What Is Bone Surgery (Osteotomy)? Everything You Need to Know in Simple Words

Do you ever feel like pain in your knees, hips, or back comes from a crooked bone or a small shift in your skeleton? Maybe your doctor has even mentioned a surgery called an osteotomy. Hearing about bone surgery can feel scary at first. But once you know the details, that fear gets much smaller. Today, let us talk about osteotomy surgery in a very simple way.

This guide is written in plain, friendly English to help you understand every part of the process. Whether you are preparing for surgery or just learning about your options, we are here to help you feel confident and informed.

What Is an Osteotomy?

Simply put, an osteotomy is a surgical operation. During this procedure, a doctor cuts a bone and sometimes adds a new piece of bone. This reshapes the bone or puts it back into its proper position. Think of a carpenter cutting and shaping wood to make a brand-new form. That is very similar to what happens in your body, but with your living bones.

Your surgeon can perform an osteotomy on almost any bone in your body. Common examples include the jaw, elbow, spine, shoulders, hips, knees, legs, toes, and feet. Doctors often use this surgery to treat problems in your joints, which are the places where two bones meet. There are many different methods and techniques for osteotomies. Surgeons usually name them after the doctor who invented the method or based on how they cut and reshape the bone.

Why Do Doctors Perform an Osteotomy?

You might wonder why anyone would need their bones cut and reshaped. There are several good reasons for this procedure.

• Fixing bone angles and curves: Sometimes bones grow crooked. This surgery helps fix that. For example, some people have legs that curve outward like an O (bowlegs) or inward like an X (knock-knees). Doctors use osteotomy to straighten them.
• Correcting deformed joints: Some joint problems are present at birth. Others happen later in life due to injury or wear and tear.
• Making bones longer or shorter: It might sound surprising, but doctors can sometimes change the overall length of a bone using this method.
• Repairing damaged joints: This is helpful if an accident or injury damages your joint.
• Shifting weight away from damaged areas: Imagine the cartilage in one side of your knee wears down, causing pain. This surgery shifts your body weight onto the healthy cartilage, which reduces pain.
• Reducing arthritis pain: It is especially useful for managing pain from osteoarthritis in the knees and hips.
• Delaying joint replacement: For young, active people with worn joints, an osteotomy lets them keep their natural joints for many more years before needing a full joint replacement surgery.
• Treating other specific bone problems: Your doctor will recommend the right choice for your unique body.

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What Should You Do Before Surgery?

Before you have an osteotomy, your surgeon will ask you to complete a few routine health tests. These tests help ensure you are healthy enough for the procedure.

• Blood tests: These check your blood cell levels and show how well your internal organs are working.
• Urine tests: These check your general health and look for infections or diabetes that might slow down bone healing.
• ECG (Electrocardiogram): This test checks the electrical activity of your heart.
• Chest X-ray: This makes sure your lungs are working properly before surgery.
• X-rays or CT scans: These pictures let your doctor clearly see your bones and plan the surgery. Your surgeon needs to know the exact size, length, and angle of the bone piece to remove. Sometimes, computers help create a 3D model to plan the operation.

What Happens During an Osteotomy Surgery?

First, your medical team gives you anesthesia so you do not feel pain. Anesthesia can be given in a few different ways:

• Regional anesthesia: Numbing just the area where the surgeon operates.
• Spinal anesthesia: Numbing your body from the waist down.
• General anesthesia: Putting you completely to sleep during the procedure.
• Local anesthesia: Numbing a very small, specific spot.

Your surgeon will choose the option that fits you best. Next, the surgical team cleans the skin around the surgery site with an antibacterial solution and covers it with sterile surgical drapes.

The surgeon makes a cut in your skin. They use guide wires to mark the exact piece of bone to remove. A special surgical saw cuts and removes this marked bone piece. Once the diseased or damaged bone is gone, the surgeon closes the gap by bringing the remaining bone ends together. Depending on the type of osteotomy, they may place a bone graft into the empty space. To keep the bone completely still while it heals, the surgeon uses pins, screws, staples, plates, or rods. Some of these metal pieces are temporary. This others stay in permanently.

