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Our bones provide structure, support, and allow for movement. However, sometimes, due to various reasons, bones may not be aligned properly, leading to pain, limited mobility, and even joint degeneration. In such cases, a surgical procedure called osteotomy comes to the rescue. This article is a compilation of all the necessary information about this procedure, including what it is, how it’s performed, the recovery phase and tips to lead life afterwards.
Synopsis
What is Osteotomy?
Osteotomy, literally translated as "bone cutting," is a surgical procedure where a bone is strategically cut and repositioned to improve alignment, correct deformity, or relieve pressure on a joint. This procedure can be performed on various bones, including the jaw, knee, ankle, hip, and spine.
Types of Osteotomy
1. Knee Osteotomy
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Purpose: Used for early-stage osteoarthritis or leg misalignment. It realigns the thigh (femur) or shin (tibia), shifting weight away from damaged cartilage to the healthy side.
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Types: High Tibial Osteotomy (for bow‑legs), Distal Femoral Osteotomy (knock‑knees), or Tibial Tubercle Osteotomy (relieves kneecap pressure).
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Goal: Pain relief, joint preservation, and delaying knee replacement by 10+ years.
2. Hip Osteotomy
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Purpose: Aimed at treating hip dysplasia or impingement in younger patients. It corrects socket (acetabular) or thigh-bone (femur) misalignment.
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Types: Periacetabular Osteotomy (PAO) adjusts the hip socket for better coverage; Femoral Osteotomy corrects femur alignment.
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Aim: Improve stability, reduce hip joint stress, and delay hip replacement.
3. Spinal Osteotomy
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Purpose: Corrects severe spinal deformities such as kyphosis or lordosis.
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Types: Posterior or Anterior Spinal Osteotomies (e.g., Vertebral Body Wedge Resection) straighten spinal curvature and restore alignment.
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Benefit: Enhances posture, relieves pain, and improves function in conditions like ankylosing spondylitis.
4. Jaw (Maxillofacial) Osteotomy
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Purpose: Realigns the upper (maxilla) or lower (mandible) jaw to correct bite problems, facial imbalance, or obstructive sleep apnea.
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Types: LeFort I, II, III: Segmental repositioning of the upper jaw or midface.
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Sagittal Split Mandibular Osteotomy: Moves the lower jaw forward or backwards for bite correction.
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Outcome: Improved chewing, speech, facial aesthetics, and airway support.
Each osteotomy type targets a specific bone or joint to correct structural issues, alleviate pain, improve function, and potentially delay joint replacements.
Why is Osteotomy Performed?
There are several reasons why an osteotomy might be recommended by an orthopaedic surgeon in Gurugram:
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Correcting Bone Deformity - This could be due to congenital conditions like bowed legs (genu varum) or knock knees (genu valgum), or acquired deformities from injuries or arthritis.
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Realigning Misaligned Joints - Osteotomy can help realign joints like the knee or ankle to improve weight distribution and reduce pain through osteotomy knee surgery.
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Lengthening or Shortening Bones - This might be necessary in cases of leg length discrepancies or for bone lengthening procedures.
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Relieving Pressure on Joints - In some cases of osteoarthritis, osteotomy can help redistribute pressure away from the damaged area of the joint, potentially delaying the need for joint replacement surgery.
Benefits of Osteotomy
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Improved joint alignment: Cuts and reshapes bone to realign joints, reducing stress on diseased areas.
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Significant pain relief: Offloads arthritic or overloaded joint parts to ease discomfort without needing a full replacement.
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Enhanced mobility and function: Restores range of motion and allows return to daily activities and even sports.
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Delays need for joint replacement: Especially in younger, active patients, osteotomy can postpone hip or knee replacement by 10+ years.
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Preserves natural tissue and bone: Retains the patient’s own joint, reducing artificial implant risks.
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Reduces progressive wear and tear: Redistribution of mechanical load slows joint degeneration.
These advantages make osteotomy an excellent choice for suitable patients, particularly younger, active individuals who wish to maintain joint health, stay active, and delay more invasive surgeries.
The Osteotomy Procedure
While the specifics may vary depending on the bone and the reason for the osteotomy operation, here's a general overview of the procedure:
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Anaesthesia - You will be administered general or regional anaesthesia depending on the complexity of the bone-cutting surgery.
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Incision - The surgeon will make an incision to expose the bone.
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Bone Cutting - Using specialised tools, the surgeon will carefully cut the bone at the predetermined location.
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Repositioning and Fixation - The bone fragments will be repositioned in the desired alignment and secured using various methods like screws, plates, or wires.
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Closure -The incision will be closed with sutures or staples.
To know more about surgeries, book an appointment at the best orthopaedic hospital in Gurugram.
Recovery after Osteotomy
Recovery after osteotomy typically involves:
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Hospitalisation - Depending on the complexity of the osteotomy surgery, you might stay in the hospital for a few days.
