When knee pain arises from uneven alignment rather than widespread arthritis, a knee osteotomy can offer lasting relief by realigning the joint and shifting weight away from damaged areas. This joint-preserving surgery is especially valuable for younger or active patients who wish to maintain natural knee function and delay total knee replacement. Dr Sumit Karak, an expert Orthopaedic Surgeon skilled in Joint Replacement, Arthroscopy, and Complex Trauma, applies precision-guided osteotomy techniques to restore balance, reduce discomfort, and promote long-term joint health.

Why Choose Knee Osteotomy?

While total knee replacement replaces damaged cartilage uniformly, osteotomy reshapes and reorients bone to correct alignment. Benefits include:

• Preservation of native cartilage and bone, delaying the need for joint replacement.
• Targeted pain relief is achieved by offloading stress from the worn compartment.
• Higher activity returns, allowing patients to maintain sports or labour-intensive work.
• Extended joint longevity since proper alignment slows arthritis progression.

Ideal candidates are under 60, have pain confined to one side of the knee (unicompartmental arthritis), and possess adequate bone quality.

Preoperative Evaluation

A thorough assessment ensures personalized treatment:

• Clinical Examination: Gait analysis, ligament stability, and range of motion testing reveal functional deficits.
• Weight-Bearing X-Rays: Show the extent of malalignment and cartilage wear under load.
• MRI or CT Scans: Identify cartilage health, meniscal tears, and ligament injuries.
• 3D Planning Software: Models precise correction angles, guiding Dr Karak’s osteotomy cuts for optimal realignment.

High Tibial Osteotomy (HTO)

HTO addresses varus deformity (bow-legged alignment) by adjusting the tibia:

• Open-Wedge Technique: A controlled cut opens the medial side of the tibia, inserting a wedge-shaped bone graft or spacer to shift weight laterally away from the worn inner compartment.
• Closed-Wedge Technique: A small triangular section of bone is removed on the lateral side, and then the tibia is closed and fixed in place.

Dr Karak secures the bone with contoured plates and screws that promote stability and healing. The choice between an open or closed wedge depends on the patient's anatomy and bone quality.

Distal Femoral Osteotomy (DFO)

For valgus deformity (knock-knee alignment), DFO realigns the femur:

• A cut is made above the knee joint on the distal femur.
• The bone is shifted to correct the angle, moving the load toward healthier cartilage compartments.
• Internal fixation with locking plates ensures secure healing.

DFO is especially useful when arthritis affects the lateral compartment, or persistent lateral knee pain undermines function.

Combined Osteotomies and Arthroscopic Assistance

In some cases, both the tibia and femur require adjustment. Dr Karak expertly plans staged or simultaneous HTO and DFO to achieve ideal alignment. Additionally, arthroscopic techniques can address accompanying issues:

• Meniscal Repair or Trimming: Protects or removes torn meniscus tissue contributing to pain.
• Cartilage Debridement or Microfracture: Stimulates cartilage healing in localized defects.

Recovery and Rehabilitation

Recovery after knee osteotomy focuses on controlled mobility and gradual strengthening:

• Hospital Stay: Usually 1–2 days.
• Weight-Bearing Protocol: Partial weight-bearing with crutches begins immediately, progressing to full weight-bearing over 6–8 weeks as guided by X-ray evidence of healing.
• Physical Therapy: Starts in the first week and focuses on a range of motion, quadriceps activation, and hamstring flexibility.
• Long-Term Conditioning: Balance training, low-impact cardio, and muscle endurance exercises support joint longevity.

Most patients return to recreational sports by 6–9 months, with reduced pain and improved function.

Risks and Management

As with any surgery, osteotomy carries risks. However, meticulous technique and patient selection minimize complications:

• Non-Union or Delayed Union: Managed with bone stimulators or secondary grafting.
• Infection: Prevented by perioperative antibiotics and sterile surgical environments.
• Hardware Discomfort: Plates can be removed once bone healing is complete.
• Over- or Under-Correction: 3D planning and intraoperative imaging reduce misalignment, and minor revisions can address residual deformity.

Dr Karak’s extensive experience in complex trauma and reconstructive procedures ensures high success rates and swift complication resolution.

Success Stories and Long-Term Outcomes

• Significant pain reduction: Patients often experience relief soon after they begin weight-bearing.
• Natural gait restoration: Improved alignment helps restore stable walking patterns and boost confidence.
• Joint longevity: Osteotomy can delay the need for total knee replacement by 10–15 years.

Real-life examples include athletes returning to competitive sports and labourers resuming active work without limitations.

Embracing Joint Preservation

Knee osteotomy represents a proactive, joint-preserving strategy for younger patients with targeted arthritis or malalignment. By correcting the root cause—uneven load distribution—Dr Sumit Karak helps you reclaim pain-free movement and maintain an active lifestyle without rushing into joint replacement.

Schedule a consultation with Dr Sumit Karak today to see if knee osteotomy suits you.