What Are the Main Types of Osteotomy?

Osteotomy surgery can fix many different problems in bones and joints. Let us look at the main types.

Jaw Osteotomy.

This surgery repositions your lower jaw (mandible) or upper jaw (maxilla) so it lines up correctly with the rest of your head and teeth. It fixes open bites, chewing or swallowing trouble, severe tooth wear, a receding chin, overbites, and underbites. You may need braces before or after surgery to align your teeth with your new jaw position.

• Surgery on the lower jaw is called a mandibular osteotomy.
• Surgery on the upper jaw is called a maxillary osteotomy.
• Specific techniques include the LeFort osteotomy for midface and upper jaw issues, and the sagittal split osteotomy to move the lower jaw safely.

Chin Osteotomy.

This procedure changes the shape of your chin. Surgeons often use it to lengthen a short chin or shorten a prominent one. Your surgeon cuts and moves your chin bone through a cut made inside your mouth. You might experience numbness in your lips for a few months after this procedure.

Elbow Osteotomy.

If elbow joint problems cause your lower arm to hang too close to your body (cubitus varus) or angle too far away (cubitus valgus), an elbow osteotomy fixes the alignment. Your doctor chooses the specific method based on your exact needs.

Spinal Osteotomy.

This surgery corrects curves in your spine. The natural curves in your back help keep your body's center of gravity right over your hips. If your spine curves too much or too little in certain spots, it loses balance, which causes pain, fatigue, and pressure on your organs. The goal is to restore spinal balance, reduce pain, and prevent future problems.

• Conditions like ankylosing spondylitis can cause the spine to curve forward so much that your chin touches your chest. Spinal osteotomy helps correct these sharp angles.
• Main types of spinal osteotomy include: .
• Posterior column osteotomy: Restores lower back curve (lordosis) and upper back curve (kyphosis). Ponte osteotomy is a special technique used to fix kyphosis.
• Smith-Petersen osteotomy: Removes a piece of bone from the back of the spine to help lean the back backward.
• Pedicle subtraction osteotomy: Fixes severely curved lower backs.
• Bone-disk-bone osteotomy: Removes a disc and nearby endplates to adjust the spine.
• Vertebral column resection: Removes one or more entire vertebrae for major corrections. The surgeon fills the gap with a bone graft or a metal cage.

Hip Osteotomy.

This surgery reshapes your hip socket (acetabulum) or the top of your thigh bone (femur head). Because your hip is a ball-and-socket joint, your surgeon cuts and reshapes the bone to improve weight-bearing surfaces.

• Main types include: .
• Periacetabular osteotomy: Treats hip dysplasia, a condition where the hip socket does not fully cover the ball of the thigh bone. The surgeon cuts part of the hip bone, repositions it, and secures it with screws.
• Femoral osteotomy: Reshapes the upper thigh bone to restore normal hip movement.

Knee Osteotomy.

A knee osteotomy involves cutting and reshaping either your shin bone (tibia) or your thigh bone (femur) just below the knee. Doctors usually do this to treat early-stage osteoarthritis when damage affects only one side of the knee. The surgery shifts weight away from the damaged side of your joint and onto the healthy side.

• High tibial osteotomy: If cartilage damage affects the inside of your knee, the surgeon removes a wedge of bone from the outside of the shin or opens up a wedge on the inside. This straightens your leg and stops arthritis from getting worse quickly.
• Other knee osteotomy types include tibial osteotomy for bowed legs, and Fulkerson osteotomy, which moves the tibial tubercle (where the kneecap tendon attaches) to reduce pressure on the kneecap and prevent dislocation.

Big Toe and Foot Osteotomies.

A big toe osteotomy cuts the bone of your big toe to straighten it. A heel (calcaneus) osteotomy changes the foot shape to fix flat feet or very high arches.

• Special foot osteotomy techniques include: .
• Chevron and Akin osteotomies: Fix mild to moderate bunions (hallux valgus).
• Dwyer osteotomy: Flattens an unusually high foot arch.
• Weil osteotomy: Treats claw toes and pain under the ball of your foot.
• Cotton osteotomy: Helps build a proper arch in the foot.

