Osteotomy: Know About the Procedure & Recovery

Orthopedics & Joint Replacement | by Dr. Ananda Mandal | Published on 02/02/2023

About Osteotomy :

Osteotomy is a surgical operation to reshape or re-align a bone. The surgeon can perform osteotomy on bones all over the body (jaw, legs, spine, shoulder, etc.), depending on the purpose or type of disease.  Osteotomy benefits patients seeking treatment for excessive angulation of long bones, joint mal-alignment due to bone deformities, arthritis, etc.

If you are looking to undergo an osteotomy procedure, this blog can provide a reference to help you prepare for the surgery. However, the importance of a doctor’s consultation cannot be replaced and you must seek medical assistance to analyze the risks and benefits of the procedure.

Different Types Of Osteotomy:

The surgeon may perform different types of osteotomies depending on the requirement and location of defects. Different joints where the surgeon can perform osteotomy include -

• Hip: The surgeon reshapes the hip socket so to cover the ball of your hip joint.
• Knee: A deformed kneecap can be extremely painful. Moreover, arthritis can make it worse. Knee osteotomy involves cutting and reshaping either tibia (upper shinbone) or femur (lower thighbone) to reduce the pressure on the damaged knee joint.
• Spine: The surgeon removes a wedge-shaped piece of bone from a section of the spine to correct a swayback or reduce a hunchback.
• Jaw: A mandibular (lower jaw) osteotomy realigns the lower jaw into a new position. Jaws that don’t line up with the bite of their teeth can be corrected through this procedure.
• Big toe: The surgeon removes a segment of bone from the big toe to straighten it and prevent it from jamming into the other toes.
• Chin: This procedure is done to narrow a broad or square chin.

 

 

 

Name of the Joint	Type of Osteotomy
Jaw	Mandibular osteotomy Maxillary osteotomy LeFort osteotomy Sagittal split osteotomy
Spine	Posterior column osteotomy Smith-Petersen osteotomy Pedicle subtraction osteotomy Bone-disk-bone osteotomy Vertebral column resection
Elbow	French Osteotomy
Chin	Osteotomy of the Chin
Knee	Tibial osteotomy High tibial osteotomy Fulkerson osteotomy
Hip	McMurry osteotomy Pauwels osteotomy Salter’s osteotomy Periacetabular osteotomy Femoral osteotomy Chiari’s osteotomy

 

Osteotomy: How To Prepare For The Surgery?

Osteotomy surgery can be a major procedure that usually requires comprehensive diagnostic tests to identify the locations and degree of damage. The doctor usually performs a physical examination and analyzes the severity of the symptoms. Further, there may be some diagnostic tests like x-ray imaging, CT-scan, blood tests, etc. to identify the affected bone and check for blood clots. After the doctor is convinced of surgical intervention, the hospital provides pre-surgery instructions to help you prepare for the procedure -

• Discuss your history of medical conditions and surgeries with the doctor
• Stop smoking and consuming alcohol a week before the surgery as they can increase the recovery time
• Inform your doctor in case you have a history of bleeding disorders
• Wear loose-fitting and comfortable clothes which do not put pressure on the surgical site
• Do not eat or drink anything the night before the surgery. It is generally recommended to not take any meal after midnight.
• Inform your doctor of any ongoing medications and history of an allergic reaction to anesthesia to avoid complications during the surgery
• Take the prescribed medications, if any, before the surgery as directed by the physician

What Happens During Osteotomy?

Osteotomy is a major procedure depending on the area of deformity. For minor procedures such as on the toes, the patient is given local anesthesia before the surgery. The patient does not feel any pain or discomfort during the surgery.

During the procedure, the surgeon makes a small cut in the skin to expose the affected bone. Special guide wires are used to measure the bone. The surgeon, then, carefully takes reshapes or realigns the natural bone using a special surgical saw. Sometimes, if necessary, the surgeon may place implants or bone grafts to restructure the bones.

Finally, the bones are held in position using screws and metal plates which are removed once the bones are healed. In case the bones do not heal, they may be placed permanently. Finally, the incision is closed using surgical sutures and the patient is sent to the recovery room.

Recovery After Osteotomy:

After the procedure, the patient is sent to the recovery room to check the progress. The recovery period may vary depending on the type of procedure and the severity of the condition. Initially, the surgical site may be very sore. Therefore, the doctor recommends not putting any pressure on it after the procedure.

The doctor may recommend several post-surgery tips for a smooth recovery. This includes consulting a physical therapist to strengthen the leg muscles and regain your balance over time. There are also certain restrictions associated with eating in case of jaw osteotomy.

Furthermore, the doctor can also suggest certain medications and dietary restrictions to avoid the risk of obesity. A high body mass index (BMI) usually extends the recovery period. Smoking or consuming alcohol also increases the risk of complications and must be avoided.

FAQs:

1. Are there any complications of the surgery?

2. What is a tibial osteotomy?

Tibial osteotomy is done on patients with bone deformity in the knees. The surgeon corrects the bowlegged alignment which puts excessive stress and pressure on the knee.

3. What is a tibial tubercle osteotomy?

Tibial tubercle osteotomy is a surgical procedure to treat bone deformity in the knees. The procedure is usually performed subsequently with other procedures to treat patellar instability, patellofemoral pain, and osteoarthritis.

4. What is a Fulkerson osteotomy?

Fulkerson osteotomy is a specific technique that involves removing a part of your tibial tubercle. The procedure is done to take the pressure off your kneecap and prevent dislocation by changing the kneecap tendon, attached to the tibia.