Osteotomy
What is Osteotomy ?
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Why do you need Osteotomy ?
Osteotomy is indicated for:
- Joint misalignment:
- Knee: High tibial osteotomy (HTO) for medial compartment osteoarthritis in younger patients (bowlegs).
- Hip: Periacetabular osteotomy (PAO) for hip dysplasia.
- Deformity correction:
- Congenital deformities (e.g., genu varum/valgum), post-traumatic malunion.
- Joint preservation:
- Delays knee/hip replacement by redistributing weight away from damaged areas.
- Associated conditions:
- Often combined with other procedures (e.g., ACL reconstruction, meniscectomy).
- Candidates:
- Typically younger patients (<60 years) with early arthritis or deformities, not yet needing joint replacement.
The procedure aims to improve alignment, reduce pain, and preserve joint function by cutting and repositioning the bone, often using hardware (plates/screws) for stability.
Why Do Osteotomy Costs Vary in Philippines?
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Osteotomy Procedure
- Before Surgery Evaluation:
- Diagnosis:
- X-ray/CT: Assesses bone alignment, joint space, and deformity (e.g., HTO: mechanical axis deviation).
- MRI: Evaluates cartilage, meniscus, or ligaments (if combined procedures needed).
- Blood tests: Blood sugar, clotting profile.
- Medications: Stop blood thinners (e.g., aspirin) 5–7 days prior if safe.
- Consent: Risks, including nonunion, are explained.
- Diagnosis:
- Surgical Techniques:
- Osteotomy:
- Performed under general or spinal anesthesia, lasting 1–3 hours.
- Incision: Varies by site (e.g., 5–10 cm for HTO near the tibia).
- Bone cut:
- High tibial osteotomy: Wedge-shaped cut in the tibia to realign the knee (opening or closing wedge).
- Periacetabular osteotomy: Cuts around the acetabulum to reposition the hip socket.
- Realignment: Bone adjusted to correct deformity (e.g., shift weight to healthier cartilage).
- Fixation: Plates, screws, or staples secure the bone (e.g., titanium plates).
- Incision closed with sutures; a brace or cast may be applied.
- Intraoperative Tools:
- Fluoroscopy: Guides bone cuts and alignment.
- Osteotome/saw: Cuts the bone.
- Plates/screws: Stabilizes the bone.
- Osteotomy:
- After Surgery:
- Hospital stay: 2–5 days.
- Care: Ice, elevation, and compression to reduce swelling; keep incision dry.
- Pain management: Moderate pain for 3–7 days; managed with analgesics (e.g., paracetamol, tramadol).
- Instructions: Non-weight-bearing or partial weight-bearing with crutches for 6–12 weeks; start physiotherapy early.
Recovery After Osteotomy
- Hospital Stay: 2–5 days.
- Post-Surgery Care:
- Pain/Swelling: Peaks at 3–7 days; ice and elevation help; resolves in 2–4 weeks.
- Mobility: Non-weight-bearing for 4–6 weeks (e.g., HTO); partial weight-bearing with crutches by 6–8 weeks.
- Physiotherapy: Starts within 1–2 weeks; focuses on range of motion, strength (e.g., quadriceps for HTO), and gait; continues 3–6 months.
- Brace: Worn for 4–6 weeks to protect the osteotomy site.
- Activity: Avoid high-impact activities (e.g., running) for 6–12 months; normal walking in 3–4 months.
- Follow-Up:
- Visits at 1 week, 2 weeks (suture removal), 6 weeks, 3 months, and 6 months.
- X-ray: At 6 weeks, 3 months to monitor bone healing (callus formation).
Most resume normal activities in 3–6 months; full recovery (including sports) takes 6–12 months. Success rate: 80–90% achieve pain relief and improved alignment; delays joint replacement by 5–10 years in 70–80% of cases.
Risks and Complications
- Surgical Risks:
- Infection (2–5%): Superficial or deep; treated with antibiotics, may need hardware removal.
- Bleeding (1–3%): Hematoma at surgical site; may need drainage.
- Nerve/vessel injury (1–2%): Numbness or vascular compromise (e.g., peroneal nerve in HTO); rare.
- Post-Surgery:
- Delayed healing (5–10%): Nonunion or slow union; may need bone grafting.
- Hardware issues (2–5%): Loosening or irritation; may need removal after healing (additional cost: ₹20,000–₹50,000).
- Over/undercorrection (2–5%): Misalignment persists; may need revision surgery.
- Deep vein thrombosis (DVT, 1–3%): Blood clot in leg; prevented with early mobilization.
- Long-Term:
- Arthritis progression (5–10% over 10 years): If alignment not optimal; may still need joint replacement later.
- Chronic pain (2–5%): At osteotomy site; usually resolves in 6–12 months.
Report severe pain, swelling, fever, or calf pain (possible DVT) promptly.
Frequently Asked Questions (FAQs)
What conditions require osteotomy?
Early arthritis (knee/hip), deformities (bowlegs, knock-knees), or malunion in younger patients.
Can I avoid osteotomy?
Yes, if mild: Physiotherapy, bracing, or injections; osteotomy is for significant misalignment or to delay joint replacement.
Is osteotomy painful?
Moderate pain for 3–7 days, managed with medication; discomfort reduces in 2–4 weeks.
How soon can I resume activities?
Walking: 3–4 months; normal activities: 3–6 months; sports: 6–12 months.
Is osteotomy covered by insurance in India?
Yes, for functional issues; confirm with your provider.
Signs of complications?
Severe pain, swelling, fever, or calf pain.
Will I still need a joint replacement later?
Possibly; osteotomy delays replacement by 5–10 years in 70–80% of cases.
Lifestyle changes post-surgery?
Follow weight-bearing instructions, attend physiotherapy, avoid high-impact activities for 6–12 months, and maintain follow-ups.
Conclusion
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Looking for Best Hospitals for Osteotomy
Note: we are not promoting any hospitals
We do not promote any hospitals. All details are sourced from Google and hospital websites. Please verify independently. Start with your surgery—here’s the list of government, budget, and superspecialty hospitals accredited by the Department of Health (DOH), Philippine Health Insurance Corporation (PhilHealth), and Joint Commission International (JCI)
- click on your city and schedule your surgery now done in good hands.
| City | Minimum Price (₱) | Maximum Price (₱) |
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Angeles City |
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Antipolo |
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Bacolod |
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Bacoor |
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Baguio |
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Butuan |
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Cagayan de Oro |
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Caloocan |
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Cebu City |
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Dasmariñas |
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Davao City |
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General Santos |
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General Trias |
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Iligan |
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Iloilo City |
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Las Piñas |
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Makati |
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Malolos |
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Manila |
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Muntinlupa |
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Parañaque |
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Pasay |
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Pasig |
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Puerto Princesa |
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Quezon City |
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San Fernando |
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San Jose del Monte |
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Taguig |
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Valenzuela |
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Zamboanga City |
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Disclaimer
This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.