The knee joint is formed by the lower end of the femur (thigh bone) and the upper end of the tibia (shin bone). The surfaces of the joint are covered by a smooth elastic tissue called cartilage. The cartilage allows the joint surfaces to glide smoothly and painlessly against each other. Damage to the cartilage and bone within the knee joint is called osteoarthritis. This can result from degeneration (wear and tear) or trauma (fractures and ligament injuries).
Patients who develop osteoarthritis of the knee joint can present with pain, stiffness, joint deformity and limping. This can sometimes be severe enough to affect daily mobility and one’s quality of life. The diagnosis of knee osteoarthritis is made after a thorough clinical assessment of the knee joint. X-rays and MRI scans are done to confirm the diagnosis.
Patients with early osteoarthritis and mild symptoms may be treated non-surgically with a course of rehabilitation. However, patients with severe symptoms and advanced osteoarthritis are candidates for surgical treatment. In particular, patients who are relatively young and physically active may benefit from joint preservation surgery in the form of knee osteotomy.
Knee osteotomy (or bone-reshaping surgery) is used to improve the overall alignment and shape of the knee. This is useful in patients who have osteoarthritis mainly affecting one compartment of the knee that is associated with deformity or bowing of the knee. (See Figures below) Such surgery is usually performed under general anaesthesia and may take about 2 hours to perform. A 1-2 stay in hospital is usually required after the surgery and 4-6 weeks of crutch-assisted ambulation may be advised.
The rehabilitation process after the surgery is generally supervised by a physiotherapist, and consists of progressive range of motion exercises, muscle strengthening exercises, and functional therapy. The whole rehabilitation process may last to 3-6 months following the procedure. The success rate of knee osteotomy surgery has been reported to be about 80-90%. The complications of this procedure include infection, damage to the blood vessels and nerves around the knee, and progression of the osteoarthritis in the knee.
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