Osteotomy & Joint Preservation

Realigning the Knee, Protecting Your Future

For some patients, knee pain and early wear are driven not by a single injury but by how load is distributed across the joint - often due to bow-legged (varus) or knock-kneed (valgus) alignment. Joint preservation surgery, including osteotomy, aims to correct this and redistribute load away from a damaged or worn area of the joint.

Dr Adam Farrier is a consultant knee surgeon offering osteotomy and knee joint preservation surgery for patients in Carlisle and across Cumbria, including West Cumberland (Whitehaven), and in Newcastle upon Tyne and the North East.

Is Osteotomy Right for You?

Osteotomy is typically considered for younger, active patients with early to moderate wear localised to one side of the knee, particularly where malalignment is contributing to the problem. It is not usually suitable for widespread, advanced arthritis affecting the whole joint, where joint replacement may be a more appropriate option.

The Procedure

Osteotomy involves carefully cutting and realigning the shin bone (or occasionally the thigh bone) to shift the mechanical axis of the leg, redistributing weight-bearing load away from the worn part of the knee and onto healthier cartilage. The bone is then held in its new position with a plate and screws while it heals, a process that typically takes several months.

The Benefits of Joint Preservation

• Redistributing Load: Correcting alignment shifts pressure away from damaged cartilage, which can significantly reduce pain in the affected compartment of the knee.

• Preserving Your Own Joint: Osteotomy aims to delay or avoid the need for joint replacement, which can be particularly valuable for younger, active patients.

• Maintaining an Active Lifestyle: Unlike joint replacement, osteotomy generally has no restrictions on high-impact activity once fully healed.

• Buying Time: For many patients, osteotomy provides years of improved function, potentially delaying joint replacement until an age where it is more appropriate.

Important Considerations & Risks

• Longer Recovery than Arthroscopic Surgery: Bone healing takes time, and weight-bearing is typically restricted for several weeks while the osteotomy consolidates.

• Hardware: The plate and screws used to hold the correction sometimes cause local irritation and may need removal once healing is complete.

• Not a Permanent Solution for All: Depending on the progression of any underlying arthritis, some patients may still require joint replacement later in life.

Frequently Asked Questions

How do I know if I need an osteotomy or a joint replacement?

This depends on your age, activity level, and the pattern and severity of wear in your knee, assessed through examination and weight-bearing X-rays. This will be discussed with you in detail before any decision is made.

How long does it take to recover?

Most patients are on crutches for around 6 weeks while the bone heals, with a gradual return to full activity over several months guided by X-ray healing and physiotherapy progress.

Will I need further surgery later?

Some patients eventually go on to joint replacement years later, but many gain substantial, lasting benefit from osteotomy alone, particularly when performed at the right stage.

Dr Farrier's Note

"Joint preservation surgery is about playing the long game - giving younger patients more good years with their own knee before joint replacement becomes necessary. Getting the timing and the correction right is what makes the difference."