Osteotomy Surgeries
Osteotomy is a surgical intervention designed to alleviate stress on a damaged joint by reshaping and repositioning a bone near the affected area. Often recommended as part of osteoarthritis therapy, this procedure aims to redistribute weight away from damaged cartilage towards healthier regions. For instance, in knee osteoarthritis, where cartilage damage is typically more severe on the inner side of the joint, osteotomy involves removing bone from the outer side of the tibia to realign weight distribution towards healthier cartilage and away from the damaged area.
Primarily performed on younger, more active patients seeking to delay joint replacement, recovery from osteotomy varies based on the surgery’s extent and the patient’s overall health and strength. Immobilization with a cast or splint may be necessary initially to restrict joint movement. Physical therapy typically commences soon after the procedure to aid in rehabilitation.
Why is an osteotomy performed?
Your surgeon may perform an osteotomy to:
- Adjust the angle, bowing, or rotation of bones.
- Correct the alignment of a misaligned or unjoined joint.
- Shorten or lengthen bones.
- Address a damaged joint.
- Redistribute weight from a damaged area of a joint to a region with healthier cartilage.
- Alleviate pain caused by osteoarthritis, particularly in the knee and hip.
- Postpone the necessity for joint replacement surgery in younger, active individuals.
- Address or rectify other specific bone issues.
How do I prepare for an osteotomy?
Your surgeon may request routine tests to assess your overall health, including:
- Blood tests to evaluate levels of certain components and organ function.
- Urine tests to detect any issues affecting bone healing, such as infection or diabetes, and to assess general health.
- Electrocardiogram to evaluate the electrical activity of your heart.
- Chest X-ray to ensure proper lung function prior to surgery.
- X-rays or computed tomography (CT) scans to visualize your bones and joints, aiding in surgical planning. This allows the surgeon to determine precise dimensions and angles for bone section removal. In some cases, a computer-generated 3D model may be utilized for surgical planning.
The main types of spinal osteotomy procedures
- Posterior column osteotomy addresses inward arching of the lower back (lordosis) and forward curvature of the upper spine (kyphosis). Ponte osteotomy, a specific technique, targets kyphosis correction.
- Smith-Petersen osteotomy corrects lordosis by removing a bone section from the back of the spine, allowing the spine to tilt backward.
- Pedicle subtraction osteotomy tackles severe lordosis in the lower spine by arching it less aggressively.
- Bone-disk-bone osteotomy addresses spine issues above and below a disk by removing the disk and adjacent endplates.
- Vertebral column resection involves complete removal of one or more vertebrae for significant correction. Fusion of the spine area is necessary using grafts or metal cages due to the extensive bone removal.