An osteectomy is a surgical procedure that involves the precise removal of bone tissue from the body. The specific amount and location of bone removed during an osteectomy depend entirely on the patient’s underlying medical condition and the surgical goal. This type of surgery is performed to address various bone-related issues, aiming to alleviate pain, improve function, or correct structural problems.
What Bone Is Removed
During an osteectomy, surgeons remove targeted sections or types of bone tissue. This can include a small wedge or section of bone to correct a deformity or realign a joint. For instance, in a knee osteotomy, a wedge of bone might be taken from the shinbone (tibia) or thighbone (femur) to shift weight distribution and reduce pressure on damaged cartilage. A portion of the femoral head and neck can also be removed, as seen in a femoral head and neck osteectomy, to address hip joint issues.
The removal might also involve bony growths, such as osteophytes (bone spurs), which can cause pain or impede movement. Diseased or necrotic (dead) bone tissue from infections or other conditions is also a common target for removal to promote healing and prevent further damage. In more complex cases, a larger segment of bone may be removed, especially when dealing with bone tumors, whether benign or malignant. The exact part and quantity of bone excised are carefully determined based on detailed imaging and the specific needs of the patient’s condition.
Medical Reasons for Bone Removal
Osteectomies are performed for various medical conditions, each requiring precise bone removal for specific therapeutic outcomes. A primary reason is to correct bone deformities resulting from congenital conditions, injuries, or degenerative diseases. For example, an osteectomy can realign bones in cases of bow-legged or knock-kneed deformities, or reshape bones in the jaw or foot to improve function and appearance.
Another application involves removing abnormal bone growths like tumors, whether cancerous or non-cancerous, to prevent their spread or alleviate symptoms. Bone infections, such as osteomyelitis, often require removing infected or dead bone to eliminate the source of infection and allow healthy tissue to regenerate. The procedure also prepares bones for other interventions, such as creating space or correcting alignment before a joint replacement.
How Bone is Removed During Surgery
Removing bone during an osteectomy involves specialized surgical instruments designed for precision and control. Surgeons often use oscillating saws for accurate cuts, especially when removing wedges or larger segments. Other instruments include osteotomes, chisel-like tools used with a mallet for controlled bone shaping, and rongeurs, forceps-like instruments designed to bite off small pieces of bone.
The surgical approach varies, ranging from traditional open surgery with a larger incision to minimally invasive techniques using smaller incisions and specialized tools or scopes. The choice of technique depends on the bone’s location and size, as well as the procedure’s overall complexity. Regardless of the approach, the goal is to precisely remove targeted bone tissue while preserving surrounding healthy structures.