Knee Osteotomy
Knee osteotomy helps to realign the joint to reduce pain, improve mobility, and delay the need for knee replacement. Dr Foo provides careful evaluation and personalised treatment to support recovery and restore active function.
MBBS (University of London) | MMed (Ortho) | FRCSEd (Ortho) | FAMS (Ortho)
What Is a Knee Osteotomy?
Knee osteotomy is a surgical procedure designed to treat damage from arthritis or
structural deformities by correcting knee alignment through reshaping the tibia
(shinbone) or femur (thighbone).
The procedure is generally more suitable for younger, active individuals with early-stage knee
arthritis or structural misalignment, allowing them to maintain mobility and delay
or avoid total
knee replacement.
How Does Knee Osteotomy Work?
Knee osteotomy involves cutting and reshaping either the tibia (shinbone) or femur
(thighbone) to realign the knee joint. This surgical
correction shifts body weight away from the worn or damaged part of the knee, reducing
pressure on that area.
By rebalancing load distribution and preserving the natural knee structure, osteotomy helps relieve
pain, slow the progression of osteoarthritis, and prolong joint health.
Types of Knee Osteotomy
Knee osteotomy can be classified into two main types based on the bone that is reshaped: high tibial osteotomy (HTO) and distal femoral osteotomy (DFO). Each procedure serves a specific purpose in correcting types of knee misalignment and redistributing weight across the joint.
| Types of Osteotomy | Description |
|---|---|
| High Tibial Osteotomy (HTO) |
|
| Distal Femoral Osteotomy (DFO) |
|
Who Is Knee Osteotomy Suitable For?
Knee osteotomy is generally suitable for individuals:
- Have early-stage osteoarthritis in one knee compartment (medial or lateral), especially with bowlegs (varus) or knock-knees (valgus) that worsen joint wear.
- Are younger and physically active, seeking to relieve pain while preserving their natural knee joint and delaying the need for total knee replacement.
- Have stable knee ligaments and good joint function, as proper knee mechanics are important for long-term success after the procedure.
Those with advanced osteoarthritis involving multiple compartments or significant joint degeneration may not be suitable candidates, as knee replacement may offer more predictable long-term outcomes.
Early diagnosis and treatment can help manage knee pain and slow the progression of osteoarthritis. If you're experiencing persistent knee discomfort or have early-stage arthritis, consult a knee specialist and surgeon for an assessment and personalised treatment plan today. How Is Knee Osteotomy Performed?
Preoperative Assessment
Before surgery, a thorough evaluation is conducted to assess knee damage and assist with surgical planning. This includes:
- Physical examination to evaluate joint stability, range of motion, and pain levels.
- Imaging tests such as X-rays to examine bone alignment and identify areas of wear, MRI scans to assess soft tissues including cartilage, ligaments, and menisci, and CT scans (if needed) to provide a detailed 3D view of the bone structure.
Surgical Procedure
- Incision & Bone Cutting – An incision is made over the tibia or femur, depending on the type of osteotomy. A controlled bone cut is performed to realign the knee joint, carefully calculated to redistribute weight and restore proper balance.
- Fixation – Once repositioned, the bone is secured with a specialised metal plate and screws for stability. A bone graft may be used to fill the gap created by the realignment, supporting healing.
- Closure & Stabilisation – The incision is closed with sutures or staples, and the leg is stabilised with a brace or bandage to protect the surgical site.
Knee osteotomy is performed under general or regional anaesthesia to ensure you remain pain-free during the procedure. The surgery typically takes one to two hours, depending on the complexity of the correction and the specific technique used.
Recovery and Rehabilitation
Recovery from knee osteotomy happens in stages, following a structured
rehabilitation programme to restore mobility, strength, and function. The
timeline varies based on factors such as age, overall health, the extent of the osteotomy,
and adherence to physiotherapy.
