Cartilage wear that is limited to a compartment of the knee (internal or external) accompanied by a misalignment of the limb can be treated with osteotomy in order to realign the deformed limb and transfer the damaged compartment’s weight to the healthy one. However, the healthy compartment will wear out as well in the future.
Osteotomy is usually performed on patients under 60 years of age. This intervention protects the damaged compartment for around 10 years.
Osteotomy is usually done on the tibia. Two procedures are available:
- Opening wedge osteotomy: This is the most frequently employed procedure.
It involves cutting the tibia along a cut line and spreading the edges to insert a piece of mineral bone.
- Closing wedge osteotomy: This procedure involves removing a piece of bone from the tibia. A portion of the fibula has to be severed as well.
In both cases, fixation is secured using osteosynthesis equipment (nail-plate fixation) that is removed 2 years later (ambulatory surgery). The patient should walk with crutches and keep the splint for 6 weeks while taking anticoagulant treatment. Resumption of normal everyday life is possible 8 to 10 weeks after surgery