Treatment: osteotomy around the knee

Osteoarthritis, genu-varum and genu-valgum: a source of pain in the knee

In osteoarthritis of the knee, the cartilage, one of the structures in your joint, is worn down or destroyed. Pain is its primary symptom. Osteoarthritis is considered a chronic disease because it is very debilitating daily. Indeed, your two knees support your body's weight and allow you to bend, jump, and move forward or backward. When you suffer from femorotibial osteoarthritis, which is the most frequent, a deviation of the mechanical axis is involved.

Genu-varum and genu-valgum are orthostatic pathologies. These articulatory anomalies, called architectural, and specific to each person, are responsible for your pain. Whether your knees bend outward, forming an arc, or whether they turn inward, creating an x, the curvature of your lower limb is abnormal. In both cases, your movements are disrupted, your feet are deformed by poor support, and you damage your cartilage until you develop a form of osteoarthritis, accompanied by the inherent pain.

Why an osteotomy?

Osteotomy, from the Greek words "tomê" and "oste," is the action of cutting the bone. It is a surgical operation that reshapes the bone and thus corrects the axis of your lower limb. This way, the forces within your knee are redistributed, and pain is eliminated. Called "conservative," this surgery preserves your entire joint.

The osteotomy is a customized operation! Before any osteotomy is performed, examinations are conducted to determine the architectural anomalies that characterize you and are responsible for your deformities. Once the bone has been cut, a graft can be added to fill the opening before being fixed in its new position with a plate and screws. Complications are rare. They may occur during surgery in the form of a hematoma or infection.

The operation can generate phlebitis, followed by a pulmonary embolism, or lead to knee stiffness if the rehabilitation is poorly conducted and unpredictably to algodystrophy (continuous pain). Calf pain, fever, or scarring problems would sound the alarm.

After surgery

Once you return home, the osteotomy requires post-operative care and monitoring. It is best to make appointments with the nurse of your choice before the operation. They will be responsible for injecting daily anticoagulants for one month and re-dressing every five days until the wound has healed. After fifteen days, the stitches or staples are removed.

After this initial period of care, you will need to make an appointment with a physical therapist to follow a rehabilitation protocol. You will not be allowed to stand or walk for one month. During this time, your paramedic will work on draining your knee, locking the quadriceps muscle, gradually regaining flexion, and achieving full knee extension. Then, an additional month allows you to resume walking according to a recovery schedule, followed by reeducation at the beginning of the next month.  

Although time-consuming, this surgery is the best way to eliminate knee pain and recover almost all your mobility and muscle strength. It also avoids the need for a prosthesis.