First of all, we should get the information of what Osteotomy actually is.
Cutting and reshaping of either the tibia(shinbone) or the femur(thighbone) to relieve pressure on the knee joint is known as Osteotomy. It is a surgical operation whereby a bone is cut to shorten or lengthen it or to change its alignment and is sometimes performed to correct a hallux valgus, or to straighten a bone that has healed crookedly following a fracture.
Knee Osteotomy is used when a patient has an early-stage osteoarthritis that has damaged just one side of the knee joint. By shifting weight off of the damaged side of the joint, an osteotomy can relieve pain and significantly improve function in an arthritic knee.
Generally, patients will begin walking unaided 8 to 12 weeks post-surgery. A complete recovery can range from 6 months to an entire year. Regardless of the exact timeline, a knee osteotomy recovery and rehabilitation program focuses on pain control, wound healing, protecting the osteotomy, improving flexibility and range of motion, and building muscle strength.Some of the important things that a patient who just had Osteotomy on them should follow are:
- Pain control: Recovery from knee osteotomy surgery is painful. Pain medication will be given in the hospital and prescribed for after discharge. If at any time pain is not being controlled well with medications, patients should talk to their doctor.
- Soft tissue wound healing: While in the hospital, a patient will be taught how to care for the wound once he or she gets home, including changing bandages and bathing. Keeping the wound clean and free of infection is very important.
- Reduce swelling and prevent deep vein thrombosis: In the first two weeks following the surgery, steps must be taken to reduce swelling present in the knee, avoid blood pooling in the leg veins and prevent Deep Vein Thrombosis (sometimes called DVT). The leg should be elevated, and ice packs may be used intermittently to reduce swelling.
- Protecting the osteotomy: Patients will wear a brace to help protect and support the leg. Giving too much weight on the leg too soon after surgery could cause the bone at the osteotomy site to shift, upsetting the knee’s newly corrected alignment. Therefore, it is important for patients to carefully follow their doctors’ instructions. Some osteotomy patients are allowed partial weight bearing soon after surgery. Many other patients are told not to bear any weight on the leg for at least 6 weeks, when an x-ray can confirm the osteotomy is healing well.
- Patients who are told to avoid weight-bearing activity will use crutches, keeping the affected leg completely off the floor. Once partial weight bearing is permitted, a doctor or physical therapist should give specific instructions about how to use crutches and perform exercises without putting too much weight on the leg.
- Improving flexibility and range of motion in the area of surgery. The formation of fibrous scar tissue is part of the healing process, but too much scar tissue can impede the knee’s ability to completely straighten and flex. Scar tissue can also feel uncomfortable and lumpy under the skin. Knee stretching and flexing exercises will help prevent the build-up of scar tissue after surgery.
- Typically, a doctor will want the patient to be able to bend the affected knee to at least a 90-degree angle and fully straighten it within 1 or 2 weeks after surgery. After several weeks of physical therapy, the knee should fully straighten and flex at least 135 degrees.
- Building muscle strength of the place. As swelling decreases and the wound heals, priorities will shift to building muscle strength. Physical therapy will include various leg lifts and slowly integrate more challenging partial- and eventually full-weight bearing exercises, such as squats. Likewise, some patients may use a stationary bicycle, initially doing short rides of 5 to 10 minutes without any resistance and gradually building up to longer rides with some resistance.
- While it may be tempting as the leg improves, patients should avoid any exercise that puts stress on the osteotomy wound without first having medical approval. Doing so may jeopardize the knee’s new alignment of the tibia, femur and patella (knee cap).
- Most patients will still be using crutches and performing leg-straightening exercises at 8 weeks. It may take 3 to 6 months for osteotomy patients to walk normally and regain full range of motion. It may be 12 months or more before patients can participate in high impact activities, such as jogging.