Knee Osteotomy
How is a Knee Osteotomy performed?
A knee osteotomy is performed by cutting the tibia and/or femur, correcting abnormal limb alignment, and fixing the bone cuts with plates/screws. This is done to redistribute weight away from the arthritic part of the joint or improving stability of the knee.
During surgery:
A knee arthroscopy will first be performed to ensure the knee cartilage is healthy enough to benefit from an osteotomy
An incision is made along the upper tibia (shin bone) or lower femur (thigh bone), depending on where the deformity lies.
A controlled bone cut (osteotomy) is made to realign the leg, improving load distribution across the knee joint.
The new position is fixed in place using a plate and screws and, occasionally, a wedge bone graft. Sometimes a wedge of bone is removed and the bone cuts are closed onto themselves.
What Technologies Are Used When Performing a Knee Osteotomy?
Modern technologies improve the accuracy, safety, and precision of osteotomy surgery.
Computer Navigation: Real-time navigation systems track bone and instrument position during surgery, ensuring precise correction of the alignment angle.
Patient-Specific Instrumentation (PSI) Guides: Custom cutting guides are created from your preoperative CT or MRI scans to match your anatomy. These guides help the surgeon make exact bone cuts and achieve the planned correction.
These technologies allow for more consistent results, better alignment, and potentially improved long-term outcomes.
What Is the Recovery in the Immediate Postoperative Period?
Hospital stay: Most patients stay 2-3 days in hospital working with physiotherapy.
Weight bearing: Depending on which bone is cut, patients can expet to be non-weight bearing or partial weight bearing for 6 weeks.
Brace: No braces are required after surgery.
Range of motion: Early motion starts right away.
Ice and elevation: Used frequently to control pain and swelling. You should ice for 20 minutes, 3–4 times per day right after surgery. An ice/compression machine can be hired from a third party.
Assistive devices: You will use crutches for 6 weeks after surgery, progressing to a cane as comfort improves. It can take 8–10 weeks before you can walk independently.
How Is the Wound Managed?
Bulky dressings will be removed 1–2 days after surgery.
A waterproof underlay dressing should be left on for 2 weeks.
Incisions typically heal within 2 weeks.
Showers are permitted while wounds are covered with waterproof dressings during the first 2 weeks.
Do not submerge incisions in water (baths, pools, or ocean) for 6 weeks.
A wound check with your GP, allied health provider, or our clinic is recommended at 2 weeks.
Absorbable sutures are usually used and do not require removal, though small remnants may surface naturally during healing.
How Do I Prevent Blood Clots (DVT/PE)?
Blood clots (deep vein thrombosis or pulmonary embolism) can occur after surgery.
You can reduce the risk by:
Moving your foot and ankle regularly while resting.
Walking early with assistance.
Avoiding long periods of sitting or immobility.
Wearing compression stockings for the first 4–6 weeks.
Using compression devices while in bed in hospital.
Taking aspirin for 2–4 weeks to prevent DVT/PE. If you have a history of blood clots or risk factors, a stronger blood thinner may be prescribed.
If you plan any long-distance travel within 6 weeks of surgery, please inform our clinic for preventative medication.
Seek immediate medical attention if you develop calf pain, swelling, chest pain, or shortness of breath.
How Do I Manage My Pain After a Knee Osteotomy?
Your anaesthetist will discuss possible spinal or regional nerve blocks to help control pain immediately after surgery.
Local anaesthetic will be injected into the wound during surgery.
Use ice regularly (20 minutes, 3–4 times per day). An ice machine may be hired from a third party.
Take prescribed pain medication as directed. Opioids may be used short-term but have known side effects (nausea, constipation, dependence). Non-opioid medications are preferred when tolerated.
Use a compression dressing on the knee for 6 weeks to manage swelling.
Begin gentle range-of-motion and muscle activation exercises as soon as recommended.
Use walking aids for stability while recovering your gait.
What Issues Should I Call the Clinic Regarding?
You should contact your surgeon or clinic immediately if you notice:
Increasing redness, swelling, or drainage from the wound.
Persistent or worsening pain not controlled by medication.
Fever, chills, or night sweats.
Calf pain or swelling (possible blood clot).
Any acute injury to your operative knee.
Prompt review allows early management of potential complications.
When Can I Return to Normal Activities after a Knee Osteotomy?
Return to activities depends on the nature and intensity of the activity.
General guideline:
Walking: Start immediately after surgery with weight-bearing restrictions.
Stationary cycling: Can start right away and is encouraged. Road cycling can take 6–8 weeks.
Light gym exercise (Pilates, pool work, yoga): 8–10 weeks.
Sport: Typically 5–12 months, depending on intensity.
When Can I Drive?
You can usually drive once you can safely control the vehicle and perform an emergency stop comfortably.
This is typically 8–10 weeks after right knee surgery, and 2–3 weeks for the left knee.
You must not drive while taking strong pain medication (e.g., opioids).
When Can I Return to Work?
Return to work depends on your occupation:
Office or sedentary work: 1–2 weeks (once you can commute safely).
Light manual work: 4–6 weeks.
Heavy manual labour: 3–4 months or longer, depending on recovery.
Should I See a Physiotherapist?
Yes. Physiotherapy is essential for optimal recovery and long-term success after UKR.
Your physiotherapist will:
Guide you through a structured rehabilitation program.
Focus on restoring range of motion, strength, balance, and gait mechanics.
Progress exercises gradually from early mobility to functional activity and low-impact sport.
Most patients continue physiotherapy for 3–6 months to achieve full functional recovery.
What Are the Complications After a Knee Osteotomy?
While knee osteotomy is a safe and effective procedure, all surgery carries potential risks:
Infection
Wound complication
Blood clots (DVT/PE)
Neurovascular injury/Compartment Syndrome (both of which are rare but limb-threatening)
Delayed or incomplete bone healing (non-union)
Fracture at the osteotomy site
Hardware irritation or screw prominence (often requiring removal)
Over- or under-correction of alignment
Persistent pain or stiffness
Progression of knee arthritis
Lengthening or shortening of the limb
Injury to the extensor mechanism
Stiffness caused by the lowering of the patella (patella baja)
Failure to improve pain or instability
