Knee realignment (osteotomy) Q&A

Ask the Consultant

Prof Adrian Wilson is a Consultant Orthopaedic Surgeon specialising in knee realignment surgeryThe minimally invasive technique realigns the knee joint preventing further damage to the worn side. 

Prof Wilson runs a bespoke research team that follows up all of his osteotomy patients, collection of both clinical information and patient reported outcome measures. It is from these ‘results’ that they draw conclusions about their surgery and present their data.

Here we ask Prof Adrian Wilson about the procedure, the benefits and the recovery.

Adrian Wilson

This is a procedure carried out to offload a part of the knee that is damaged and load up the good side. It is a credible alternative, either partly or completely replacing the joint and is especially good in younger, more active patients. 80% of patients with knee replacements are happy but sadly 20% aren't therefore our research has confirmed an overall patient satisfaction score of 8.5/10 on over 1000 patients. This is in line with other outcome studies. 

You can see how an osteotomy procedure works in our animated video.

Adrian Wilson

An Osteotomy procedure is usually carried out for pain relief (90%) and in some instances to make the knee more stable (10%). It is very effective as a treatment for wear and tear arthritis that is confined to one side of the joint. The most common patient is someone who has bowed legs (a bit or a lot) and has had pain on the inside or outside of the knee only. Often the patient will have had a tidy up of the cartilage with key hole surgery which is often only beneficial for a short amount of time.

In some limited cases it can be used to re-tension a ligament or protect a meniscal procedure such as a repair or transplantation. It can also serve to protect the knee after a joint-surface procedure such as cartilage transplantation. The idea is to ‘buy time’ by delaying the need for arthroplasty (knee replacement) surgery for as long as possible. It allows younger, more active patients to continue at far higher activity levels than if they had to have their knee replaced.

Adrian Wilson

First we analyse the limb with special x-rays which are loaded into a software programme and this is used to plan to within a millimetre how much the bone needs to be opened or closed just below or less commonly above the knee. We use specially designed instruments to allow this procedure to be carried out quickly, reproducibly and safely. We have developed techniques to fill the gap created by the osteotomy, allowing for rapid healing, and very small fixation devices, to reduce pain and irritation.

Adrian Wilson

A knee realignment procedure is joint preserving and highly successful in my patients. We follow up every single patient of ours who has had an osteotomy, monitoring pain and function. We have the largest research series in the world and our results are changing the direction of knee surgery on a global scale. Our results, show comparable results for osteotomy when we compare this to partial knee replacement in patients who are age matched and matched in terms of the amount of wear and tear. 

Our unit like many other specialist osteotomy units in Europe have found osteotomy to be life changing for patients with both early wear and tear and bone on bone arthritis. With people living much longer and with a limited life expectancy of a joint replacement we believe everything should be done to preserve the knee and knee function for as long as possible.

Adrian Wilson

Like all major procedures there are of course risks but in our series the risks are less than for say a knee replacement and are overall less than 5% and for serious complications less than 1%. This is based on data on over 1000 cases that our unit has performed (2001-2016).

Adrian Wilson

The recovery time for an osteotomy procedure varies but patients can fully weight bear from day 1 and can usually get back to work by 4-6 weeks. 

Some patients have returned to sport by 12 weeks. 1/3 of all patients report no pain following knee osteotomy with the knee minimally invasive procedure I have developed which utilises a precision bone wedge and specialised cryotherapy post operatively.

Adrian Wilson

I always wanted to be a doctor and the natural progression for me was into knee surgery and orthopaedics. Success for me is measured by how much your peers respect you and as a consultant which is the final stage of our journey in training I have super specialised in joint preservation. 

I am very proud of the fact that I am asked to talk about my new techniques and instruments /tools I have developed all around the globe and I travel internationally 1-2 times per month. 30 % of my practice comes from other specialist knee surgeons and I am very proud that I have been able to be so successful with my ideas and career.

Adrian Wilson

Being asked to perform an osteotomy on one of the leading South African knee surgeons who flew up from South Africa last Christmas for his osteotomy and he is now doing brilliantly. That is an unbelievable acolade.

Find out more about the Osteotomy procedure by calling us on 0808 101 0337 or make an online enquiry.

  • Man Men's Health Discover engaging articles dedicated to male health. This includes advice, trends and interviews with our top male health Consultants.
  • Woman Women's Health Stay on top of your health with our tips, advice and Q&A’s with leading women’s health Consultants.
  • Runners Health and Wellbeing Get inspired for a healthier you. Find the latest in healthy living and fitness tips, as well as our medical and treatment updates.
  • Man Men's Health Discover engaging articles dedicated to male health. This includes advice, trends and interviews with our top male health Consultants.
  • Woman Women's Health Stay on top of your health with our tips, advice and Q&A’s with leading women’s health Consultants.
  • Runner Health and Wellbeing Get inspired for a healthier you. Find the latest in healthy living and fitness tips, as well as our medical and treatment updates.