.

At Chennai Orthopaedics, Dr Bharani Kumar Dayanandam and his team provide advanced knee osteotomy treatments that correct the knee alignment issues and discomforts for better knee health.

What is knee osteotomy?

Knee osteotomy is a surgical way of aligning the bones in your knee joint to provide pain relief and improve the functions that you have lost due to arthritis or other deformities. This is different from total knee replacement, as only the damaged part are corrected and the rest of the joint functions are preserved. 

This procedure is usually done for younger patients, usually below 60 years of age, who might be at their early stage of arthritis or have misalignments of the legs like bowleg or knock-knee deformities. The knee angle is adjusted so that the affected side does not get much pressure and the patient will be able to walk without much pain.

There are two main types of knee osteotomy performed by doctors.

• High tibial osteotomy (opening and closing wedge osteotomy)
• Distal femoral osteotomy.

In this article, we shall look into both these procedures in detail and the causes and symptoms of osteotomy, the benefits and risks associated with it, if any, and more.

Types of Knee Osteotomy Procedures

Knee osteotomy can be done mainly in three different ways according to the deformity type.

High Tibial Osteotomy (HTO)

High tibial osteotomy is done for realignment of the knee joint for patients suffering from unicompartmental osteoarthritis due to varus deformity. This procedure is done on young sportspeople and helps them get back on their feet by avoiding knee replacement surgery. The patients getting this osteotomy can usually be able to delay the knee replacement surgery requirements up to 10-15 years.

Distal Femoral Osteotomy (DFO)

This is a more corrective surgery that is done on the lower (distal) part of the femur (thigh bone). This is mainly used to correct the knock-knee or valgus deformity where the knee’s outer area experiences cartilage wear, resulting in excess pressure between the joints.

The surgeon realigns the femur inwards. The closing wedge and opening wedge apply in this method as well, depending on the requirement. Metal plates and screws are used here as well.

High tibial osteotomy can be done in two ways.

Medial opening wedge osteotomy – In the open wedge procedure, a wedge of the patient’s own bone graft or a synthetic piece is placed on the medial side of the tibia and is secured into it with a metal plate and screws.

Lateral closing wedge osteotomy – In this method a wedge of bone is taken from the outer or lateral side of the shinbone (tibia); that area is closed, which brings the cut edges together with the help of metal plate and screws. This is usually done for a larger deformity and is preferred for complex corrections.

Benefits of Knee Osteotomy

Knee osteotomy is a minimally invasive procedure that includes cutting and reshaping bone of the tibia or femur to lessen the knee joint stress. 

Most patients get pain relief and a delay in arthritis progress, helping them to lead a healthy and normal lifestyle. Osteotomy may delay the need for knee replacement surgery for up to 10 years. 

An effective procedure preserves and maintains your natural knee alignment and there won’t be any restrictions once the healing stage is over but some activities msut be done with some extra care for being on a safer side. Patients can normally return to high-impact workouts or other physical activities.

Indications of Knee Osteotomy

If you have pain only on one side of your knee or pain during activity or long hours of standing, then you can consult a doctor to confirm if you can get it healed through osteotomy. If you are at your early stages of knee arthritis and below 60 years old, you can discuss osteotomy with your doctor.

You must be a non-smoker, and your bone density must be healthy for proper healing. If you have a bowleg or knock-knee deformity, then you can get osteotomy surgery.

There should not be any discomfort under your kneecap, though, and you should be able to straighten your knee and bend to at least a right angle measure (90 degrees).

However, if you have a severe arthritic condition, obesity or concerns with ligaments, like damage, or other discomforts, then your surgeon might consider other alternatives instead of osteotomy.

The Knee Osteotomy Procedure

A knee osteotomy procedure might take about 1-2 hours to complete, and it is a minimally invasive surgery usually done under general or spinal anaesthesia.

Preoperative steps

Before the surgery your doctor evaluates you for the condition you are having with your medical history, your lifestyle, and the exact difficulty you are facing. The anaesthesia choices will be discussed with you. The doctor might need X-rays and physical examinations or MRI scans.

