What is limb realignment?
Limb realignment is a group of surgical procedures, also known as osteotomies, that re-orient and re-direct weight bearing forces through the knee.
What are osteotomies used for in the knee?
The most common reason for an osteotomy is arthritis of the knee that is limited to a single area or compartment. This usually occurs because of a severe bow-legged or knock-kneed shape to the knees. Because the other parts of the knee remain healthy, an osteotomy can be used to direct most of the body weight through this area, avoiding the pressure across the arthritic part of the knee and the resultant pain. Other reasons osteotomies can be used include cartilage restoration procedures and realignment after a malunion (abnormal healing position) of a fracture.
How is an osteotomy done?
After careful calculation of the weight bearing axis of the limb and the deformity of the knee, either the tibia (shin bone) or femur (thigh bone) is cut to realign the limb to the desired position. The osteotomy is then held still with a combination of plates, screws, and bone graft.
What is the recovery like?
Osteotomies around the knee are major surgeries. It is done in the hospital, and most patients stay overnight and are out of work for about a week or two. Weight bearing and activity will be limited for the first 6 weeks to allow the osteotomy site to heal, however, immediate motion of the knee will be started in therapy. Most patients begin full weight bearing on the limb by 6-8 weeks, and full recovery can be expected by 4 months.
How do I know if I am a candidate for limb realigment/osteotomy?
Because osteotomies are used to treat different problems in the knee, there is no single sign or symptom that might suggest you are a candidate. Often patients have abnormal alignment of the knee; however, an abnormality of alignment in the absence of symptoms does not require surgery. Consultation and examination by an orthopedist experienced in limb realignment surgery, in addition to full-length, weight bearing x-rays of both legs, will be very educational and help with your decision on the right treatment for your problem.
For more information, please visit the following links:
AAOS Orthoinfo osteotomies of the knee