Joint Preservation & Osteotomy

The knee is a complex joint and where possible it is important that one tries to preserve it. In this regard, it is prudent to repair meniscus tears and treat articular cartilage lesions where appropriate and consider all non-operative options. Knee replacement surgery is generally a very successful operation in selected patients but once the joint is excised, this is irreversible. It may not always be the best option for some patients, for example young patients, very active older patients and those who undertake physically demanding occupations or pursuits. Joint restoration and preservation procedures may help put off joint replacement surgery.

Knee Realignment (Osteotomy) Surgery

‘Osteotomy’ essentially means cutting a bone. The weight bearing mechanical axis of your healthy knee joint usually falls close to the centre of the knee. However, where damage from osteoarthritis principally affects one compartment of your knee, the mechanical axis can sometimes deviate significantly from normal such that your body’s weight increasingly loads the damaged compartment. If the medial (inner) side of your knee is more affected, this can result in a varus (bow-legged) deformity. If the lateral (outer) side of the knee is more damaged, this can give you a valgus (knock-knee) deformity.

An osteotomy is designed to help shift the mechanical axis and your body’s weight off the damaged area of your knee joint and onto the more normal cartilage on the opposite side of your knee. For bow-legs, the top of your shin bone is normally re-aligned (high tibial osteotomy). For knock-knees, the osteotomy is usually performed on the lower part of the thigh bone (femoral osteotomy). Sometimes, the osteotomy needs to be performed on both the tibia and femur bones. The osteotomy is usually fixed with plates and screws and bone graft may be used.

Osteotomies of the knee can be effective at decreasing pain and delay the need for knee replacement surgery. Many, but not all, patients who undergo a knee osteotomy for arthritis will eventually need a knee replacement.

You rely on your knees to live a full and active life.

Entrust their care to specialists.