Double-level osteotomy – femur and tibia


Richard is a very fit and active 56-year old gentleman who has his own business. After his own internet research he went forward with a double-level (femur and tibia) osteotomy, and has not regretted it.

He developed medial knee pain on the left side and noticed quite a bowing of his leg which was getting progressively worse. He went up to London and saw some very well known orthopaedic surgeons who all recommended an osteotomy.

He did some research and found that I was considered to be an expert in osteotomy and came to see me because of my expertise. Prior to doing the surgery he had become very sedentary and was finding walking difficult and couldn't enjoy a round of golf - he could only get to the ninth hole. He used to enjoy cycling but could no longer do this.

Discussing Osteotomy

The first time I spoke to him about osteotomy he was really quite frightened at the prospect because of what was described, but he actually looked into it in great detail and found some of my articles and videos on the internet. He read some of the blogs and heard stories from the patients and was amazed at how quickly they recovered and how predictable the results were within my practice.

After evaluation and discussion he was then booked in for an osteotomy in the autumn of 2016.

Double-level osteotomy - DFO and HTO

We did the X-ray analysis and he was really very bent (varus) so he required a double-level correction. So I did a closing-wedge in the femur (thighbone) on the outside and an opening wedge in the tibia (shinbone) on the inside. This allowed me to get him back to neutral and gave him a straight leg, and the post-op long leg X-rays reflect that we actually got a perfect result.

Richard tells his story...

Edited transcript of video

Richard sent this latest photo -

"Back on the slopes and no pain!"

after double-level osteotomy
adrian wilson

Adrian Wilson

I am delighted to say that nine months down the line he is now able to walk completely pain free and walk anywhere he likes, any distance and over any sort of terrain. There is no issue with hills and he can go up and down steps once more without pain or discomfort. He is absolutely delighted with his result, as am I, and I am very grateful to Richard that he has allowed us to share his experience.

range of motion
post osteotomy
post osteotomy

Post-op images

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martins says October 10, 2018

am 28years old, I had a closed wedge femoral osteotomy on the right knee, but with unstable knee joint and difficulty in walking after 6months post operation. what could be the cause and solution?

    Adrian Wilson says November 10, 2018

    The most likely cause is a delayed union of the osteotomy
    Needs up to date X-rays and possibly a CT scan to assess

    The most common complication with closed wedge dfo surgery is a hinge fracture and instability laterally
    If this happens Intra operatively or post operatively we need to address the lateral side with anatomical reduction and a second plate

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