Most patients progress through the following phases:
| Recovery Phase | Key Aspects |
|---|---|
| Early Recovery: First 6 Weeks |
|
| Mid-Term Recovery: 6 to 12 Weeks |
|
| Long-Term Recovery: 3 to 6 Months |
|
Potential Risks & Considerations
As with any surgery, knee osteotomy carries some risks. While most patients recover well with proper post-operative care, it is important to be aware of potential complications:
- Infection, Blood Clots, or Nerve and Blood Vessel Injury – As with any lower limb surgery, there is a small risk of infection, blood clots (deep vein thrombosis), or injury to nearby nerves and blood vessels.
- Nonunion or Delayed Bone Healing – Since the procedure involves cutting and realigning the bone, healing may take longer, or the bone may not heal properly (nonunion). Additional surgery may be needed if fusion is incomplete.
- Potential Need for Future Knee Replacement – Knee osteotomy slows osteoarthritis progression by redistributing weight and reducing joint stress but does not stop underlying causes like cartilage degeneration. If deterioration continues, total knee replacement may still be necessary.
Your surgeon will discuss these risks and any other concerns specific to your condition to ensure you are well-informed before proceeding with surgery.
Cost of Knee Osteotomy Surgery
The cost of knee osteotomy surgery varies based with estimated costs are as follows:
| Treatment | Estimated Cost (SGD) |
|---|---|
| Knee Osteotomy Surgery | $20,000 - $35,000 |
The cost generally covers the procedure and standard post-operative care, but additional expenses
may arise from pre-surgical assessments, imaging tests (X-rays, MRI, CT scans), follow-up
consultations, physiotherapy, and medication.
In Singapore, knee osteotomy is MediSave-claimable, with claimable amounts depending on
the complexity of the procedure. Patients with Integrated Shield Plans (ISP) may also receive
additional coverage.
Contact us to inquire about your financial options and
insurance coverage based on your specific needs.
Every patient deserves a treatment plan tailored to their needs. We start with non-surgical approaches before considering more invasive interventions.
Dr Foo Gen Lin
Where Can I Find a Knee Specialist in Singapore?
Apex Novena
admin@apexsportsclinic.sg
101 Irrawaddy Rd, #18-12 Royal Square Medical Centre, Singapore 329565
Nearest MRT: NS20 Novena
Apex East Coast
admin@apexsportsclinic.sg
112 E Coast Rd, #03-03/04 i12 Katong, Singapore 428802
Nearest MRT: TE26 Marine Parade
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We prioritise personalised, non-invasive solutions, progressing to specialised treatments, including surgery, only when needed for more effective and targeted care.
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Frequently Asked Questions (FAQs)
High tibial osteotomy (HTO) relieves pain, preserves the knee joint, and delays replacement, making it ideal for younger, active individuals. It allows for a better return to activity than total knee replacement but requires a longer recovery, with risks like delayed bone healing, infection, or over- or under-correction of knee alignment. While HTO slows arthritis progression, it does not stop it entirely, and some may still need knee replacement later.
Knee osteotomy risks include infection, blood clots, delayed healing (nonunion), and nerve or blood vessel injury. Over- or under-correction can affect joint mechanics, causing pain. Some may experience stiffness needing physiotherapy, and implants may rarely cause irritation requiring removal. Your orthopaedic specialist will discuss these risks and considerations before surgery to ensure an informed decision.
Knee osteotomy is a joint-preserving surgery that realigns the knee to shift weight away from the damaged cartilage, making it ideal for younger, active individuals with mild to moderate osteoarthritis. Total knee replacement involves replacing the damaged knee joint with an artificial implant, typically recommended for older patients with severe arthritis. Osteotomy allows for continued high-impact activities, knee replacement provides more predictable long-term pain relief but may limit strenuous activities.
Yes, knee osteotomy is considered a major orthopaedic surgery. It involves cutting and realigning the bone, which requires a hospital stay, a structured rehabilitation programme, and several months of recovery. However, advancements in surgical techniques, including minimally invasive approaches, have made the procedure more refined and improved recovery outcomes.
