Realignment Osteotomy
What is a realignment osteotomy?
A realignment osteotomy of the knee involves making a saw cut in the bone to allow the alignment in the bone to change. This is usually performed in the context of arthritis affecting one side of the knee where the alignment of the knee is such that more force passes through that side. Occasionally, osteotomies are performed to help with the knee's stability or offload the site of a cartilage regeneration or ligament reconstruction procedure.
What is involved in realignment osteotomy surgery?
The steps involved in realignment osteotomy surgery include:
Pre-operative planning
X-rays and CT scans are organised to determine the degree of correction required with the osteotomy. This data is analysed, and a custom-made jig is prepared for your osteotomy surgery.
Bone cuts made (osteotomy)
The custom-made jig is applied to the bone (tibia or femur). A saw is used to cut through the bone for which the osteotomy is planned.
Change in the bone alignment
Opening wedge osteotomy: This involves opening the gap where the osteotomy has been made to change the alignment (as shown in the diagram).
Closing wedge osteotomy: This involves removing a wedge of bone at the osteotomy site to change the alignment.
Fixation of the osteotomy
A metallic plate with screws is used to hold the bone in its new position. In opening wedge osteotomy, a bone graft is sometimes packed at the osteotomy site to fill the gap. This is usually performed if a significant correction is required.
What is my follow-up schedule after the operation?
Approximately 3-4 weeks of leave from work is required for a desk-based job.
2 weeks
The wound dressings will be removed, and the wound will be reviewed to ensure it has healed. The sutures will be removed at this stage. Crutches are to be used for weight-bearing until 4 weeks after the operation.
8 weeks
The range of motion in the knee will be assessed. It is expected that you will be able to fully straighten the knee and bend it more than ninety degrees. A special X-ray is taken from the hip to the ankle to confirm the alignment of your knee has been changed to a satisfactory position. Another X-ray is taken of the knee to ensure the osteotomy site is healing. Complete healing of the osteotomy is not expected at this stage.
4 months
An X-ray is performed to ensure the osteotomy site is healing. The knee should have a full range of motion but may have residual swelling around it.
8 months
A final X-ray is performed to ensure the osteotomy site has healed. Return to sports will commence 6-8 months post-operatively. If things have progressed as expected, this will be the final appointment.