Knee realignment surgery
Knee realignment surgery (correction of knee malalignment – varus/valgus knee)- high tibial osteotomy, distal femoral osteotomy, tibial tuberosity transfer
If the normal mechanical axis of the knee is disturbed (such as in knock knee-genu valgum, bow leggedness-genu varum or patella malalignment) the weight bearing is unevenly distributed within the joint and early degenerative changes might develop. To prevent that or to treat the painful joint correction of the knee malalignment might be necessary. Depending on the type of the malalignment a wedge of bone might be excised or may be inserted into the most affected bone around the knee. In case of bow leggedness usually high tibial osteotomy is performed. If knock knee is present the correction is performed on the distal femur. Abnormal position of the patella might also cause pain or instability in the patellofemoral joint therefore the tibial tuberosity might be transferred and so the alignment of the structures holding the patella in place is corrected. These surgeries usually involve cutting through the bone and the parts have to be fixed using plates, screws or staples. After surgery mobilization will start in the bed the same day and the first day the patients are allowed to get up and walk using walking aids with non-weight bearing or partial-weight bearing technique. In certain cases knee brace is applied to restrict certain motions and to support the freshly operated knee. Continuous passive motion might be useful in the recovery.
The healing is regularly assessed with x-ray and once healing is achieved full weight bearing is allowed. Once thebony surfaces are healed the fixation instruments implanted (screws, plates) do not serve a function anymore. If the patient has any complaint due to the implants, they can be removed with a small surgical procedure.