Why knee osteotomy is gaining popularity among surgeons
Knee osteotomy is being increasingly recognised as a highly effective alternative to total knee replacement, particularly for more active patients.
In this article, Mr Ronald van Heerwaarden, a consultant orthopaedic and specialist knee surgeon at Orthopaedic Innovation, explores why knee osteotomy is becoming a preferred choice among surgeons and how it benefits patients seeking long-term pain relief while preserving their natural joint and maintaining mobility.
What is knee osteotomy?
Knee osteotomy is a surgical procedure that involves cutting and reshaping the tibia or femur to correct misalignment and redistribute weight more evenly across the knee joint.
The procedure is primarily performed on patients with early-stage knee osteoarthritis affecting one side of the knee (unicompartmental knee osteoarthritis). By shifting pressure away from the damaged section, it helps relieve pain, improve joint stability, and slow disease progression.
It is also commonly performed in individuals with a structural imbalance, such as bow-leggedness (varus deformity) or knock knees (valgus deformity).
Why is knee osteotomy gaining popularity?
With growing interest in alternatives to total knee replacement, knee osteotomy is becoming an increasingly popular option among surgeons.
Preservation of the natural joint
Unlike total knee replacement, which involves removing and replacing the damaged joint with an artificial implant, knee osteotomy preserves the patient’s natural joint structure, allowing for greater flexibility and more natural movement.
Delays the need for knee replacement
Many patients who undergo an osteotomy experience long-term relief from knee pain, often delaying the need for total knee replacement by 10 to 15 years or more.
This is significant as knee replacements have a limited lifespan and revision surgeries can be more complex and less effective.
Recent studies suggest that approximately one-third of all total knee replacements, which amounts to over one million cases worldwide, could be suitable for an osteotomy or other joint-preserving procedures instead.
Ideal for active individuals
While total knee replacement often requires lifestyle modifications to protect the artificial joint from excessive strain, knee osteotomy allows patients to continue engaging in high-impact activities like running, hiking and skiing.
Advancements in surgical techniques
Recent innovations have significantly improved the precision and outcomes of knee osteotomy, including:
- 3D imaging and computer-assisted planning: advanced imaging technologies, like CT scans and 3D models, allow for precise preoperative planning.
- Custom surgical guides: surgical guides tailored to the patient's unique anatomy are used to ensure accurate alignment during surgery, reducing the risk of misalignment and improving outcomes.
- Robotic-assisted surgery: robotic systems allow surgeons to make highly controlled and precise cuts, which is especially useful in complex cases.
Who is a good candidate for a knee osteotomy?
Knee osteotomy is most suitable for individuals who have:
- Localised knee arthritis affecting only one side of the joint
- No significant pain under the kneecap (patellofemoral arthritis)
- Activity related pain that improves with rest
- The ability to fully straighten the knee and bend it at least 90° before surgery
- No severe ligament damage
- An active lifestyle or a desire to maintain mobility
Patients with advanced arthritis affecting the entire knee joint may still be better candidates for total knee replacement. A thorough consultation with an orthopaedic surgeon is essential to determine the best course of action.
What to expect after surgery
The recovery period for knee osteotomy varies but typically:
- Most patients stay in hospital for 1–2 days
- Crutches are required for 6–8 weeks while the bone heals
- Physiotherapy to help restore strength and mobility
- Most patients achieve full recovery within 6 to 12 months
Knee osteotomy is revolutionising the treatment of knee arthritis and misalignment by offering patients a joint-preserving alternative to total knee replacement.
If you suffer from knee pain and want to explore your treatment options, consult with Mr Ronald van Heerwaarden via his Top Doctors profile to determine whether a knee osteotomy is right for you.