Skip to main content

Knee Osteotomy

Knee osteotomy corrects alignment by cutting and repositioning the tibia (high tibial osteotomy) or femur (distal femoral osteotomy) to shift weight off the damaged compartment. The natural joint stays intact. For younger patients with single-compartment arthritis and a correctable alignment problem, it can put off knee replacement by 10-15 years — sometimes indefinitely.

Find a Surgeon
Knee Osteotomy surgery - orthopaedic procedure overview and what to expect

Who Needs Knee Osteotomy?

Best suited for active patients under 55-60 with arthritis in one compartment only (not the whole joint), a varus (bow-legged) or valgus (knock-kneed) deformity that can be corrected, and good range of motion. Often done alongside cartilage restoration procedures.

What to Expect

1
Full-leg standing X-rays to measure alignment and plan the correction angle
2
Surgery takes 1.5-2.5 hours under spinal or general anesthesia
3
A wedge of bone is cut and the angle corrected; metal plate and screws hold the correction
4
Hospital stay of 1-2 days
5
Non-weight-bearing or partial weight-bearing for 6 weeks while bone heals
6
Hardware (plate) is typically left in place permanently unless it causes irritation

Recovery Timeline

Weeks 1-6

Crutches required. Restricted weight bearing while the bone heals. Range-of-motion exercises.

Weeks 6-12

Progressive weight bearing as bone healing confirmed on X-ray. Physical therapy begins.

Months 3-4

Full weight bearing without crutches. Increasing strength and walking distance.

Months 4-6

Return to recreational activity: cycling, hiking, swimming.

Months 6-12

Full return to sport and high-demand activity for most patients.

Risks & Complications

  • Delayed bone healing or non-union
  • Infection (1-2%)
  • Hardware irritation requiring plate removal
  • Overcorrection or undercorrection
  • Peroneal nerve injury (lateral osteotomy)
  • Blood clots (DVT)

Frequently Asked Questions

Who is a good candidate for knee osteotomy vs. knee replacement?

Osteotomy fits younger patients (under 55-60) who are active, have arthritis in one compartment, and have a correctable alignment problem. Knee replacement is generally for older patients or those with arthritis across multiple compartments. A successful osteotomy can push replacement back by a decade or more.

Can I still get a knee replacement after osteotomy?

Yes. Osteotomy doesn't close off that option. Technically, the replacement is slightly more complex afterward, but results are comparable to primary replacement when done by an experienced surgeon.

How long is recovery from knee osteotomy?

Crutches for about 6 weeks while the bone heals. Recreational sport typically at 4-6 months. Contact and impact sports at 9-12 months. Bone healing is confirmed by X-ray at 3-6 months.

Find a surgeon for Knee Osteotomy

Compare orthopaedic surgeons who perform this procedure.

Search surgeons

Estimated Cost

$20,000 - $45,000 (before insurance). Covered by most insurers when appropriate alignment criteria are documented.

Full cost breakdown

Related Specialty

Knee Specialists →

Other Procedures

Total Knee ReplacementTotal Hip ReplacementACL ReconstructionRotator Cuff RepairArthroscopic SurgerySpinal Fusion

This information is for educational purposes only. Costs are estimates and vary by location, surgeon, and insurance. Always consult a qualified healthcare provider.