Covers surgery (osteotomy) to remove a wedge of bone near a damaged joint. Looks at why it is done and what to expect after surgery. Covers physical therapy. Includes info on how well it works and the risks of surgery.
Osteotomy for Osteoarthritis
Osteotomy ("bone cutting") is a procedure in
which a surgeon removes a wedge of bone near a damaged joint. This shifts
weight from an area where there is damaged
cartilage to an area where there is more or healthier
osteoarthritis, cartilage breakdown in the knee often
is much greater in the inner part of the knee joint, often resulting in a
In knee osteotomy for osteoarthritis of the
inner knee, your surgeon removes bone from the outer side of the large lower
leg bone (tibia) near the knee. This tilts your body weight toward the outer,
healthier part of the knee cartilage and away from the inner, damaged
cartilage. Weight is spread more evenly across the joint cartilage. After
removing the bone wedge, your surgeon will bring together the remaining bones
and secure them, most often with either pins or staples. An osteotomy for
osteoarthritis of the outer knee is just the opposite—your surgeon will remove
bone from the inner side of the lower leg to shift the weight toward the inner
Osteotomy may be effective for hip and knee joints. Doctors
often do an osteotomy to correct certain knee deformities such as bowleg
(varus) and knock-knee (valgus) deformities of the knees. Hip osteotomy
involves removing bone from the upper thighbone (femur). Osteotomy may allow an
active person to postpone a total joint replacement for a few years and is
usually reserved for younger people.
What To Expect After Surgery
Recovery depends on the surgical
technique as well as the strength and motivation of the person having surgery.
A cast or splint may limit movement of the joint for 4 to 8 weeks.
You will start physical therapy immediately, even if you are in a cast or
splint. When the cast is removed, you can put your full weight on the joint 10
to 12 weeks after the surgery. It may take up to a year for the knee to fully
adjust to its corrected position.
Why It Is Done
Doctors use osteotomy if destruction
of the knee
cartilage mainly affects a single disc of cartilage:
the disc (meniscus) either on the inner part or on the outer part of the knee
Osteotomy is an appropriate treatment for younger, active
people with osteoarthritis who are able to delay a total joint
How Well It Works
Osteotomy is most often done in
younger people. It can help relieve pain and delay the need for joint
A failure of the bones to heal or failure to
Bleeding in the
Inflammation of joint tissues, nerve damage, or
What To Think About
By shifting the weight onto good
cartilage, osteotomy may "buy time" for younger or more active people before
they need a total joint replacement.
Lozada CJ (2013). Treatment of osteoarthritis. In GS Firestein et al., eds., Kelley's Textbook of Rheumatology, 9th ed., vol. 2, pp. 1646–1659. Philadelphia: Saunders.
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