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Introduction to Osteotomy
The main reason why surgeons advocate osteotomy is to unload damaged areas of the knee, but they also use it to re-tension ligaments, improve movement and as an adjunct to other procedures.
Osteotomy & Age
This slide shows how well our patients have done in the more elderly age groups - if you have the right patient, osteotomy works very well regardless of how old you are.
Our indications are active patients with disease in just one compartment, but where the alignment is not favourable, we sometimes do it in cases of severe arthritis.
Our work has shown also that the osteotomy procedure does work in high BMI patients.
Minimally-invasive Osteotomy
As our techniques move to these tiny incisions - just 3 cm incisions - it allows us to be very ‘soft-tissue-preserving’ and mini-invasive with a rapid rehabilitation. Together with the accuracy of the digital planning the complication rate continues to fall.
You may also be interested in this recent publication by BMI, where Prof Wilson answers a number of questions about osteotomy...
Age and body mass obviously need to be taken into consideration when one is choosing between a knee replacement and an osteotomy. But everything is relative.
Recently, while I was sitting having lunch with Konrad Slynarski in Poland I saw this elderly gentleman - who is obviously very active - doing some beautiful roller-blading in the park! This really highlights how active people are if they maintain a high level of fitness as they get older. This guy would certainly not do well with a knee replacement.
COMMON OSTEOTOMIES AROUND THE KNEE
- High Tibial Osteotomy (HTO). Also called Proximal Tibial Osteotomy.
- Distal Femoral Osteotomy (DFO)
- Combined HTO & DFO
Historically people used to consider this operation to have a very high complication rate, but that is not our experience and we less than 5% complications and less than 2% serious complication.