Skip to main content

CORRECTIVE OSTEOTOMY FOR A DISLOCATING KNEECAP

Method
Correction of the axis or of rotation in instability of the kneecap
Duration
90 minutes
Recovery time
3 to 6 months

How the operation proceeds

The corrective osteotomy is an important surgical element in treating a kneecap that dislocates chronically or repeatedly. The aim of the operation is to correct bony deformities that encourage the kneecap to slip out – for instance an increased Q angle, a valgus deformity (knock knees) or excessive inward rotation of the thigh bone (femoral torsion).

The most common procedures are the distal femoral varisation osteotomy (DFO) for a valgus axis and the derotation osteotomy of the femur for increased femoral torsion. Both aim to restore the natural course of the kneecap in its groove (the trochlea).

After precise analysis beforehand using X-ray, CT or MRI, the exact site to be corrected is determined. The bone is divided under X-ray control. Depending on the findings, a wedge of bone is removed or rotated in order to correct the axis or the rotation. Fixation then follows with locking titanium plates.

This measure is usually carried out in combination with soft-tissue procedures (for instance an MPFL reconstruction) in order to achieve a stable and lasting result.

Rehabilitation after a corrective osteotomy

The rehabilitation phase after a corrective osteotomy is guided by the healing of the bone and by the functional restoration of the gait:

Phase I (0-6 weeks): protective phase
  • Partial weight-bearing with forearm crutches (10-20 kg)
  • Leg orthosis in extension, a mobilisation splint where needed
  • Physiotherapy: lymphatic drainage, mobilisation, isometric exercises
Phase II (6-12 weeks): building up load
  • Progression to full weight-bearing depending on the X-ray check
  • Active training of the leg muscles, leg press, step exercises
  • Gait analysis and gait training
Phase III (from week 12): functional return
  • Sport-specific training (according to the intended level of loading)
  • Stability and co-ordination training
  • Testing of load-bearing capacity before sport is cleared