Osteotomy: An alternative to knee replacement for osteoarthritis?

Osteotomy is an alternative to knee replacement for some people with osteoarthritis of the knee.

Knee replacement surgery can improve knee problems associated with osteoarthritis. But it is typically performed on older adults. Young, physically active adults are more likely to wear out their new knee prematurely. For these people, a doctor may recommend an alternative surgery, such as osteotomy.

Osteotomy is a procedure in which the surgeon removes or adds a wedge of bone below or above your damaged knee joint. The decision whether to create a wedge above or below the knee joint depends on which area of the knee is most damaged with arthritis, causing either a bowlegged or knock-kneed deformity. The osteotomy changes the alignment of your knee — shifting weight from the damaged area of the joint to a healthier area.

Studies show that osteotomy relieves pain, improves joint function and may delay the progression of osteoarthritis in the affected joint. However, there's still a moderate chance you may eventually need knee replacement surgery five to 15 years later.

Osteotomy is most often recommended for people who are younger than age 60, active or overweight and have osteoarthritis limited to one side of their knee joint. Depending on how quickly you heal, you may be able to resume your normal activities within three to six months. Potential complications of osteotomy include continued pain from osteoarthritis, blood clots and infections.

Although surgery can be an effective treatment for osteoarthritis, more conservative treatments — such as medications, self-care, and physical and occupational therapy — also can provide a benefit and should be tried first.