Osteotomy is a surgical procedure where a bone is cut and realigned or repositioned to improve the forces going through the area.
Page updated September 2023 by Dr Sheila Strover (Clinical Editor)

Planning software with full-length weight-bearing X-rays allows pre-operative calculation of the required amount of wedge correction in the tibia in mm.

Laminar spreaders open the wedge of a high tibial osteotomy, and then the bone is held in the new position with a plate and screws until new bone fills the gap.

Strong metal or carbon fibre plates and screws are used fix the bones in the new position, until new bone heals the defect, after which time the surgeon and patient may elect to remove the plate.
When is an osteotomy indicated?
Osteotomies may be performed when a poor alignment of the joint results in limb deformity or pain, or to decrease the forces going through a vulnerable area such as the meniscus in the knee, but may also be done to improve the cosmetic appearance of a limb or joint.
Common osteotomy procedures in the knee
Common osteotomy procedures relating to the knee include -
- high tibial osteotomy
- distal femoral osteotomy
- tibial tubercle osteotomy
- derotation osteotomy
Peer-reviewed papers
- Distal/Medial TTT, MPFL, and Distal Femoral Osteotomy 6/13/11
Complex surgery - with loads of support from forum readers.
Forum discussions
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Osteotomy Around the Knee: The Surgical Treatment of Osteoarthritis
: Peng H, Ou A, Huang X, Wang C, Wang L, Yu T, Zhang Y, Zhang Y. Osteotomy Around the Knee: The Surgical Treatment of Osteoarthritis. Orthop Surg. 2021 Jul;13(5):1465-1473. doi: 10.1111/os.13021. Epub 2021 Jun 10. PMID: 34110088; PMCID: PMC8313165.Citation
Quote: Osteotomy..."is an effective treatment for knee osteoarthritis and has unique advantages compared to knee arthroplasty. Knee arthroplasty is at a high risk of postoperative infection. What's worse, younger patients who have had the replacement may need repeated revisional surgery afterwards. Osteotomy is easily operated, low‐risk, and almost all cases obtain rapid recovery after surgery, which is comparable to arthroplasty.
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