Osteotomy vs Knee Replacement
An Osteotomy and a Knee Replacement comparedOsteoarthritis in the knee joint is a very common problem associated with getting older. The problem might start as a bit of stiffness and aching, but the continued wear and tear can make the problem worse over the next few months and years.
When painkillers, anti-inflammatory drugs, physiotherapy and other treatments no longer help, the only option is surgery. In the UK, the vast majority of patients with knee pain are referred for knee replacement surgery.
The advantages of OsteotomyFor younger patients with arthritis on one side of the knee, removing the knee joint involves taking away mostly healthy tissue. It is possible to have partial knee replacements, and this may be an option.
Osteotomy should also be considered as an option. By realigning the bones of the leg so that the weight of the body does not pass unevenly through the knee joint, the pressure on the damage tissue can be relieved.
The advantages of Osteotomy in suitable patients are
- Reduced knee pain without removing the natural knee joint.
- Improved movement and function after surgery, with a wider range of movement possible compared to after a knee joint replacement.
- Fast recovery – patients are mobile immediately and rehabilitation takes 6-12 weeks. Apart from those with highly active or manual jobs, patients usually return to work after 6 weeks.
- An osteotomy can delay the need for a knee replacement, but does not rule this option out. If the arthritis continues to worsen, a knee replacement is still possible several years down the line.
- Knee osteotomy surgery can often make the knee feel more stable. Patients report that they don’t feel that their knee is in danger of giving way anymore.
As knee replacements have a life of around 20 years in someone over 65 but often only 10 years in someone under 50, this extra time becomes very significant.
How patients feel after Knee Replacement SurgeryIn a survey of younger, more mobile patients, this is a typical response:
- 20% are happy with the outcome of their treatment. Their knee pain is much reduced, they are able to move about well and they are very glad they underwent surgery.
- 70% are glad they had the surgery because their knee is better than it was just before surgery. However, they are not totally satisfied because they still have problems. Their knee is not as good as it was 10 years before surgery.
- 10% are, sadly, worse off than before the operation to replace their knee joint. About 2% experience excruciating knee pain, which is much more intense and difficult to live with than the pain they had just before their knee replacement.
The problem with an artificial knee joint, despite the great improvements that have been made in surgery and technology, is that it will never be as good as the natural joint.