Osteotomy is one of the methods of pain relief in patients with arthritis, especially in the hip and knee area, and this method is used instead of hip and knee joint surgery. It can be done under general anesthesia or its alignment is changed.... This operation is used to correct the deviation of the big toe or to straighten the bone that has healed after a crooked fracture.... Osteotomy is sometimes used to correct hip flexion, crossed legs, and obese legs... Application of osteotomy The surgeon performs the osteotomy operation with the following goals: - Correcting the angle, bending or rotation of the bones - Correcting the alignment of a deformed or broken joint - Lengthening or shortening of bones - Repairing the damaged joint - Weight transfer from the damaged part of the joint to the part that has healthier cartilage - Pain relief from arthritis (especially in the knee and hip) Postponing the need for joint replacement surgery in young and active patients - Correcting or fixing other specific bone problems Advantages and disadvantages of osteotomy Knee osteotomy is performed with three goals: - Weight transfer from the injured part of the knee to the healthy area - Correction of improper knee position - Increasing the lifespan of the knee joint The advantages of osteotomy are: - Successful osteotomy surgery by preserving the anatomy of the knee postpones the need for joint replacement for several years.... - After recovery after the operation, you will not have any restrictions on physical activity and you can do your favorite activities and even high-impact sports.... Of course, osteotomy also has disadvantages, which include: - Pain relief after osteotomy is not as predictable as partial or total knee replacement... - Recovery after osteotomy is usually longer and more difficult because you probably cannot put weight on the operated knee.... Recovery after osteotomy takes about 6 weeks.... - In some cases, total knee replacement surgery after osteotomy is not possible.... Since partial and total knee replacement surgeries have been very successful, how is knee osteotomy for surgery? An osteotomy is prepared, but this method is available for many patients.. The surgeon will likely order routine tests to check the patient's general health, including the following: - Blood test to determine the level of blood components and the level of organ function - Urine test to check general health and diagnose problems such as infection or diabetes that interfere with bone healing.... - Electrocardiogram to check the electrical activity of the heart... - Chest X-ray before surgery to ensure proper lung function - X-ray or CT scan to view the bones and joints and plan the surgery... The surgeon must determine the exact size and angle of the bone he wants to remove... Sometimes a 3D model is created using a computer to guide the surgery... First, based on the surgeon's choice, you will receive one of the following anesthesia: - only anesthesia of the surgical area (regional anesthesia) - Anesthesia from the waist down (spinal anesthesia) - Putting the patient to sleep (general anesthesia) - only anesthesia of the incision site (local anesthesia) Then the surgical team sterilizes the area around the surgical site using an antibacterial solution and covers it with a cloth. The surgeon cuts the skin and identifies the desired part of the bone using a guide wire and removes it. Then, with the help of a special surgical saw, they hold the specified area of ​​the bone. Plates or rods are either realigned during recovery. These metals are temporarily or permanently placed in the bone. your recovery Types of osteotomy Osteotomy solves various bone and joint problems, including the following.... ### Jaw osteotomy Jaw osteotomy adjusts the bones of the lower or upper jaw with the rest of the head or teeth and causes problems such as open bite, difficulty chewing or swallowing, excessive wear of the teeth, receding chin, overbite or underbite. It may be necessary to use a brace before or after surgery to align the teeth with the jaw. - **Mandibular osteotomy:** Mandibular surgery - **Osteotomy of the upper jaw:** Surgery of the upper jaw - ** Lefebvre osteotomy:** This special technique fixes the mid-face fracture involving the upper jaw.. ​​### Chin osteotomy In this surgical method, the shape of the chin is changed. The surgeon usually performs a chin osteotomy to correct a short or tall wide chin or to shorten a narrow chin.... ### Elbow osteotomy Through this method, the problems of the elbow joint that cause disharmony in the lower part of the arm are solved. The arm hangs either too