Knee realignment surgery (osteotomy)

The knee joint is a hinge joint divided in to two parts. The inside of the knee joint (medial compartment) and the outside of the knee joint (lateral compartment).

To prevent pain and later down the line prevent the onset of early degenerative changes to either the medial or lateral compartment a structurally normal knee joint has a good balance and alignment between these two compartments in standing.

In some cases the knee may lean towards the outside or inside too excessively which can cause abnormal and excessive loads on the medial (if the knee leans outwards) or lateral (if the knee leans inwards). In some cases this may need to be surgically corrected with knee realignment surgery.

Knee realignment surgery takes place under a general anaesthetic and involves several stages. Using xrays taken before the operation the surgeon will assess the degree of realignment which needs to be undertaken. Once measured for the realignment the surgeon uses special cutting instruments and makes a wedge cut near to the top of the lower leg bone (tibia).

The surgeon is then able to realign the knee angulation by levering the ends of the tibia together at the wedge. The fractured ends are secured with a strong plate and screws and if necessary the surgeon will add bone graft to secure the fractured tibia further. The most common form of knee realignment surgery described here is termed a high tibial osteotomy.

To allow the fractured tibia bone to heal safely in the new alignment following surgery, it is normal for patients who have undergone knee realignment surgery to be non weight bearing for six weeks.

The specialist team will take further x-rays after six weeks and check the fractured ends are have healed sufficiently to start weight bearing through the operated leg.

After this initial period, circle health’s expert physiotherapists always supervise our patients and guide them through a comprehensive rehabilitation package until they are able to walk normally and are back to full activities of living and sports (if applicable).

Initially, rehabilitation after knee realignment surgery, will often comprise of simple range of motion and flexibility exercises to ensure full mobility to the knee is restored. Non weight bearing strengthening exercises will also be advised to prepare the knee for more aggressive exercises later down the line.

Higher level rehabilitation will involve weight bearing exercises to restore optimum function and fitness to the operated leg. These types of exercises may include:

  • Wall squats
  • Lunges
  • Step ups
  • Leg press machine

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