An 'osteotomy' is an operation where a bone is cut and re-positioned. The 'tibia' is the shin bone. In a high tibial osteotomy the bone of the upper tibia is cut and repositioned. Knee osteotomy is commonly used to realign your knee structure if you have arthritic damage on only one side of your knee. The goal is to shift your body weight off the damaged area to the other side of your knee, where the cartilage is still healthy.
Osteotomy is a procedure in which the surgeon removes or adds a wedge of bone below or above your damaged knee joint. The decision whether to create a wedge above or below the knee joint depends on which area of the knee is most damaged with arthritis, causing either a bowlegged or knock-kneed deformity.
The procedure is done under general anesthesia. Exact size of the bone wedge will be map out by surgeons either using an X-ray, CT scan, or 3D computer modeling. A four- to five-inch incision is made down the front and outside of your knee, starting below the kneecap and extending below the top of your shinbone. Guide wires are drilled into the top of your shinbone (tibia plateau) from the outside (lateral side) of your knee. The wires usually outline a triangle form in your shinbone.
A standard oscillating saw is run along the guide wires, removing most of the bone wedge from underneath the outside of your knee, below the healthy cartilage. The cartilage surface on the top of the outside (lateral side) of your shinbone is left intact.
The top of your shinbone is then lowered on the outside and attached with surgical staples or screws, depending on the size of the wedge that was removed. Most patients remain in the hospital for two to four days following an osteotomy.
Most patients will have significant improvement.
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