The Surgery

Your surgeon will align your knees with the proper equipment after evaluating your X-rays or scan reports. A small incision will be made at the starting point below your kneecap in the front portion of your knee. The doctor uses guidewires to understand the correct size of the wedge to be cut out. The surgeon then uses an oscillating saw to cut the wedge bone. Then a metal plate is fxed with screws is fixed in the space, and the wound is then closed.

Post-operative care 

This stage includes covering up the cuts and wounds with proper sterile dressings, and medications will be administered to manage pain. Your condition will be monitored properly to make sure there are no complications. 

Recovery & Rehabilitation

Patients usually recover within 3-6 months, but it depends on how well you follow the prescribed aftercare guidelines.

The hospital stay after the surgery will end in two days in most cases. Pain management will be done with medications, and it’s very crucial to enhance the healing process.

During the first two weeks, you would be advised to walk only with crutches to avoid weight bearing on the treated knee. Additionally, the knee might be covered with a cast for additional protection and healing. You must adhere to all the postoperative measures that your surgeon has given to ensure full recovery takes place. 

During the 3rd to 6th week, the small weight-bearing exercises might start to regain knee motion and blood circulation. By 3-6 months there will be a great improvement, and you can get back to your normal activities, but the low-impact ones. After 6 months most types of activities can be carried out if your surgeon clears it.

You must do timely follow-up visits to get your progress evaluated by the doctor. This might need further x-ray reports or other examinations. Physiotherapy is a very crucial step to follow to ensure an effective recovery. You must avoid certain habits like smoking/alcohol consumption.

Risks & Complications of Knee Osteotomy

Even though the knee osteotomy is a minimally invasive procedure, it comes with some risks in some cases. Your doctor will be able to point out all those for making sure you take good care of them after the surgery till you get a full recovery. The most common risks involved are 

• Blood clots and infections
• Knee joint stiffness.
• Blood vessels or nerves might get injured.
• Unsuccessful healing of osteotomy might require a re-surgery.

Cost of Knee Osteotomy Surgery in Chennai

The pricing of knee osteotomy in Chennai varies with different factors like the hospital, expertise of the surgeon, location, your problem severity, what type of osteotomy is done, and more. The general cost for knee osteotomy in Chennai ranges from Rs 1,20,000 to Rs 1,80,000.

At Chennai Orthopaedics, led by Dr Bharani Kumar Dayanandam, you have flexible payment options for knee osteotomy, and the cost is affordable to ensure people get the timely help without a compromise on quality factors. 

You will find insurance coverage along with the flexible payment method at Chennai Orthopaedics, but for more details you may have to get in touch with the financial department.

Why Choose Dr Bharani Kumar Dayanandam for Knee Osteotomy Surgery in Chennai?

Dr Bharani Kumar Dayanandam completed his MBBS from Tamil Nadu and brings with him over 26 years of experience as an orthopaedic surgeon and trauma specialist. He did his AFRCSI in 2001 at the Royal College of Surgeons in Ireland and a Diploma in orthopaedic engineering in 2004 at the College of Engineering & Medicine, University of Cardiff, Wales. In 2010 he also received an FRCS in trauma & orthopaedics.

Dr. Bharani Kumar Dayanandam is one of the most well-recognised and trusted doctors and is liked by all his patients and fellow doctors for his simple way of explaining things to his patients, which makes them confident and ready for the treatment procedures. He is popular for his patient-centred treatment methods and compassionate approach to them. He has worked with a broad spectrum of interests with many senior surgeons both in India and the UK.

His areas of interest are knee osteotomy, arthroscopic knee surgery, ligament reconstructions, cartilage-preserving surgery, patella realignment, joint arthroplasty, meniscus transplants/implants and much more. 

So if you feel you have any of the symptoms or have difficulty in doing everyday activities that require your legs, then you have to consult an orthopaedician for further diagnosis. Dr. Bharani Kumar at Chennai Orthopaedics has the perfect solution for all your problems.

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