It is common to have arthritis affecting one (inner) compartment of the knee. Often this is seen along with Bowing like shape of the legs.
Bowing and arthritis of the knee is generally detrimental to “Knee-Health”.
Generally after one’s height stops growing the legs and knees have one of the three shape pattern.
a) Straight legs
b) Knock Knees (Valgus alignment)
c) Bow legs (varus alignment)
When a Knee and entire leg is mal-aligned the forces are transmitted through one part of the knee. That half of the knee gets more wear and tear. If this process starts early in 3rd or 4th decade of life then the knee can start wearing out earlier.
If the conservative treatment has failed then these patients may be considered for Alignment – High Tibial Osteotomy. The operation works very well especially in younger patients and heavy duty workers.
In this operation the Tibia bone (shin bone) which is bent (knock knee shaped) is aligned by making appropriate adjustment to more straighter shape. A plate and screws are used to fix and hold on to this new adjusted position.
The ambulation starts with the help of walker or Elbow crutches as tolerated. Once the bone heals (in about 6 to 8 weeks) the shape of the leg is re- aligned. The weight is now transmitted through normal part of the knee and hence the pain relief.
The advantage of this operation is that –
1) Does not affect the Knee joint ligaments, cartilage hence good knee movement is retained
2) Knee joint bone is not affected in the operation so patients also recover well and feel “normal” after the operation.
3) After full recovery patients can actually sit on floor and participate in heavy manual work.
4) Can be performed for younger individual with arthritis and Bow legs.
Generally it is expected that this operation lasts for 12 to 15 years, in many of the patients it is known to even last for more then 20 years before arthritis develops in other areas of the knee.