High Tibial Osteotomy
What is Knee Osteotomy?
Knee osteotomy is a surgical procedure in which the upper shinbone (tibia) or lower thighbone (femur) is cut and realigned. It is usually performed in arthritic conditions affecting only one side of your knee and the aim is to take pressure off the damaged area and shift it to the other side of your knee with healthy cartilage. During the surgery, your surgeon will remove or add a wedge of bone either below or above the knee joint depending on the site of arthritic damage.
Indications of Knee Osteotomy
Knee Osteotomy is commonly indicated for patients with osteoarthritis that is isolated to a single compartment (unicompartmental osteoarthritis).
High Tibial Osteotomy Procedure
A high tibial osteotomy is the most common type of osteotomy performed on arthritic knees. After general anesthesia is administered, your surgeon will map out the exact size of the bone wedge to be removed, using an X-ray, CT scan, or 3D computer modeling. A four- to five-inch cut is made down in front of the knee, starting below the kneecap and running below the top of the shinbone. Guide wires are drilled from the lateral side to the top of the shinbone. A conventional oscillating saw is run along the guide wires and the bone wedge underneath the outside of the knee, below the healthy cartilage, is removed. The cartilage covering the top of the outside of the shinbone is left intact. Then the top of the shinbone is reduced and fastened with surgical staples or screws. After the procedure is completed, the surgical site is then sutured usually with absorbable sutures and closed in layers.
Complications of Knee Osteotomy
Complications following high tibial osteotomy may include infection, skin necrosis, non-union (failure of the bones to heal), nerve injury, blood vessel injury, failure to correct the varus deformity, compartment syndrome and deep vein thrombosis or blood clots.