Knee Osteotomy-
A good or bad alternative?

Knee Osteotomy is one of the oldest surgical treatment used to treat knee osteoarthritis symptoms!

Is it still used in time of partial and total knee replacement surgery?


Well if you are reading about it and searching for it that mean still there are many doctors who would initially advise patients to go for high tibial osteotomy.

It is mainly indicated in the treatment of knee arthritis affecting mainly one compartment of knee joint. For more understanding the knee compartments check knee joint anatomy.

When I talked to some of the doctors on their views about knee osteotomy, they said their main criteria for patient selection for this surgery are:

  • Young patients
  • unicompartmental knee arthritis
  • Patients having heavy physical demands from their knee.

If you are ever wondering why some doctors does not go for some type of knee arthoplasty surgery, it is because a replaced knee or artificial knee can wear out over a period so they go for knee osteotomy or other alternatives to knee replacement surgery.

Have you got bow legs or knock knees?

knee osteotomy

If you see above diagram you would see a normal knee alignment, a knock knee appearance( scientifically called genu valgum) and a bow leg( called genu varum) appearance.

  1. Normal Healthy knee joint: When a person does not have a knee osteoarthritis symptoms and he has a healthy knee the alignment is straight between knee bones.
  2. Knock Knees: As you see in Knock knees your lateral compartment of tibio femoral joint is affected. That is mainly causes arthritic knee changes in outer compartment.
  3. Bow Legs: Bow legs are most common knee deformity seen in knee pain patients and in this deformity osteoarthritis symptoms are present in medial or inner compartment or medial tibio femoral joint is affected.

SO you might be wondering what is wrong with this kind of deformity? Are you?

Well let us take an example of bow legs.

Story time

Let us say I have bow leg deformity.(I am just trying to explain the situation here.)

In that case the normal alignment is lost and it puts more stress on medial compartment of knee joint. So my whole medial or inner knee needs osteoarthritis treatment.

After prescribing different treatment doctor considers surgical option.

But wait, I am 32 year old and the latest best knee replacement which they call last 30 years will last me till 62 years.

That means if Knee replacement option is taken than eventually I have to go for revision knee replacement surgery later down the line.

So doctor tells me that "Sir, it is not right time for you to go for knee replacement surgery, let us take a chance with high tibial Osteotomy."

He showed me some x-rays and made me understand how it might relieve my osteoarthritis symptoms.

knee osteotom

What they do in bow leg deformity is they remove a part of the bone from medial shin bone and then realigned with metal plates and screws.

Femur may be wedged or may be not.


Drawbacks of knee osteotomy!

Well we have to understand that it is a surgical alternative for knee replacement surgery.

Still there are some downside to it like:

  1. Recovery time is longer- Keep in mind your bone is cut and then fixed with metal plate.
  2. Infection chances are higher.- the reason are bone is cut .
  3. Non healing of bone can be a possibility too.
  4. Sooner or later patient has to be prepared for knee replacement surgury.

Majority of patients who go for knee Osteotomy needs knee arthoplasty with in 5-20 years.

Will you be able to delay your surgery by that long? You never know.

Go back to home page from here.

Go back to alternatives to knee replacement from knee osteotomy.


Please if you have a real life experience or you liked what I have shared with you here please comment in comment section so that other people who read this can get benefited.

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See Also

Knee Replacement alternative

Revision Knee replacement

Best Orthopedic Surgeon

Arthroscopic Knee Surgery