The OS Clinic Osteotomy Group
The OS Clinic Osteotomy Group brings together world-renowned surgeons with an interest and expertise in knee joint preservation and is led by internationally renowned osteotomy surgeon Mr Raghbir Khakha.
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What is an osteotomy?
An osteotomy is a surgical procedure used to correct bone alignment by cutting and reshaping a bone. It can be performed in various parts of the body, such as the knee, hip, or jaw, to treat conditions where bones are misaligned or have healed improperly. By realigning the bones, osteotomy can help relieve pain, improve function, and prevent further joint damage. This procedure is often used to treat conditions like arthritis, joint deformities, or bone fractures that haven’t healed correctly.
Our approach
The consultant team is supported by a multidisciplinary team of anaesthetists, radiologists, specialist physiotherapists and the very latest state-of-the-art diagnostic imaging technology, contributing to a fast and accurate diagnosis for patients.
Collectively, The OS Clinic Osteotomy team has performed more than 5,000 osteotomy procedures across the UK and Europe.
Osteotomy surgery is carried out on patients experiencing a range of hip, knee and ankle conditions, including arthritis and sports-related pain and injury. An osteotomy can usually help to significantly delay the need for arthroplasty (replacement), or fusion surgery and in many instances, remove the need for it altogether.
In patients whose leg bones are not correctly aligned, if they are bow-legged or knock-kneed for example, a knee osteotomy procedure, such as a high tibial osteotomy or femoral osteotomy, restores the normal alignment of the affected joint by correcting the tibia or femur bone, relieving pain and removing pressure on the arthritic or injured area of the joint as a result.
Osteotomy for hip problems
Rotational correction, a surgical technique used to realign the rotational angle of the femur or tibia, can be highly effective in treating hip pathology. When the hip joint is misaligned or rotated abnormally, it can lead to pain, reduced mobility, and increased wear on the joint, potentially causing conditions such as hip impingement. By correcting the rotational alignment, the procedure helps restore proper joint mechanics, reducing pain and improving function. This realignment can also help prevent further joint damage, making it a valuable treatment option for individuals with hip-related issues.
Osteotomy for the correction of malunion
A malunion occurs when a fractured bone heals incorrectly, leading to misalignment that can cause pain, deformity, or impaired function. Osteotomy is an effective treatment for malunion, as it involves surgically cutting and realigning the bone to its correct position. By restoring the bone’s proper alignment, osteotomy can relieve pain, improve mobility, and enhance the overall function of the affected limb. This procedure is often used when other treatments, such as braces or physical therapy, are insufficient to correct the deformity.
Knee Osteotomy
Knee osteotomy surgery offers a less invasive alternative to a knee replacement for patients suffering with arthritis caused by the bones in their legs being misaligned. This misalignment puts additional pressure on the knee joint, causing pain and increasing the damage to the knee.
Another group of patients who may benefit from a knee osteotomy are younger patients including elite sportsmen and women, and active older patients. For these patients, an osteotomy helps them to get back to their previous activity levels more quickly, including competitive sport.
You might need this type of surgery if you are:
Bow-legged – this can result in damage from arthritis to the inner side of the knee joint. Alignment surgery is known as ‘high tibial osteotomy’ where the top part of the tibia (shin bone) is realigned. Around 80% of our realignment procedures are for bow-legged patients.
Knock-kneed – this can result in damage from arthritis to the outer side of the knee joint. Bone alignment surgery is known as ‘femoral osteotomy’ where the bottom part of the femur (thigh bone) is realigned.
Our expert surgeons utilise a minimally invasive technique for osteotomy that enables patients to get back to normal activities as quickly as possible. All the results of surgery are carefully monitored so that the procedure is evidence-based. In many cases, the results are comparable to joint arthroplasty.
X-rays will determine the position of the bones in your leg to gauge the correction required to realign your knee.
If you are bow-legged, the high tibial osteotomy procedure involves a wedge being cut into the bone from the outside of the tibia, using precise measurements calculated during a pre-surgery scan. The wedge is removed, and the bone is then pulled slightly apart, using the space created by the removal of the wedge of bone, and fixed into the correct position using a metal plate and pins. The whole leg is realigned during surgery to prevent further damage to the knee.
If you are knock-kneed, surgery involves making cuts into the bone, using precise measurements calculated during a pre-surgery scan. Plates and pins are used to fix the bone into its new position. All the bones in the leg are realigned during surgery to prevent further damage to the knee.
In the UK, the vast majority of patients with arthritis are offered knee replacement surgery. For younger patients with damaged knees where the wear and tear is very severe or even where there is significant bone-on-bone disease (in some cases, down to the bone), the only traditional options would have been to either put up with pain or have steroid injections, which usually provide only temporary benefit.
While knee replacement may be the answer for some people, for others – particularly younger patients, sportsmen and women, and older patients who are very active – removing the damaged knee joint, which also means taking away a great deal of healthy tissue, may not be the best option. Knee osteotomy surgery can usually significantly delay the need for knee replacement surgery (although patients may need this procedure to treat advanced arthritis later on, most commonly 10-15 years later); in some cases, it can avoid the need for it completely.
The main advantages of osteotomy include:
Reduced knee pain without needing to remove/replace your damaged knee joint
A better range of movement and function
Faster recovery
The knee can feel more stable than after knee arthroplasty
You can return to your normal activities including competitive sport, which isn’t recommended after a knee arthroplasty as it can wear out the artificial joint
You are not having any bone or tissue replaced, you keep your own knee.
A knee osteotomy usually involves an overnight stay in hospital, although in some cases you may be able to go home the same day. Most people are able to bear their own weight and move freely within 24 hours while full rehabilitation takes between 6-12 weeks. Unless your job is highly active or involves manual labour, you are likely to be able to return to work after six weeks.
Rehabilitation is an integral part of a patient’s knee osteotomy recovery. The OS Clinic Osteotomy Group has immediate access to the UK’s best private rehabilitation centres. These provide patients with access to a multidisciplinary team of specialist physiotherapists, occupational therapists, and dedicated rehabilitation gyms.
After a short period of rehabilitation, sportsmen and women are generally able to return to normal activity and competitive sport very quickly.
Elite sportsmen and women have been able to return to normal following an osteotomy and, having regained their fitness levels, they’ve gone on to compete successfully. This includes one elite triathlon runner who, after having his osteotomy procedure, went on to become the top ranked sportsman in his age group.
FAQ's
After eight weeks, most knee osteotomy patients will still require crutches and to continue their rehabilitation exercises. It normally takes between three and six months to regain a full range of motion.
The surgeon’s fee for knee osteotomy is in the region of £5,000-£10,000. Prices vary according to the individual patient’s condition and the treatment required. The hospital and anaesthetist fees are in addition to this fee. Following consultation and once the surgical plan has been advised we will be able to provide an estimate of costs based on the exact surgery required and admitting hospital.
A typical knee osteotomy procedure takes between one and two hours.
The procedure is performed under general anaesthetic, so you will not be aware of any pain during the operation.
You are likely to experience some post-operative pain for at least the first week after a knee osteotomy. Pain relieving medication and icing your knee several times a day will help with this.
No surgery is completely risk-free, but knee osteotomy is a recognised evidence-based procedure which carries minimal risk to patients.
