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Child Orthopedics
Spine - Cervical
Spine - Lumbar
Spine - Thoracic

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I'm getting ready to have an osteotomy surgery on my right knee to correct an alignment problem that's causing arthritis on the inside of my knee. I can't believe all the tests I've had to have for what I thought was a fairly simple procedure. Is this all really necessary?

Surgeons are advised to do a thorough preoperative evaluation before doing any kind of surgery, but especially an osteotomy where getting just the right amount and type of correction is necessary for a successful result. It may seem like a simple procedure but it takes quite a bit of technical skill, precision, and attention to detail. A complete patient history will be taken during the medical interview. Your symptoms (including pain, difficulty walking, restricted function or activities) will be discussed at length. Pinpointing the cause of the problem is an important part of the treatment process. The surgeon will take a look at the areas above (hip and spine) and below (ankle and foot) the knee. Range of motion, ligament stability, and strength will be evaluated. Imaging studies will be ordered such as full standing (weight-bearing) hip-to-ankle X-rays. Dynamic movement analysis and MRIs help show how you move, as well as assess the status of the joint ligaments, cartilage, and other soft tissue structures. Any instability, weakness, or damage to these areas can affect what's going on in the knee now and affect how the knee will respond to the surgery. All of these tests provide the surgeon with information about what's wrong and how to fix it -- how much correction should be made? How should that correction be done? What should be left alone? It's not just a matter of removing a piece of bone, it's also important to make sure the joint moves normally, remains stable and won't dislocate, evens out the weight-bearing load across the joint so other problems don't develop, and restore normal pain free motion. So, if your surgeon is insisting on a barrage of preoperative tests that don't make any sense to you, don't hesitate to ask the benefit of each one. Most likely you'll find you are in the hands of a thorough, capable, and meticulous surgeon -- just the kind you want for a procedure like this.


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