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Some patients may present with early onset wear and tear arthritis which has resulted from previous limb injury or having an underlying limb malalignment (excessively bow-legged or knock-kneed) which has resulted in accelerated wear within one knee compartment. Very often these patients are too young or their demands are too great for knee replacement surgery. Their symptoms may be identical to those with advanced arthritis, complaining of pain, stiffness and loss of function. In those patients who have had a previous ligamentous injury to the knee, they may complain of the knee "giving way".
Your surgeon will undertake a detailed history and examination before sending you for x-rays of the entire lower limb (called "long-leg alignment views"). The reason for carrying out this investigation is to chart the alignment of your limb and map your "weight-bearing axis". If for example you are rather bow-legged and you have arthritis on the inner side of your knee, you may be suitable for a limb straightening procedure (osteotomy) to offload the painful part of the knee.
The operation will take roughly two hours. Most commonly, the bone that will require straightening is the tibia (shin bone). Normally, two cuts are made in the proximal tibia (upper shin bone) and the leg is gradually straightened. X-rays are taken throughout the procedure to image the straightening procedure. When the limb has been straightened, the osteotomy (cut bone) is held securely in its new position with a strong plate and screws.
You will require 2-3 days in hospital following the procedure. Your weight bearing will be restricted for up to 6 weeks although you will generally be able to partially weight bear (50% of your body weight) through the operated limb straight away. You will need to use crutches during this time. You will be carefully followed up in the outpatient clinic and will require x-rays to monitor the bone healing at the osteotomy site (where the bone was cut).
A. It normally takes a minimum of 3 months to improve your gait, strength, fitness and movement enough to get back to normal following the operation.
A. The leg alignment will look different forever following the surgery. The muscle bulk and tone will be reduced and take some time to rehabilitate.
A. No. The knee joint is not altered during the surgery. The alignment and consequent loads going through the worn areas of the knee joint are changed. As a result of offloading the worn area the gristle lining the bones can regenerate (grow back).