Macquarie University Hospital
&
Lingard Hospital
Osteotomies
Below is links to useful patient information developed by the American Academy of Orthopaedic Surgeons
Coronal plane osteotomies
DFO / Distal Femoral Osteotomy/ HTO / High tibial Osteotomy
Osteotomies around the knee involve cutting the bone of the tibia and/or femur to change the alignment of the leg, often from bow leg or knock knee to straight, so the 'plumb line'/alignment is improved to offload the 'bad side' of the knee.
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This is often a way of prolonging an active lifestyle/delaying a knee replacement in the young to middle age adult.
Derotational osteotomy
Femoral/Tibial torsion/ excessive femoral anteversion/ miserable malalignment
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Excessive torsion can lead to hip, knee, ankle pain, dislocating knee caps and difficulty with running.
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This website gives a good explanation of the problem and surgical solution with videos and pictures.
Severe rotation/torsion- On the left the feet face forward but the knee cap faces excessively inward, on the right with the knee cap facing forward, the feet face excessively outward/sideways.
Sagittal plane osteotomy
TDO- tibial deflexion osteotomy/ slope decreasing osteotomy/ ACL osteotomy
The tibia has a normal amount of slope or incline, in those who re rupture their ACL, they commonly have increased slope which increases the stress on the ACL.
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Dr Dan learnt the procedure while on fellowship at the Lyon Knee School, where the surgery was first performed, and has published extensively on the procedure.
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Click here to an article explaining one patient's return to professional sport after two failed standard ACL reconstructions.
Tibial Tubercle Osteotomy
TTO/ Patellar realignment
The tibial tubercle is where the patella tendon/ligament inserts. By modifying the position of the tibial tubercle, the knee cap/patella position can be changed, improving patella tracking, offloading certain areas of the cartilage and forces in the patellar tendon can be manipulated, making it a useful surgery for patella dislocations, pain and tendinopathy.
