Tibial Osteotomy with Closed Wedge
Osteotomy literally means “cutting of the bone.” In a knee osteotomy, either the tibia (shinbone) or femur (thighbone) is cut and then reshaped to relieve pressure on the knee joint. Both areas are operated on using the same technique, and are usually done to correct a knock-kneed alignment. Knee osteotomy for the tibia is also called a high tibial osteotomy.
Knee osteotomy is used when you have early-stage osteoarthritis that has damaged just one side of the knee joint. By shifting your weight off the damaged side of the joint, an osteotomy can relieve pain and significantly improve function in your arthritic knee.
During a tibial osteotomy with closed wedge, a wedge of bone is removed from the outside of the tibia, under the healthy side of the knee. When the surgeon closes the wedge, it straightens the leg. This brings the bones on the healthy side of the knee closer together and creates more space between the bones on the damaged, arthritic side. As a result, the knee can carry weight more evenly, easing pressure on the painful side.
The tibial osteotomy with closed wedge is the most commonly used osteotomy procedure.
Treatment
The operation for tibial osteotomy with closed wedge treatment typically lasts between 1 and 2 hours.
Your surgeon will make an incision at the front of your knee, starting below your kneecap. He or she will plan out the correct size of the wedge using guide wires. With an oscillating saw, your surgeon will cut along the guide wires, and then remove the wedge of bone. He or she will “close” or bring together the bones in order to fill the space created by removing the wedge. Your surgeon will insert a plate and screws to hold the bones in place until the osteotomy heals.
After the surgery, you will be taken to the recovery room where you will be closely monitored as you recover from the anesthesia. You will then be taken to your hospital room.
Recovery Time
In most cases, patients stay at the hospital for 2 to 4 days after an osteotomy. During this time, you will be monitored and given pain medication.
After the operation, your surgeon may put your knee in a brace or cast for protection while the bone heals.
You will most likely need to use crutches for several weeks.
About 6 weeks after the operation, you will see your surgeon for a follow-up visit. X-rays will be taken so that your surgeon can check how well the osteotomy has healed. After the follow-up, your surgeon will tell you when it is safe to put weight on your leg, and when you can start rehabilitation.
During rehabilitation, a physical therapist will give you exercises to help maintain your range of motion and restore your strength.
The total recovery time for tibial osteotomy with closed wedge before resuming full activities is 3 to 6 months.
