Osteotomy is a surgical operation that repairs bone and joint deformities, mainly in the knee, hips or jaw.

An osteotomy (from the Greek oste: bone; and tomê: cut) is a surgical procedure that consists of cutting a bone in order to modify its axis, size or shape. This type of surgery is generally performed for restorative purposes in the event of a malformation or degenerative disease, such as osteoarthritis of the knee or hip, for example. But in certain cases, the operation can also have an aesthetic aim, such as for example during an operation of the chin or a rhinoplasty (operation to modify the shape and the structure of the nose).

Osteotomy is performed in the following cases:

• a deformity of the knee joint, such as legs arched outward (the genu varum) or legs arched inward or say “in X” (the genu valgum);
• hip dysplasia (or hip dislocation), a birth or acquired deformity of the hip joint;
• osteoarthritis of the knee or hip in order to delay the fitting of a prosthesis in young patients;
• a deformity of the spine that results in a bent or “hunchbacked” back (kyphosis) or as a treatment of last resort in more severe cases of scoliosis (“S” deformity of the spine);
• a malformation of the lower jaw (mandible) or upper jaw (maxilla) that prevents normal alignment of the teeth;
• a bunion (or hallux valgus) a deviation of the big toe towards the other toes and the appearance of a lump towards the outside of the joint.

Plastic surgeons also perform an osteotomy to change the shape of the chin.

Usually, during surgery, the bones are cut with specialized instruments. Then, the cut ends are realigned in the desired position and are then held with plates, screws or metal rods (intramedullary nails). The entire operation takes place either under general anesthesia or under local anesthesia. The decision is made by the anesthetist in agreement with the patient and depending on the type of osteotomy performed.

Recovery after surgery depends on the bone affected by the osteotomy. Usually, pain-relieving treatment is prescribed by the doctor, as well as partial or total immobilization of the targeted joint (hip, knee, jaw). Full recovery also varies from a few weeks to several months depending on the extent of the surgery.

After jaw surgery, it is usually advisable to avoid smoking.

Like any surgical procedure performed under anesthesia, osteotomy presents a risk of allergic reaction to anesthetics or of developing breathing difficulties.

More generally, this type of operation involves risks inherent in any surgical operation. Let us quote for example:

• the development of a nosocomial infection;
• blood loss ;
• the formation of a blood clot at the site of the operation (most often in the leg during knee surgery);
• damage to a nerve causing loss of sensitivity or mobility of the joint (knee, jaw);
• chronic pain after the operation;
• a bone fracture;
• visible scars.

Finally, the success of the operation is never guaranteed. Also, there is a risk of failure which would then require additional surgeries.

Heavy surgeries and general anesthesia are frequently not recommended for very old people or people suffering from other pathologies such as heart problems.