Osteotomy: Purpose, procedure, and recovery (original) (raw)

Osteotomy is surgery to reshape the bones in a joint, fix a misalignment, or treat other joint problems. Arthritis is a common reason to have the surgery, which involves cutting into the affected bones.

Osteotomy is surgery to cut a bone to reshape it. It may shorten or lengthen a bone by removing or adding bone tissue to realign it and correct an issue.

The surgery can help treat problems affecting various joints, including the knee, hip, spine, and jaw.

Osteotomy may also help treat conditions such as osteoarthritis or spinal deformities.

People may have an osteotomy to correct deformities, misalignment, or joint problems. Conditions people may have an osteotomy for include:

• osteoarthritis
• hip dysplasia
• spinal deformity
• sleep apnea
• misalignment of the teeth or jaw

A person may have a chin or jaw osteotomy for aesthetic reasons to alter the face’s proportions.

The main types of osteotomies are:

• Jaw: A jaw osteotomy can help straighten the jaw or realign the teeth if the lower and upper jaws do not align. People may also have a jaw osteotomy to improve facial proportions or as a treatment for sleep apnea.
• Chin: A chin osteotomy can reduce an over-protruding chin and alter facial proportions.
• Elbow: An elbow osteotomy may help treat distal humerus fractures, which is a break in the upper arm bone near the elbow.
• Knee: A knee osteotomy cuts the shinbone or the thighbone to ease pressure on the knee joint. A knee osteotomy can help relieve pain and improve function for people with early stage osteoarthritis of the knee.
• Spine: A spinal osteotomy can help to treat spinal deformities and create a more typical curve in the spine. This can help relieve pain and improve quality of life.
• Hip: A hip osteotomy may treat misalignments of the hip joint, such as hip dysplasia or impingement. A surgeon will cut a section of either the pelvic bone or the femur bone and realign it into the correct position.
• Big toe: People may have an osteotomy of the big toe joint to correct bunions or arthritis.

The specific steps of an osteotomy vary depending on the body part needing surgery. First, a person has a local or general anesthetic, which depends on the type of surgery and their medical history.

A surgeon may inject a contrast dye and take an arthrogram, an X-ray of a joint, so they can examine the area that needs correcting.

During an osteotomy, a surgeon makes incisions to access the bone. They may use guide wires to mark out the area of bone that needs cutting. They then use a specialized saw to cut or reshape the area of bone.

A surgeon will use plates and screws to keep the bone in the new position. They will then close any incisions.

People will stay in a recovery room for monitoring while the effects of the anesthetic wear off.

To prepare for an osteotomy, a doctor will check whether people are fit for surgery. This may include taking a full medical history, a physical examination, medical tests, and discussing how to manage any existing health conditions.

A doctor will discuss what people can expect before, during, and after surgery, including the recovery period.

People will need to stop smoking pre-surgery if they smoke and avoid taking aspirin, anti-inflammatory drugs, or any herbal supplements, as these can increase the risk of bleeding and bruising.

A person will usually go into the hospital on the day of the surgery. Before having anesthetic, the surgeon may draw on the skin with a marker to indicate the incision sites.

People will need to arrange for someone to drive them home after surgery.

Recovery from an osteotomy may depend on the type of surgery. People may need to stay in hospital for 1 to 2 days while they recover, but it can be longer in some cases.

People may experience some pain, but the healthcare team can help manage this. A doctor may prescribe pain medication such as nonsteroidal anti-inflammatory drugs (NSAIDs), which can help ease pain and help the body recover more quickly.

A person may need a brace, cast, or crutches for several weeks to avoid weightbearing on the affected area.

For a hip osteotomy, people may need to wear a body cast for 6 to 8 weeks. They may then need to wear a brace for 6 to 12 weeks, either full- or part-time.

It is important to attend any follow-ups after surgery. A doctor can check how the surgery is healing and check the recovery process.

People may need to do rehabilitation exercises, which a physical therapist can advise on. These can help restore range of motion and strength in the affected joint.

As with any surgery, an osteotomy carries risks, which may vary with the type of procedure. General risks include:

• infection
• blood clots
• stiffness of the affected joint
• injury to blood vessels or nerves
• poor healing
• bleeding
• swelling
• anesthetic risks

In some cases, such as the osteotomy failing to heal, people may need a second surgery.

The risks for jaw and chin surgery include scarring, numbness, damage to the teeth, or jaw problems.

A surgeon will talk through the potential risks with people before surgery and discuss measures to help prevent them.

What is the success rate of osteotomy?

The success rate of an osteotomy can vary. A 2024 systematic review looked at people who had undergone high tibial osteotomy, which realigns the knee joint. At follow-up, 5 and 10 years after surgery, “survivorship” of the surgery was, on average, 96.3% and 74.6% respectively.

Can an osteotomy fail?

The results of an osteotomy can vary. Factors likely to contribute to better outcomes of a high tibial osteotomy include:

• being younger than 55 years at the time of surgery
• not having obesity
• having surgery before symptoms become disabling

How painful is an osteotomy?

During an osteotomy, people will have a general or local anesthetic to numb the pain or put them to sleep during surgery. After the surgery, people may experience some pain and discomfort, but pain medications can help manage this and improve recovery.

Is an osteotomy a major surgery?

An osteotomy is a major surgery that involves cutting and reshaping bone. The complexity of the surgery may depend on the type of osteotomy people are having.

An osteotomy is a surgical procedure to reshape or realign a joint by cutting into the affected bones. An osteotomy can help treat conditions affecting joints such as the jaw, knee, hips, and spine.

Before having an osteotomy, a doctor will discuss the potential risks and benefits and what to expect from surgery and recovery. It is important to follow the surgeon’s postoperative instructions to help support recovery.