Osteotomy Surgery Causes, Diagnosis and Symptoms

Osteotomy surgery is a specific orthopedic operation intended for correcting bone abnormalities, alleviating arthritis-related joint discomfort, and restoring normal alignment in musculoskeletal disorders. The term “osteotomy” translates to “cutting of the bone.” In this osteotomy surgery, the surgeon shapes and removes bone to correct the misaligned joints and/or remove the associated pressure due to the misalignment.  

This surgical technique is more commonly applied to the knee, hip, spine, and jaw, where it surgically aids in the early-stage osteoarthritis, bowlegged or knock-knee deformities, and hip dysplasia. Unlike replacement surgeries, osteotomy surgery is done mostly to preserve the natural joint and post-operatively delay or avoid the need for a prosthetic implant.  

For patients with chronic joint pain and reduced mobility, osteotomy surgery offers a possible life-altering option by significantly improving functionality and relief.  

Why Choose Osteotomy Surgery?  

1. Joint Preservation  

Osteotomy surgery has its advantages over joint replacement, especially for younger, active patients. This osteotomy surgery helps bone misalignment which subsequently preserves the natural joint structure providing greater motion and durability of the results.

2. Pain Relief  

Patients undergo osteotomy surgery to relieve chronic joint pain experienced as a result of uneven force on the cartilage. During the procedure, bone realignment will help redistribute weight and relieve stress, which leads to a substantial reduction in discomfort and pain.  

3. Delaying Joint Replacement  

In patients with early-stage osteoarthritis or hip dysplasia, osteotomy surgery serves as an intermediary step prior to joint replacement, alleviating the need for a more invasive procedure until absolutely necessary. This is particularly advantageous in younger patients who would otherwise need to rely on an artificial joint for mobility.  

4. Improved Mobility And Quality Of Life  

Post-operative patients can expect greater ease in performing everyday activities, including walking and standing with improved joint function, posture, and balance. As a result, these individuals can lead much more active lives, requiring less pain management, and no longer needing mobility aids.

Signs for Consideration in Osteotomy Surgery  

Being aware of the signs which suggest the possibility of osteotomy surgery are crucial for proactive measures. Osteotomy surgery has symptoms such as: 

• Painful joints during movement or while stationary  
• Deformity of the leg and joints (for instance, knock knees and bowlegs).  
• Reduced flexion in the afflicted joint.  
• Stiffness and swelling in the joints post physical exertion, more so in the hypermobile joints.  
• Imbalance in bearing weight while walking or standing.  

Gait changes and limping.  

Osteotomy surgery may be considered after detailed assessment and thoughtful evaluation if these symptoms are exisiting along with significant disruption in routine, even with conservative management.  

Reasons Indicative for Osteotomy Surgery  

Lifestyle habits combined with several medical conditions may cause osteotomy surgery due to bone deformities. These include:  

1. Osteoarthritis :- These are chronic conditions where the cartilage of the joints undergoes gradual damage. This leads to uneven distribution of joint load in specific joints, including hips and knees .It is important to perform osteotomy to adjust the joints as well as slow down the advancement of the disease.
2. Congenital bone deformities :- Bone deformities like knock knees, bowleggedness, and hip dysplasia can be progressive as a patient ages. Therefore, it requires immediate surgical intervention as it conservative nature management fails.
3. Post-Traumatic Injuries :- Limb misalignment can occur as a result of progressive fractures or joint dislocations, which are osteopathic injuries. Realignment of the bone and restoration of function can be achieved via an osteotomy.
4. Overuse and Occupational Stress :- Sustained and overly repetitive actions are characteristic of many occupations and may lead to permanent changes to the upper and lower body, especially the knees. Correction of the biomechanical imbalance is achieved through osteotomy.

Diagnosis for Osteotomy Surgery  

An accurate diagnosis is crucial when planning an osteotomy. Orthopedic specialists often combine clinical evaluation and imaging to decide which patients are candidates for osteotomy surgery.  

1. Physical Examination  

• The clinician evaluates:  
• Joint and movement patterns  
• Joints and their values of motion  
• Gait and weight bearing activities   
• Alignment evaluating through looking at limbs  

2. Imaging Tests  

• Radiographs for evaluating bone and joint spaces for X-ray visualized gaps.  
• MRI or CT scan for evaluation of the cartilage and other soft-tissue structures.  
• Static and dynamic evaluations of pressure distribution in weight-bearing X-rays.  

3. Patient history  

A comprehensive understanding of the patient’s medical history, symptoms and associated factors along with their lifestyle is paramount before surgical recommendations.

Osteotomy Surgery Treatment Plan  

Following a diagnosis that justifies osteotomy, it is essential to define a treatment plan that typically consists of:  

• Preoperative Preparation  
• Imaging and surgical 3D modeling planning  
• Assessment of Nutrition and Fitness  
• Preoperative physiotherapy in select cases  

Surgical Procedure  

Most osteotomy surgery are performed under general or spinal anesthesia. The surgeon performs a bone cut, removes a section or repositions it, then secures it with plates, screws, or rods, based on the required alignment. Types of osteotomy surgery include:  

• High Tibial Osteotomy (HTO): Common for knee misalignment
• Femoral Osteotomy: Often used in hip dysplasia
• Pelvic Osteotomy: Used in severe hip disorders
• Spinal Osteotomy: For scoliosis or kyphosis correction
• Mandibular or Maxillary Osteotomy: Jaw alignment surgeries  

Postoperative Care  

• 2-4 days hospitalization depending on the complexity of the case
• Crutches or braces prescribed to limit weight bearing
• Medications for pain management
• Physical therapy aimed at mobility restoration

In total, full recovery may take 3-6 months depending on the site and extent of surgery.  

Conclusion

The aim of osteotomy surgery goes beyond correction; it takes a more proactive approach for long-term preservation of the joints and overall musculoskeletal health. Most suitable for the young or physically active people, the procedure provides a potential substitute to joint replacement by dealing with the underlying issue of misalignment and stress on the joint.

Through more bone realignment, equal and balanced weight bearing over the joint surface, osteotomy surgery reduces pain with improved range of motion and also delays degenerative changes. Congenital deformities, injuries, and chronic overuse arthritis all can lead to loss of mobility and quality of life; osteotomy surgery helps restore hope and agility.