close to the body (cubitus varus) or too far from the body (cubitus valgus). These abnormal positions that change the angle of the elbow are corrected using various osteotomy surgical methods. The spine helps to align the body's center of gravity on the pelvis, which is a bony structure in the lower part of the body. is.. If one or more parts of the spine have too much curvature or not enough curvature, the spine is out of alignment, causing pain, fatigue and pressure on internal organs.. Spinal osteotomy aims to restore balance and relieve pain, prevent pain from getting worse, relieve pain. spondylitis Ankylosing occurs and in severe cases causes fusion of parts of the spine. The main techniques of osteotomy of the spine are: - **Posterior osteotomy of the spine:** Through this surgery, the lumbar arch is removed inward (lordosis) and the front arch in the upper part of the spine (kyphosis). Pont osteotomy is a special technique to correct kyphosis... - **Stem osteotomy:** This surgery corrects the arch of the lower region. The spine using a graft or metal.... ### Hip osteotomy In this surgical procedure, the socket of the hip joint (acetabulum) or the head of the femur (femoral head) is modified. The hip joint is a type of ball and socket joint. - **Periacetabular osteotomy:** The surgeon performs this osteotomy to fix hip dysplasia (a situation where the thigh cavity does not completely cover the ball of the bone).. ### Osteotomy of the knee In a knee osteotomy, one of the bones of the lower leg (tibia) or thigh (femur), which is located under the kneecap, is cut and its shape is changed. Knee joint surgery is usually performed to correct the damage caused by arthritis, and by re-aligning the bone, the pressure and weight on the damaged part of the knee is transferred to the healthy part of the knee joint when primary osteoarthritis of the knee is performed. The damage is only on one side of the knee joint. It depends on the appearance of the knee, for example if the cartilage inside the knee is damaged Upper tibial osteotomy is used... In this surgery, to straighten the lower leg and prevent the development of arthritis, a wedge-shaped piece of bone (geometric) is removed from the knee, or an empty space is created inside the knee, which straightens the lower leg and prevents the development of arthritis... - **Tibial osteotomy:** This surgery corrects a large part of the bend inside the knee that puts pressure on the outside... knee... leg) is removed This operation changes the place where the kneecap tendon connects to the leg and prevents dislocation by removing the pressure from the kneecap.... ### Osteotomy of the big toe and foot In a hallux osteotomy, the bone is removed from the big toe and straightened.... A heel (calcaneus) osteotomy is a procedure to reshape the foot and correct excessive flatness or arching of the sole of the foot.... Below are some specific osteotomy techniques used to treat foot problems: - **Chevron and Akin Osteotomy:** These techniques correct mild to moderate problems of the big toe caused by bunions (Hallux Valgus). Two hours before the patient is transferred to the room or ward, vital signs are checked in the recovery room.... To relieve pain and ensure adequate sleep until the next dose, the patient is injected with medication and prescribed antibiotics to prevent infection.. One head will be attached to receive fluids and medications until you can eat normally.... After stabilizing the condition and starting a normal diet, you will be discharged with detailed instructions for a full recovery... Oral pain relievers may also be prescribed if needed...probably a week after discharge to check how well the wound has healed. - **Bearing weight on the operated leg:** After surgery, you will need to use crutches for a few weeks in order not to put pressure on the operated leg... The surgeon will put a brace or cast to help the knee heal and also inform you when you can put weight on the affected leg and start rehabilitation exercises... - **Physiotherapy that will be used during the physiotherapy exercises:** Rehabilitation period.. do... this Exercises increase the mobility of the knee and help regain strength... - **Resuming activities:** You can continue your usual work and activities 3 to 6 months after surgery... ### What results should be expected after osteotomy?. The result of the treatment depends on the general health, the degree of bone damage, the specific technique chosen and the expertise of the surgeon. The surgeon will talk to you about the procedure and expectations. Don't be afraid to ask questions and raise your concerns.