Knee Osteotomy

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An Overview on Knee Osteotomy

When there is knee malalignment, patients are at increased risk of developing osteoarthritis due to force overload of one compartment. The extra stress will gradually wear down the articular cartilage covering the ends of the bones, leading to knee pain, stiffness and swelling. Valgus (knock knee) and varus (bow leg) deformities may lead to injury to the lateral (outside) and medial (inside) compartments of the knee joint, respectively. If the symptoms are significant and the patient fails conservative treatment, Dr. Jervis Yau, orthopedic knee surgeon serving the Santa Barbara, Goleta, Santa Maria and Ventura, California area, will recommend surgery. Realignment surgery can be performed at the level of the distal thigh (distal femoral osteotomy) or at the proximal leg (high tibial osteotomy) depending on the deformity. The osteotomy site is typically filled with bone graft to accelerate healing and secured through special plates and screws to allow healing and early motion.  Not infrequently, osteotomies are performed in conjunction with cartilage repair within the knee joint.

Although the recovery is slow, many patients are able to return to sports and other strenuous activities with mild limitations. However, it is important to note that this “knee arthritis” treatment is not a permanent solution in all patients.  The goal of knee osteotomy is to realign the limb so that the mechanical load is shifted from the injured to the uninjured compartment of the knee. This pressure transfer will lead to pain reduction and functional improvement of the knee joint.  By doing this, many patients are able to delay the need for a total knee replacement for many years.

The ideal surgical candidate is a patient who has persistent pain in one compartment of the knee due to focal cartilage injury and corresponding limb malalignment that has failed conservative treatment.

Distal Femoral Osteotomy (Click to Enlarge)

High Tibial Osteotomy (Click to Enlarge)

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Recovery and Rehabilitation Following Knee Osteotomy

Dr. Yau commonly uses a brace and crutches for approximately 6 weeks after surgery to allow the knee to heal.  During this time, there is an emphasis on early range of motion to prevent stiffness.  This is accomplished through physical therapy and sometimes, the use of a continuous passive motion machine (CPM).  Progression to full weight bearing without crutches is generally between 6-8 weeks after surgery. Gradual improvement in strength and function will determine when the patient is ready to return to sports and activities.   Full recovery after limb realignment can sometimes take up to a year.  However, most patients are usually able to return to most activities by six to eight months after surgery.

For additional resources on knee osteotomy, a surgical knee arthritis treatment, please contact Dr. Jervis Yau, orthopedic knee surgeon in the Santa Barbara, Goleta, Santa Maria and Ventura, California communities.

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