Osteotomy

Knee osteotomy

An osteotomy around the knee is a surgical operation whereby the bone is cut to change its alignment. Pain as a result of osteoarthritis (cartilage wear) is the most common complaint leading to an osteotomy.

The pain is severe, causing the following symptoms may occur:

Limited walking distance.
Disturbed sleep
Walking stairs is difficult.
Swollen knee.
Unreliable feel of the knee.
The leg may be a "O" or "X" position

Knee osteotomy is commonly used to realign arthritic damage on one side of the knee.

Treatment of osteotomy

Osteotomy is the main reason for osteoarthritis in the knee joint. If the wear is only on one side of the knee, it may be useful to change the alignment. Usually an O-leg bone made an X, and the opposite happens occasionally. Osteotomy is performed in relatively young patients; because of a knee prosthesis has a limited life and the need for a total knee replacement delay for up to ten years.

The procedure is as follows:

The procedure is performed under general anesthesia (anesthesia) or regional.
The surgeons map out the exact size of the bone wedge, using an X-ray. Removing most of the bone wedge from underneath the outside of the knee, below the healthy cartilage.
The cartilage surface on the top of the outside (lateral side) of the shinbone is left intact. The top of the shinbone is then lowered on the outside and attached with surgical staples or screws, depending on the size of the wedge that was removed.
The sutures are removed after about 14 days.

We use the latest techniques to minimize tissue damage so that recovery is progressing at a fast pace after surgery.

Preperation

How to prepare for your operation

Prior to your surgery, you will have a physical examination. You visit the doctor's assistant and / or anesthesiologist to determine whether the operation is possible. Besides they will explain the various forms of anesthesia and pain management, both during and after surgery. More information about anesthesia, click here.

Finally the day of surgery of is scheduled. The total hospital stay is planned for two days. You arrive on the day of surgery at the clinic. The days after surgery are used to recover and to receive instructions and exercise from the physiotherapist.
You should borrow crutches as you will need them to walk following your surgery after two weeks. For more information click www.thuiszorgwinkel.nl.
Usually it takes the two weeks to walk with a crutch at home. If you have lack of help at home please discuss this with the transfer nurse of the Vlietland hospital or home care setting of your home.

To undergo an osteotomy is not a daily matter. An osteotomy replacement is major surgery with an extended recovery period. It is important to consider all consequences. The better your physical condition before your treatment, the better your recovery after surgery.

At your arrival please wear comfortable clothing and shoes. Bring your personal items such as medicines, clean clothes, toilet articles and your crutches with you. Leave valuables at home as much as possible.

Day of surgery

You appear sober at the hospital
After your medical preparation and support stocking prior to surgery you will positioned and treated in the operating suite
After surgery you will be moved to the recovery room to recover from your anesthesia
Back on the ward the nurse checks you out. During the immediate recovery period you are given intravenous fluids and pain medication.

The day after your surgery, the physical therapist will show you how to exercise and walking with crutches

Recovery after osteotomy

The recovery period after an osteotomy comprises a few months. The days after surgery you are still hospitalized. You get pain medication and you start physical therapy immediately with instructions for home practice. After two days, the wound dressing will be removed and the wound assessed.
After a few days the pain is usually bearable and pain medication will be reduced. You may bend your knee to 90 degrees. Additionally, blood thinners will be prescribed to prevent thrombosis and pulmonary embolism.
Two weeks after surgery you use two crutches and while progressing in recovering occur you use one crutch, used on the unoperated side.
The stitches will be removed about 14 days after surgery
It is important to realize that you do not drive a car by yourself or ride a bike.
Use the supporting stocking for 6 weeks, day and night. The knee may swell by temporary by charge or practicing

The recovery period depends on the patient and his or her condition. For most cases, patients return to a more active and normal lifestyle within 6 months.

Complications after osteotomy

Although the risk of a complication of this surgery is low. Complications may be related to anesthesia or infections. Consult your surgeon with the following complications:

Bleeding from the wounds or bleeding in the knee.
The wounds remain sensitive sometimes long after osteotomy
There may be a thrombosis or pulmonary embolism occurs.
Infection of the wound of metal plate
There is no healing process of the bone
Over or under correction of the bone alignment
Damage to the knee structures around the knee, such as nerves or blood vessels; which is very rare.

An osteotomy is aimed at reducing knee pain. Sometimes the outcome of osteotomy is not what you had expected. In that case, knee prosthesis is an option.

Expectations

An osteotomy is aimed to reduce knee pain and knee replacement to be postponed. This is usually the result. Usually the outcome of surgery is much better than before. Nevertheless, you should realize that an operation involves certain risks and needs an extensive recovery process. Please do not hesitate and consult our clinic if any question or may complication occur.

Frequent asked questions (FAQ)

How long takes an osteotomy procedure?
The duration of an osteotomy session is between 40 and 60 minutes.

The operation is often performed by an osteotomy?
In the Netherlands an estimated of hundreds of osteotomies are performed each year.

How long should I wait for an osteotomy to be carried out?
This determines your level of disability, but early surgery gives a better result and that lasts longer!

Will I ‘beep’ at an airport, with the metal plate, as I go through the gate?
Not common but especially in thin patients or multiple implants it can happen.

What is the weight of the metal plate?
A plate weighs 100 grams but you find nothing of it.

Prepare yourself by reading all the information given. For any questions please telephone or email contact with Orthopedium.