Services

Knee arthritis does not always affect the entire joint. When it is confined to one side, realigning the knee can shift load away from the damaged compartment and onto the healthy one. This is the principle behind a knee osteotomy- preserving the natural joint and delaying or avoiding the need for replacement surgery.

When is it indicated

Osteotomy is generally suited to younger, active patients with arthritis affecting a single compartment of the knee and a measurable deformity- either bow-legged or knock-kneed. It is considered when symptoms have not responded to non-operative management and when the patient wants to maintain an active lifestyle including high impact activity, which is not recommended following joint replacement.

To be a candidate, the knee must have functioning ligaments, adequate range of motion, and minimal arthritis in the other compartments.

The procedure

The bone is surgically cut and realigned to shift body weight from the arthritic compartment to the healthy one. The corrected position is held in place with a plate and screws while the bone heals. The most common procedure is a high tibial osteotomy, used when arthritis affects the inner compartment of the knee. A distal femoral osteotomy is used when the outer compartment is involved. The specific technique is determined by the degree and direction of deformity, assessed from full-length leg x-rays and MRI prior to surgery.

Recovery

Most patients are walking the same day and discharged within a few hours. Bandages should remain in place for 48 hours. Ice applied regularly in the first few days helps manage swelling and pain. Recovery depends on what was treated-  a meniscectomy carries a faster recovery than a repair, which requires a period of protected weightbearing to allow healing. A specific recovery plan will be outlined at your preoperative appointment.

Outcomes

In the right patient, osteotomy reliably reduces pain and improves knee function. Studies show approximately 85% of patients have good function at five years and 70% at ten years. It is not a permanent solution but can meaningfully delay the need for joint replacement.

Follow up

Postoperative appointments are scheduled at two weeks and six weeks following surgery with ongoing review as required.