With each step, forces equivalent to three to seven times your body weight travel between your thigh bone (femur) and shin bone (tibia) in your knee. These forces are diminished by a meniscus on the inward and outward portion of the knee, and the ends of the bones are secured by articular cartilage. Patients with a condition called as osteoarthritis, or also known as degenerative arthritis, experience a consecutive wearing on the menisci and articular cartilage. These degenerative processes limit the capability of the knee to glide effortlessly and can result in popping, locking, clicking and aching.
In a condition called malalignment, unbalanced forces cause extreme pressure on either in the internal (medial) or external (lateral) portion of the knee. Degenerative arthritis and malalignment can cause the knee’s defensive tissues to wear on one side more than the other in a dreary cycle of injury. A partial or total knee replacement can exact this condition when joint injury is beyond repair. In certain cases, however, a method known as osteotomy can realign the knee, taking pressure off the injured side. A procedure known as high Tibial osteotomy wedges, open the upper shin bone (tibia) to reconfigure the knee joint. The weight-bearing part of the knee is shifted from degenerative or damaged tissue onto improved tissue.
A high tibial osteotomy is usually considered a method of extending the time before a knee replacement is essential because the benefits usually fade after seven to ten years. This procedure is usually reserved for younger patients with pain resulting from shakiness and malalignment. An osteotomy may also be executed in conjunction with other joint protection procedures in order to permit for cartilage repair tissue to grow without being exposed to excessive pressure.
Purpose of procedure:
There are two main reasons to execute high tibial osteotomy. For patients with medial section arthritis and a varus knee, its resolution is to provide years of relief former to knee replacement. This is particularly vital in patients too young to be ideal candidates for knee replacement. The other reason it is done to spot-on malalignment in patients undergoing another process such as Cartilage implantation. In these patients the HTO is performed to guard the cartilage replacement from catastrophe due to too many compressive forces on the graft.
Valgus knee and distal femoral osteotomy (DFO)
Several patients instead of being bowlegged (varus deformity), are knock-kneed or have a valgus knee malformation. To spot-on this problem, distal femoral osteotomy can be achieved. This is similar to the HTO, but instead of cutting and adjusting the tibia, the femur, or bone in the upper leg is cut in its place. This process is infrequent than HTO, but the surgical process, post-operative course, threats and benefits, and outcome is alike.
The technique is performed in a hospital with the patient going home the morning after operation. The tibia or shinbone is cut and straighten out. In many process they insert pins above and below the bone cut. Then a device called an external fixator is used to join these pins. The patient turns a small crank at home to moderately, painlessly and gradually straighten the tibia. X-rays are taken in the clinic during the initial one to three weeks that the patient wears the fixator. These X-rays are used to make sure that the knee is accurately aligned to the desired outline. Once suitable alignment is achieved, the fixator is protected and the bone is allowed to rebuild. During the healing age, patients can normally progress their actions as tolerated. At about three to four months, healing is usually complete enough to eliminate the fixator and the metal pins. This is done under a brief general anesthetic in the operating room.