Tibial osteotomy with open wedge is a surgical procedure that is used in cases where osteoarthritis has affected only one side of the knee joint. If osteoarthritis has caused damage on only one side of the knee joint, it can cause structural issues. Tibial osteotomy with open wedge is a procedure used to shift pressure off the damaged side of the knee joint. This is accomplished by cutting and realigning the tibia to shift the pressure to the healthier side of the joint. More specifically, the tibia is cut at an angle and the two sides are separated to create a wedge-shaped opening.
Tibial osteotomy with open wedge involves an incision on the front or inner side of the knee. This allows access to the tibia and knee joint. Care is taken to protect the nerves and blood vessels that travel across the knee joint. Once the tibia bone is exposed, the orthopedic surgeon determines the correct size of the wedge using guide wires. With an oscillating saw, a cut will be made along the guide wires through the upper tibia at an angle, separating the two sides to form a wedge-shaped opening. Instead of closing the wedge, the wedge of bone is “opened” and a bone graft is added to fill the space and help the osteotomy heal. The bone graft is usually taken from pelvis bone, through an incision on the side of the patient’s hip. The surgeon then inserts a metal plate, which is attached with surgical screws, to help hold open the wedge during the healing process.
In general, after an osteotomy, most patients are required to stay in the hospital for two to four days and will be monitored with pain medication. Immobilization devices such as a knee brace or crutches may be recommended for the patient to use for several weeks. During rehabilitation, a physical therapist may prescribe certain exercises to help maintain the range of motion and restore your strength. The total recovery time for tibial osteotomy with open wedge before resuming full activities is three to six months.