Osteotomy of the Knee

Osteotomy of the knee is surgery that involves making a cut in one of the bones in the lower leg. This can be done to relieve symptoms of arthritis (when other treatments no longer offer relief) by realignment of the leg. By having an osteotomy, the patient may be able to delay the need for a knee replacement for up to 10 years, but still stay active.

Arthritis most often affects the inside part of the knee. Most of the time, the outside part of the knee is not affected unless there was a knee injury in the past.

Osteotomy surgery works by shifting the weight away from the damaged part of the knee. For the surgery to be successful, the side of the knee where the weight is being shifted should have little or no arthritis.

Surgical Procedure

There are two types of surgery:

  • Tibial osteotomy is surgery done on the shin bone below the knee cap.
  • Femoral osteotomy is surgery done on the thigh bone above the knee cap.

During surgery:

  • It will be pain-free during surgery. Patient may get spinal or epidural anesthesia, along with medicine to help with relaxation. Patient may also receive general anesthesia, in which sleep occurs.
  • Surgeon will make a 4 to 5 inch cut on the area where the osteotomy is being done.
  • Surgeon may remove a wedge of shinbone from underneath the healthy side of the knee. This is called a closing wedge osteotomy.
  • The surgeon may also open a wedge on the painful side of the knee. This is called an opening wedge osteotomy.
  • Staples, screws, or plates may be used, depending on the type of osteotomy.
  • May need a bone graft to fill in the wedge.

In most cases, the procedure will take 1 to 1 1/2 hours.


Patient will be fitted with a brace to limit movement of the knee during the recovery period. The brace may also help hold the knee in the correct position.

Patient will need to use crutches for 6 weeks or more. At first, patient may be asked to not place any weight on the knee. Patient will also see a physiotherapist to help with an exercise program.

Complete recovery may take several months to a year.