Knee osteotomy is surgery to shift the positioning of the knee. This changes which part of the knee bears the most weight. This surgery is often done to treat knock-knees, which are angular deformities at the knee, in which the head of the deformity points inward. A standing child whose knees touch, but whose ankles do not, is usually said to have knock knees.
As in any operation, there are risks and complications. The risks and complications may include:
The surgery takes about 1 to 2 hours. You will stay in the hospital 1 or more nights afterward. The phases of the surgery are:
Before the Surgery Begins: An IV line is put into a vein in your arm or hand. This line supplies fluids and medicines.
To keep you free of pain during the surgery, general anaesthesia or spinal anaesthesia may be used. In some cases, a nerve block may be used. This medicine numbs the area to be worked on.
During the Surgery: The doctor will assess your knee problem and determine if the lower end of the thighbone (femur), the top end of the shinbone (tibia), or both need to be treated during the surgery. These bones make up the top and bottom parts of the knee joint. Surgery is then done using a closing or opening wedge method.
With the closing wedge method, an incision is made in the skin to expose the bone. The bone is then cut and a piece of the bone (wedge) is removed. This creates a gap in the bone. The gap is brought closer together and then closed with devices such as metal plates or screws.
With the opening wedge method, an incision is made in the skin over the knee to expose the bone. The bone is then cut. At the location of the cut, the 2 sides of the bone are pulled slightly apart. This creates a gap in the shape of a wedge. Extra bone (bone graft) is then used to fill in the gap. Bone for this graft may come from your own body, a donor, or manmade sources (bone substitutes). If bone from your own body is to be used, it is usually taken from your hipbone (pelvis). This requires a separate incision to be made in the hip during the surgery. The bone graft is secured to the bone around it with devices such as metal plates or screws.
After the Surgery: You will be given medicines to manage pain and to prevent infection. Your knee will be raised (elevated) above the level of your heart, and cold will be applied to your knee to reduce pain and swelling. Also, your knee may be placed in a brace. While you are in the hospital, you may begin work with a physical therapist. You may be taught stretches and exercises for your knee to do at home.
Keep all follow-up appointments with your doctor. Sutures will likely need to be removed about 7 to 10 days after surgery. After this surgery, recovery can take several months or longer. You may need to wear an immobilizer such as a brace for a time. The brace helps keep the knee stable and protects it from further injury. You may also need to use a walking aid such as crutches or a walker to help you move around. Also, as part of your recovery, you may need to do physical therapy (PT).
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