Osteotomy (cutting and realigning) of the bones around the knee can be helpful for patients with unicompartmental arthritis to help shift the load from the worn or damaged side of the knee joint to the more normal side. It is indicated in younger, not overweight individuals with arthritis limited to a portion of the knee joint and who intend to maintain higher levels of activity not otherwise appropriate with a joint replacement surgery. Osteotomies are used to adjust the knee alignment of a patient to unload arthritic (damaged cartilage) areas or protect ligament, meniscus or cartilage repairs in patients with varus (bow-legged) or valgus (knock-kneed) malalignment.
Dr. Chudik prefers to avoid osteotomy surgery whenever possible because it alters the weight-bearing mechanics of the knee joint, predisposing to early arthritis. In cases where it is necessary, Dr. Chudik makes a limited, open incision and exposes the bone safely retracting the soft tissues. The osteotomy is created, the bone re-aligned, and secured with hardware. Post-operatively, the patient needs protect weight-bearing for up to four to six weeks and it requires six months to return to activity. If successful, patients who have osteotomies for severe unicompartmental arthritis can often expect reasonable pain relief for up to five to ten years before the remainder of the knee develops arthritis and needs to be converted to a total knee replacement. The develop of arthritis is more gradual but accelerated in patients who have osteotomies performed for issues other than arthritis.