A large percentage of adults suffer from arthritis. Arthritis may be the result of a degenerative condition, hereditary, or may have been caused by an earlier sports injury or accident to the knee area. Patients who experience osteoarthritis often strive for ways to improve knee function, limit pain, and for many, put off knee replacement surgery. One surgery to postpone knee replacement surgery and improve function is a knee osteotomy.
A knee osteotomy is a surgical procedure that Dr. LaPrade performs on patients who have a single compartment of their knee affected by osteoarthritis. While this surgery for knee arthritis is usually effective for most patients, it is not a long-term fix for the problem. The significance of having the surgery is that for many patients, the procedure can offer years, and often a decade or more, of improvement and possibly continue to delay the need for knee replacement surgery. Osteotomies of the knee have been validated to be effective for decreasing pain and improving patient movement in most instances.
Many people who undergo a knee osteotomy will eventually need a total knee replacement. However, research studies have reported knee replacements are more successful in patients over 60 years of age. Therefore, patients in their 30’s, 40’s and 50’s are ideal candidates for knee osteotomies.
Surgical Procedure
During a knee osteotomy, Dr. LaPrade will add a wedge of bone to the upper shinbone (tibia) or lower thighbone (femur). In essence, this helps shift a body’s weight off the damaged area of the knee joint onto the more normal cartilage area on the opposite side of the knee.
During an opening wedge osteotomy, Dr. LaPrade may use hardware, such as screws and plates, to hold the bones of the knee to their new aligned position and add bone graft to help the osteotomy heal faster. Most patients who undergo an osteotomy will stay in the hospital for two days for pain control and to initiate physical therapy.
Rehabilitation Following Surgery
Patients are generally sent to physical therapy immediately after surgery to work on swelling control, muscle reactivation, and knee motion. In general, patients are non-weight bearing on crutches for 8 weeks and progressively wean off crutches over the next month. This is achieved by slowly increasing weight bearing on the leg at ¼ body weight per week. Patients are only allowed to progress their rehabilitation program with weight bearing after review of x-rays. In general, most patients are able to wean off of crutches at 3 months after surgery. A low impact exercise program to include walking, cycling, and aquatic therapy is further progressed at this time. Most patients note significant improvement of their function by 4-6 months after the osteotomy.
