Osteotomy surgery is an orthopedic procedure involving the precise cutting or removal of bone. Surgeons use it to address various musculoskeletal issues, aiming to improve bone alignment and joint function. This intervention can be performed on different bones throughout the body to correct structural problems.
What is Osteotomy Surgery?
The term “osteotomy” originates from Greek words: “osteo,” meaning bone, and “tomy,” meaning cutting. This describes the procedure’s core action: surgically cutting, reshaping, or removing a section of bone. The goal is to realign a joint or bone, distribute weight more evenly across a joint surface, or correct a deformity.
This procedure can be performed on various bones, with common sites including the knee, hip, jaw, spine, and foot. For instance, a knee osteotomy may involve cutting and reshaping the shinbone (tibia) or thigh bone (femur). Hip osteotomies can involve the pelvic bone or thigh bone to address issues like hip dysplasia. Despite the varied locations, the underlying goal is always to modify the bone’s structure for better alignment and function.
Why is Osteotomy Performed?
Osteotomy addresses medical conditions causing pain, misalignment, or impaired function. A common indication is early-stage osteoarthritis, particularly in the knee or hip. The procedure shifts weight from damaged cartilage to healthier joint areas, reducing pressure and alleviating pain. This can potentially delay the need for total joint replacement, especially in younger, active individuals.
Beyond arthritis, osteotomy corrects deformities like bowed legs (genu varum) or knock knees (genu valgum), which can arise from congenital factors or developmental issues. It also treats incorrectly healed fractures (malunions), restoring proper bone alignment. The surgery can address hip dysplasia, certain spinal deformities, bunions, or jaw misalignments affecting chewing or facial symmetry.
The Surgical Procedure
Undergoing an osteotomy involves careful preparation and precise surgical steps. Before the procedure, patients undergo pre-operative assessments, including blood tests, urine tests, and imaging studies like X-rays or CT scans. These help the surgeon plan the exact cuts and realignments. Anesthesia options, ranging from general to regional or local, are also discussed based on the surgery’s complexity and location.
During surgery, an incision accesses the bone. Surgeons use specialized instruments, often guided by wires, to precisely cut or remove a wedge-shaped bone section. This allows bone fragments to be realigned into a new, more functional position. Once realigned, the bone is stabilized using internal fixation devices like plates, screws, pins, or staples, which hold the bone in place while it heals. The specific technique and hardware vary based on the bone involved and osteotomy type.
Recovery and Rehabilitation
Recovery from osteotomy surgery is a gradual process requiring patience and adherence to medical guidance. Immediately after the procedure, pain management is a key focus, and patients may experience soreness at the surgical site. Initial mobility restrictions are common, with a cast, splint, or brace often used to protect the healing bone and limit movement. Wound care, including keeping the incision clean and dry, is also important to prevent infection.
Physical therapy plays an important role in rehabilitation, often beginning soon after surgery to help regain strength, flexibility, and function. Exercises focus on improving range of motion and building muscle strength as swelling decreases. Bone healing typically takes several weeks, with initial healing for a knee osteotomy often around 6 weeks. Full recovery and return to all regular activities can span from 3 to 6 months, or up to a year for high-impact activities. Gradual progression of weight-bearing is carefully managed by the surgeon to ensure correct bone healing in its new alignment.