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Osteotomy patient enjoying her life outside after recovering from surgery

What is an osteotomy?

An osteotomy is a surgery where your bone is carefully cut and realigned to improve how it works or to reduce discomfort. It’s often done on areas like the jaw, hips, knees, legs, toes or feet.

This procedure can help fix alignment issues, relieve discomfort and improve movement. Your surgeon will choose the best approach for your specific needs to help you feel better and move more easily.

Osteotomies are most commonly done to treat knee problems, reshape the hip (femoral osteotomy) or correct bunions on the foot (distal or proximal osteotomy).

Why might I need an osteotomy?

You might need an osteotomy if you have bone or joint issues that affect your movement, cause pain or limit your daily activities. This surgical procedure is used to cut and realign bones to improve how they function, relieve discomfort and prevent further damage.

Osteotomies are commonly used for:

  • Correcting bone deformities: Conditions like bowlegs or knock knees can put extra stress on your joints and lead to long-term damage. An osteotomy can realign the bones to reduce strain and improve alignment.
  • Relieving arthritis pain: In cases of early-stage osteoarthritis, an osteotomy can shift weight away from the damaged part of the joint to a healthier area, helping to relieve discomfort and improve mobility.
  • Repairing improperly healed fractures: If a broken bone has healed incorrectly, it can cause alignment problems. An osteotomy can adjust the bone to ensure it heals correctly.
  • Improving joint function: In cases where joint alignment affects your ability to move comfortably, an osteotomy can help restore proper function.
  • Delaying or avoiding joint replacement: For younger or active people, an osteotomy can be an alternative to joint replacement, preserving the natural joint while addressing the issue.

Your surgeon will recommend the best option based on your condition.

How to prepare for osteotomy surgery

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In the weeks leading up to the osteotomy, your orthopedic surgeon may send you for blood, urine, cardiac and imaging tests to ensure you’re healthy enough to have surgery. These tests can check for infection, control of chronic conditions, such as diabetes, and proper organ function. Your orthopedic surgeon may want to take pictures of the affected joint with an X-ray or CT scan to help plan the surgery.

As the surgery approaches, you can help the process go safely and smoothly. Be sure to:

Eat or drink as directed

Follow your orthopedic surgeon’s instructions for eating, drinking and taking medications in the hours before surgery.

Find a ride

Arrange for someone to drive you home from the hospital or surgery center.

Read up about your surgery

Learn what to expect by reading the surgery guide or other information provided by your orthopedic surgeon.

Share your allergy and medication information

Inform your orthopedic surgeon of any allergies you have and the medications and supplements you take.

Stop smoking

Smoking can slow your recovery.

Tell your orthopedic surgeon if you don’t feel well

They need to know if you come down with an illness before the surgery.

The osteotomy procedure

Osteotomies differ based on the reason for and goal of the surgery, the affected joint and the type of surgery to be performed. You’ll receive anesthesia to help you stay comfortable during the surgery. The surgeon will make an incision and cut or remove bone according to the surgical plan. Afterward, you’ll likely spend at least one day in the hospital before going home to continue your recovery.

  • Before the procedure

    On the day of your surgery, arrive at the hospital with plenty of time to check in and complete any preoperative paperwork. Before the procedure, you’ll receive anesthesia to either put you to sleep or numb the surgical area, depending on the type of surgery your surgeon will be performing. The surgical team will clean the area of the body where the surgeon will make an incision.

  • During the procedure

    The specific steps of your procedure depend on the joint involved, the problem your orthopedic surgeon will be treating and the surgical technique they’ll be using.

    Knee osteotomies are some of the most common. Typically, in this procedure, the orthopedic surgeon will make an incision in the skin at the joint and use guide wires to plan where to cut the bone. Following the wire outline, the surgeon will use a surgical saw to cut and remove an area of bone.

    To close the gap left by removing part of the bone, the surgeon brings the two pieces of bone together or inserts a bone graft to fill the space. Hardware, such as plates and screws, help keep the reshaped bone in position while it heals.

  • After the procedure

    Osteotomy surgery may take one to two hours or more, depending on the type. Afterward, you’ll go to a recovery room while the anesthesia wears off. You’ll be discharged the next day or a few days later, depending on the extent of your surgery and how well you recover.

What are the risks of an osteotomy?

The risk of complications from osteotomy is low. Your surgical team will take steps to perform the surgery as smoothly and safely as possible. Like any operation, however, this surgery can lead to complications.

Some possible complications include:

  • Anesthesia-related complications
  • Blood clots
  • Failure of the bones to heal, which may require a second surgery
  • Infection
  • Injuries to your nerves or blood vessels
  • Joint pain or stiffness
patient recovering from a Osteotomy surgery and discussing with a doctor

Osteotomy recovery

Your recovery after an osteotomy depends on the type of surgery, how much bone damage there was and your overall health. It takes time for the bone to heal, and you may feel some soreness at the surgery site.

You’ll likely need a cast, splint or crutches to limit movement and keep weight off the affected bone. This support is usually needed for a few weeks to a few months. You may need crutches for a few months for knee or hip surgeries.

Physical therapy usually begins soon after surgery, even if you’re in a cast or splint. It helps improve joint strength and movement, and it’s key to regaining balance and flexibility.

Follow-up appointments are important to monitor healing and progress. Your doctor will check how the surgery is healing and help track your recovery.

Frequently asked questions

  • How painful is an osteotomy?

    Osteotomy typically causes soreness or pain, but the severity depends on the type of surgery. Your orthopedic surgeon will prescribe pain medication or recommend over-the-counter medicines that can provide relief.

  • How long does it take to heal from an osteotomy?

    Healing time depends on the type of surgery. Some osteotomies heal in a few weeks. Others take months. Your orthopedic surgeon can provide details about the healing timeline for your specific surgery.

  • Is osteotomy major surgery?

    Yes, osteotomy is a major surgery that may require a large incision and involves cutting bone.

  • How long does osteotomy surgery take?

    Osteotomy surgery usually takes one to two hours, depending on the type. Knee surgeries take around one to two hours, while hip surgeries take two to three hours. Including time for recovery, the whole process usually takes four to six hours, and you may stay in the hospital for one or more nights.