KNEE SURGERY GLASGOW
Osteotomy for Realignment
What is an osteotomy?
An osteotomy is an operation where the bone is carefully cut and repositioned to change the alignment of the knee joint. Plates and screws are then used to hold the bone in its new position while it heals.
The aim is to shift weight away from the damaged part of the knee onto a healthier area, relieving pain and protecting the joint. This is usually offered as a joint-preserving alternative to knee replacement in younger, active patients.
Why might I need an osteotomy?
You may be advised to have an osteotomy if you have:
Early or moderate arthritis affecting one side of the knee (usually inner/medial compartment)
Bow-legged (varus) or knock-kneed (valgus) alignment that overloads part of the joint
Ongoing pain despite physiotherapy, injections, or medication
You are younger and active, and wish to delay the need for a knee replacement
What does osteotomy surgery involve?
The operation is performed under a general or spinal anaesthetic.
A cut is made in the tibia (shinbone) or femur (thighbone), depending on whether the correction is for bow-legged or knock-kneed alignment.
The bone is carefully realigned, and a wedge of bone may be opened (opening wedge) or removed (closing wedge).
A metal plate and screws are fixed to stabilise the bone while it heals.
Bone graft or substitute may be used to fill any gap created.
What will the recovery be like after surgery?
Hospital stay: usually 2–3 nights.
Weight-bearing: often limited for the first 6 weeks, with gradual increase as the bone heals. Crutches are required initially.
Physiotherapy: essential to restore knee movement, rebuild strength, and retrain walking.
Healing: bone healing typically takes 3–6 months.
Return to activity: most patients resume daily activities within 3 months, with higher-level sport possible after 6–12 months.
What are the risks of surgery?
Pain and swelling after the operation
Infection (rare)
Blood clots (DVT/PE)
Delayed or incomplete bone healing
Numbness around the incision
Irritation from the plate and screws (sometimes requiring later removal)
Rarely, over- or under-correction of alignment
Are there alternatives to surgery?
Non-surgical management: physiotherapy, weight management, pain medication, bracing, and injections can help control symptoms but will not correct alignment.
Knee replacement: an option if arthritis is advanced or widespread, though not ideal in younger patients.
Activity modification: reducing impact activities and switching to lower-impact exercise such as cycling or swimming.