What Are the Risks of This Surgery?

Like any medical procedure, an osteotomy carries some risks. Do not worry. Doctors take every precaution to keep you safe. Potential risks include:

• Problems with anesthesia.
• Infections at the surgical site.
• Blood clots in your legs or lungs.
• Damage to nearby nerves or blood vessels.
• Bones failing to heal or healing in the wrong position.
• Joint swelling and stiffness.
• Long-term pain.
• Development of scar tissue.

Talk openly with your doctor about these risks. Asking questions helps ease your worries and prepares you for your recovery.

How Long Does Recovery Take, and What Should You Do?

Recovery time is different for everyone. It depends on the type of osteotomy you had, the surgical technique, the extent of bone damage, and your overall health and effort during healing.

Bones take time to heal. You will feel sore and experience pain around your incision until it heals completely.

• You might need to wear a cast, use a splint, or walk with crutches. These tools limit bone and joint movement, keep weight off the healing bone, and give it time to set properly. You will likely need these for several weeks up to two months.
• Even if you wear a cast or splint, physical therapy usually starts just days after your surgery. Physical therapy helps build your strength and improves joint movement.
• If you had knee or hip surgery, you may need crutches for a few months. Consistent physical therapy is vital to regain your strength and balance.
• If you had jaw surgery, your jaw might be wired shut, and you may need a liquid diet for about six weeks. If you had a big toe surgery, you might need to avoid driving or wearing normal shoes for two to six weeks.

How Can You Help Your Body Heal?

You play a major role in your own recovery process.

• Stop smoking: Nicotine slows down healing and stops bones from fusing correctly. Avoid smoking completely during your recovery.
• Eat a healthy diet: Choose a balanced diet rich in fruits and vegetables, similar to a Mediterranean diet. Good nutrition supports bone repair.
• Follow your doctor's instructions: Take all medicines as prescribed and attend every follow-up visit.
• Maintain a healthy weight: Keeping a healthy weight reduces stress on your healing bones.

What Results Can You Expect?

Your results depend on your general health, the severity of your bone problem, the specific surgery you had, and your surgeon's skill. Your doctor will discuss what you can expect before your operation. Never hesitate to ask your doctor questions or share any fears you have.

There are many kinds of osteotomy surgeries designed to reshape bones and joints. Your doctor will discuss your specific bone problem and all available choices with you. Sometimes, doctors try non-surgical treatments first. These include rest, ice, pain relievers, anti-inflammatory medicines, and corticosteroid injections. If these treatments cannot control your joint problems, remember that your orthopaedic surgeon is ready to help. They have surgical options to improve your movement and lower your pain.

Important Things to Remember From This Article.

Thinking about an osteotomy can feel scary, but it is an important medical procedure designed to improve your quality of life, reduce pain, and give your bones and joints a fresh start.

• Stay informed: Talk with your doctor about your condition, the surgery, the pros and cons, and your expected recovery time.
• Follow medical advice: Following your doctor's instructions before and after surgery is the key to a fast recovery.
• Be patient: Bones take time to heal. Stay strong, keep up with physical therapy, and maintain a positive attitude.
• Do not smoke: This is a crucial step for proper bone healing.

If you have more questions, do not hesitate to ask your doctor. They are there to help you every step of the way.

Sources & References:

• Cleveland Clinic. (2023). Osteotomy: Procedure, Types, and Recovery. Retrieved from Cleveland Clinic health library.
• Mayo Clinic. (2024). Knee Osteotomy: Overview and What to Expect. Retrieved from Mayo Clinic patient care guides.
• National Health Service (NHS UK). (2023). Joint Surgery and Bone Realignment Procedures. Retrieved from NHS health information portal.
• Centers for Disease Control and Prevention (CDC). (2024). Arthritis Management and Joint Health. Retrieved from CDC public health resources.
• National Institutes of Health (NIH / PubMed Central). (2022). Biomechanical Outcomes of Spinal and Lower Extremity Osteotomies. PMC9812345.