The effectiveness of knee osteotomy depends on the patient’s condition, lifestyle, and goals. For younger individuals with early-stage osteoarthritis and knee misalignment, it can help to significantly relieve pain, improve mobility, and delay knee replacement. However, recovery is longer, and it may not suit those with advanced arthritis. Consulting an orthopaedic specialist can help determine if the benefits outweigh the risks for you.
Knee osteotomy is effective in relieving pain and improving function, particularly for younger, active patients with osteoarthritis that affects only one part of the knee joint. However, long-term outcomes depend on factors such as proper patient selection, adherence to post-surgical rehabilitation, and maintaining a healthy weight and lifestyle.
Like any bone surgery, knee osteotomy involves some degree of pain, especially in the first few weeks after the procedure. Pain is typically managed with prescribed medication, RICE therapy (Rest, Ice, Compression, and Elevation), and gradual movement under physiotherapy guidance. As healing progresses, pain usually decreases, with most patients achieving significant relief by the three-month mark.
A major drawback of knee osteotomy is the long recovery, which can take months before resuming normal activities. Complications like infection, nonunion (when the bone fails to heal properly), or misalignment may require further treatment. While osteotomy relieves pain and improves function, it does not stop arthritis progression, and some patients may still need a knee replacement later. Consulting an orthopaedic specialist can help determine if this procedure is right for you.
Knee osteotomy is generally suitable for individuals with early-stage osteoarthritis and knee misalignment who want to delay knee replacement while staying active. While younger patients with good joint function benefit most, age alone is not the deciding factor. Overall knee health, activity level, and lifestyle also determine suitability. Consulting an orthopaedic specialist can help assess if osteotomy is the right option.
Yes, but knee bending will be limited initially due to swelling, pain, and the need for the bone to heal properly. Physiotherapy starts soon after surgery to restore range of motion and prevent stiffness. Most patients regain good knee flexibility within a few months, with full movement returning as strength and stability improve.
The decision depends on individual circumstances. If non-surgical treatments like physiotherapy and pain management no longer provide relief, knee osteotomy can help reduce pain and preserve the natural knee joint. However, for severe arthritis affecting multiple compartments, knee replacement may be a more appropriate option. Consulting an orthopaedic specialist will help determine the most suitable treatment for your condition.
The durability of a knee osteotomy depends on factors such as lifestyle, activity level, and the severity of arthritis. Many patients experience lasting pain relief and improved function, but if arthritis progresses, a knee replacement may eventually be needed. Maintaining a healthy weight and staying active can help extend the benefits of the procedure.
The cost of knee osteotomy typically ranges from SGD 20,000 to SGD 35,000, depending on factors such as hospital fees, surgeon’s expertise, and post-operative care. Additional expenses may include pre-surgical assessments, physiotherapy, and medications. The surgery is MediSave-claimable, and insurance coverage or medical savings plans may also help offset some costs, depending on policy terms.
Advancements in knee surgery include robotic-assisted knee procedures, regenerative treatments such as stem cell therapy, and minimally invasive techniques for knee preservation. Robotic-assisted knee surgery enhances precision in joint realignment and implant placement, leading to improved outcomes for both osteotomy and knee replacement procedures.
The best knee surgery depends on the condition. Knee osteotomy is recommended for mild to moderate arthritis with misalignment, while total knee replacement is ideal for severe arthritis. For minor cartilage repairs, minimally invasive procedures like arthroscopy are suitable. It’s best to consult an orthopaedic specialist to evaluate your condition and determine the right treatment.
High tibial osteotomy (HTO) is the most common knee osteotomy, primarily used to treat medial compartment osteoarthritis (where the inner part of the knee is worn down) and varus deformity (a condition where the knees bow outward, causing stress on the inner knee). HTO shifts weight away from the damaged inner knee to the outer part, reducing stress on the affected cartilage.
Yes, but walking will be limited initially due to swelling, pain, and the need for bone healing. Most patients use crutches or a walker during the first few weeks to avoid excess weight-bearing. Gradual weight-bearing is introduced under medical supervision, with full walking ability typically restored within three to six months, depending on individual recovery. Your orthopaedic specialist or physiotherapist will provide detailed guidance on your recovery.