Early osteoarthritis, injury and bio mechanical abnormalities can cause increased pressure and load on one side of the knee more than the other causing pain and limitation of function. This alignment abnormality can lead to increasing wear of that side of the joint and ultimately osteoarthritis. Before the knee is consigned to a joint replacement there may be an opportunity to halt or slow down the arthritis or stop the mechanical overload before it causes arthritis. This involves an operation called an osteotomy to realign the bone, either shin bone (High Tibial Osteotomy- HTO) or thigh bone (Distal Femoral Osteotomy DFO), in a controlled manner and changing the shape of the bone to alter the alignment (plumb line) of the leg.

This surgery has the potential to reduce/remove the pain from the mechanical overload and arthritis and is often a recommended treatment for patients who have high demands on an arthritic (early or moderate) knee due to sports or heavy manual occupations.

As the bone must heal following osteotomy it is important to maintain a good blood supply to the bone, smoking is a well recognised negative factor for bone healing and it is important that patients stop smoking before their surgery if possible to reduce the risk of a slow or non healing osteotomy.

The objective of the surgery is to correct the plumb line of the leg, any restriction to the bend or straightening of the leg is harder to overcome as the arthritic joint is not removed (as it would be in a replacement) and therefore careful patient selection for this surgery is vital to avoid disappointment in the results.