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Pain Management - Medication will be provided to manage pain and discomfort.
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Physical Therapy - Rehabilitation exercises will be crucial to regain strength, flexibility, and range of motion in the affected area.
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Weight-bearing Restrictions - Initially, you might need to use crutches, a walker, or a wheelchair to limit weight-bearing on the affected bone as it heals.
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Follow-up Appointments - Regular checkups with your doctor will be necessary to monitor progress and ensure proper healing.
Living with an Osteotomy
While recovery can take several weeks or months, most individuals who undergo osteotomy experience significant improvement in their pain, mobility, and overall quality of life. However, it's important to remember that this is a surgical procedure, and long-term follow-up and potential adjustments to the implant hardware might be necessary in some cases. The following are some tips shared by our expert orthopaedic surgeon in Gurgaon:
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Adapt your home environment - Make temporary adjustments to your living space to facilitate your recovery. This could involve raising furniture, installing grab bars in the bathroom, or using a shower chair for increased stability.
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Ergonomics at work - If you've returned to work, discuss ergonomic modifications with your employer to ensure a comfortable and safe work environment that minimises strain on the affected area.
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Nutrition - A balanced diet rich in essential nutrients like calcium, protein, and vitamin D is crucial for bone health and healing. You may also consult our experienced dietitian for personalised dietary guidance.
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Maintain a healthy weight - Excess weight puts additional stress on your joints. Maintaining a healthy weight through a balanced diet and regular exercise can be beneficial in the long term.
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Don't smoke - Smoking can negatively impact bone healing and increase the risk of complications. Quitting smoking is highly recommended, and your doctor can provide support resources if needed.
Risks And Complications Of Osteotomy, Organised by Category
1. Infection
Risk of superficial or deep bone infections (osteomyelitis) at the surgical site or hardware, sometimes arising soon after surgery or even years later; may require antibiotics, drainage, or hardware removal.
2. Blood Clots (DVT) & Pulmonary Embolism
Post-operative immobility increases the risk of deep-vein thrombosis, which can progress to life-threatening pulmonary embolism.
3. Nonunion/Delayed Union & Malunion
The bone may fail to heal (nonunion) or heal improperly (delayed union), sometimes requiring additional surgery or bone grafting.
4. Nerve or Blood Vessel Damage
Rare but possible injury during the procedure can lead to numbness, tingling, or weakness, particularly affecting the peroneal or cutaneous nerves.
5. Hardware Complications & Alignment Issues
Fixation devices (plates/screws) can loosen, break, or cause pain; alignment may be over- or under-corrected, necessitating revision.
6. Stiffness & Reduced Mobility
Postoperative joint stiffness is common; inadequate physical therapy can prolong this issue.
7. Compartment Syndrome
Extremely rare but serious: swelling inside muscle compartments restricts circulation, risking tissue damage—requires immediate treatment.
8. Specific to Jaw Osteotomy
Inferior alveolar nerve damage leading to lip numbness (33–85%), “bad splits” during surgery (≈0.7%), bleeding, infection, and in severe cases, vision or hearing issues.
9. Intraoperative Fractures
For knee osteotomies, lateral hinge fractures occur in ~9%, and peroneal nerve injury in ~3%.
While osteotomy offers long-term benefits, like pain relief and delayed joint replacement, it carries notable risks. Preventive strategies like antibiotics, blood thinners, compression therapy, meticulous surgical planning, and comprehensive physical therapy significantly reduce complications. Choose our experienced orthopaedic surgeons in Gurgaon and follow postoperative care closely to optimise outcomes.
Conclusion
Book an appointment with our experienced orthopaedic surgeon for timely diagnosis of bone-related disorders and treatment to avoid further complications. Keep coming back to our official blog page to read the latest blogs shared by our doctors.
FAQ's
Yes. Osteotomy, which cuts and realigns bone, typically causes significant pain and swelling post-operatively. Pain is most pronounced in the first six weeks during weight-bearing restrictions and gradually improves over the next few months.
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Osteotomy: Involves cutting and realigning bone, often with fixation devices, to correct deformity or redistribute load.
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Ostectomy: Involves removing bone tissue entirely, often to clear space or alleviate overgrowth.
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Pre-operative tests: Blood work, chest X-ray, ECG, urinalysis, and detailed imaging (X-ray/CT) for surgical planning.
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Medical optimisation: Manage diabetes, stop or adjust medications, and improve overall general health.
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Logistics: Arrange crutches, elevated seating, home assistance, and plan for physical therapy support.
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0–6 weeks: Use crutches; no weight-bearing, daily pain rising and falling, swelling; wound monitoring.
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6–12 weeks: Begin gradual weight-bearing, taper off mobility aids, and increase physical therapy.
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3–6 months: Most patients resume favourite activities; full recovery may take up to a year.
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