If I have an operation called an osteotomy to fix my crooked knee, is there any guarantee this will keep me from needing a knee replacement? That's the impression I'm getting from what I can find on-line.

Patients with malalignment of the knee that leads to arthritis face some unique challenges. The alignment problems usually mean one side of the knee wears out faster than the other. They can't just have a knee replacement -- or even a unicompartmental procedure. Unicompartmental means just the side that's arthritic is replaced. And why not? Because the cause of the arthritis is the way the bones fit together to form the knee. In most cases, there is too much pressure on the medial compartment (that's the side of the knee closest to the other knee). Replacing the joint (or the medial half of the joint) doesn't change the alignment issues. That's where a procedure called tibial osteotomy comes in handy. In this operation, the surgeon removes a wedge- or pie-shaped piece of bone from one side of the tibia<>/i (lower leg bone). The purpose of the osteotomy is to correct the malalignment and take pressure off the medial compartment. Research results do show very favorable responses to osteotomy as a treatment for unicompartmental arthritis from malalignment problems. On average, at least 90 per cent of the patients from all studies report good results. Some studies have a 97 per cent success rate in the first five years. Their pain is reduced or relieved and their function is improved. They are able to remain active and delay the need for joint replacement by at least five to seven years. For the type of problem you have, it may be best to consult with an orthopedic surgeon. The exact cause of your knee problems should be diagnosed first before making your decision based on information found on-line. Patients often have individual factors that can influence treatment decisions. An orthopedic surgeon will assess all aspects of your situation and advise you. The information you have gained from your Internet searches will help you ask the right questions and aid you in making the best decision.

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