Osteotomy
What is Osteotomy?
Osteotomy is a surgical procedure where a bone is cut and realigned to correct deformities, redistribute weight, or delay joint replacement in conditions like arthritis. It’s commonly performed on the knee (e.g., high tibial osteotomy for osteoarthritis) or hip (e.g., periacetabular osteotomy for dysplasia). In India, osteotomy is conducted in orthopedic departments at hospitals like Apollo, Fortis, Medanta, and AIIMS, often at affordable costs. Understanding the procedure, costs, recovery, risks, and FAQs is essential for patients.
Why do you need Osteotomy?
Osteotomy is indicated for:
- Joint misalignment:
- Knee: High tibial osteotomy (HTO) for medial compartment osteoarthritis in younger patients (bowlegs).
- Hip: Periacetabular osteotomy (PAO) for hip dysplasia.
- Deformity correction:
- Congenital deformities (e.g., genu varum/valgum), post-traumatic malunion.
- Joint preservation:
- Delays knee/hip replacement by redistributing weight away from damaged areas.
- Associated conditions:
- Often combined with other procedures (e.g., ACL reconstruction, meniscectomy).
- Candidates:
- Typically younger patients (<60 years) with early arthritis or deformities, not yet needing joint replacement.
The procedure aims to improve alignment, reduce pain, and preserve joint function by cutting and repositioning the bone, often using hardware (plates/screws) for stability.
Why Do Osteotomy Costs Vary in India?
Costs range from ₹80,000 to ₹2.5 lakh :
- Procedure Type: HTO (₹80,000–₹1.5 lakh); complex osteotomies (e.g., PAO: ₹1.5–2.5 lakh).
- Hospital/Location: Higher in metro cities (Apollo, Fortis: ₹1.5–2.5 lakh); lower in government hospitals (AIIMS: ₹30,000–₹60,000, often subsidized under Ayushman Bharat).
- Surgeon’s Expertise: Experienced orthopedic surgeons charge more.
- Additional Costs: Hardware (plates/screws: ₹10,000–₹50,000), anesthesia (₹5,000–₹15,000), hospital stay (₹5,000–₹15,000/day), physiotherapy (₹10,000–₹30,000 for 3–6 months).
- Insurance: Covered for functional issues (e.g., pain, deformity); confirm with your provider.
Osteotomy Procedure
- Before Surgery Evaluation:
- Diagnosis:
- X-ray/CT: Assesses bone alignment, joint space, and deformity (e.g., HTO: mechanical axis deviation).
- MRI: Evaluates cartilage, meniscus, or ligaments (if combined procedures needed).
- Blood tests: Blood sugar, clotting profile.
- Medications: Stop blood thinners (e.g., aspirin) 5–7 days prior if safe.
- Consent: Risks, including nonunion, are explained.
- Diagnosis:
- Surgical Techniques:
- Osteotomy:
- Performed under general or spinal anesthesia, lasting 1–3 hours.
- Incision: Varies by site (e.g., 5–10 cm for HTO near the tibia).
- Bone cut:
- High tibial osteotomy: Wedge-shaped cut in the tibia to realign the knee (opening or closing wedge).
- Periacetabular osteotomy: Cuts around the acetabulum to reposition the hip socket.
- Realignment: Bone adjusted to correct deformity (e.g., shift weight to healthier cartilage).
- Fixation: Plates, screws, or staples secure the bone (e.g., titanium plates).
- Incision closed with sutures; a brace or cast may be applied.
- Intraoperative Tools:
- Fluoroscopy: Guides bone cuts and alignment.
- Osteotome/saw: Cuts the bone.
- Plates/screws: Stabilizes the bone.
- Osteotomy:
- After Surgery:
- Hospital stay: 2–5 days.
- Care: Ice, elevation, and compression to reduce swelling; keep incision dry.
- Pain management: Moderate pain for 3–7 days; managed with analgesics (e.g., paracetamol, tramadol).
- Instructions: Non-weight-bearing or partial weight-bearing with crutches for 6–12 weeks; start physiotherapy early.
Recovery After Osteotomy
- Hospital Stay: 2–5 days.
- Post-Surgery Care:
- Pain/Swelling: Peaks at 3–7 days; ice and elevation help; resolves in 2–4 weeks.
- Mobility: Non-weight-bearing for 4–6 weeks (e.g., HTO); partial weight-bearing with crutches by 6–8 weeks.
- Physiotherapy: Starts within 1–2 weeks; focuses on range of motion, strength (e.g., quadriceps for HTO), and gait; continues 3–6 months.
- Brace: Worn for 4–6 weeks to protect the osteotomy site.
- Activity: Avoid high-impact activities (e.g., running) for 6–12 months; normal walking in 3–4 months.
- Follow-Up:
- Visits at 1 week, 2 weeks (suture removal), 6 weeks, 3 months, and 6 months.
- X-ray: At 6 weeks, 3 months to monitor bone healing (callus formation).
Most resume normal activities in 3–6 months; full recovery (including sports) takes 6–12 months. Success rate: 80–90% achieve pain relief and improved alignment; delays joint replacement by 5–10 years in 70–80% of cases.
Risks and Complications
- Surgical Risks:
- Infection (2–5%): Superficial or deep; treated with antibiotics, may need hardware removal.
- Bleeding (1–3%): Hematoma at surgical site; may need drainage.
- Nerve/vessel injury (1–2%): Numbness or vascular compromise (e.g., peroneal nerve in HTO); rare.
- Post-Surgery:
- Delayed healing (5–10%): Nonunion or slow union; may need bone grafting.
- Hardware issues (2–5%): Loosening or irritation; may need removal after healing (additional cost: ₹20,000–₹50,000).
- Over/undercorrection (2–5%): Misalignment persists; may need revision surgery.
- Deep vein thrombosis (DVT, 1–3%): Blood clot in leg; prevented with early mobilization.
- Long-Term:
- Arthritis progression (5–10% over 10 years): If alignment not optimal; may still need joint replacement later.
- Chronic pain (2–5%): At osteotomy site; usually resolves in 6–12 months.
Report severe pain, swelling, fever, or calf pain (possible DVT) promptly.
Frequently Asked Questions (FAQs)
What conditions require osteotomy?
Early arthritis (knee/hip), deformities (bowlegs, knock-knees), or malunion in younger patients.
Can I avoid osteotomy?
Yes, if mild: Physiotherapy, bracing, or injections; osteotomy is for significant misalignment or to delay joint replacement.
Is osteotomy painful?
Moderate pain for 3–7 days, managed with medication; discomfort reduces in 2–4 weeks.
How soon can I resume activities?
Walking: 3–4 months; normal activities: 3–6 months; sports: 6–12 months.
Is osteotomy covered by insurance in India?
Yes, for functional issues; confirm with your provider.
Signs of complications?
Severe pain, swelling, fever, or calf pain.
Will I still need a joint replacement later?
Possibly; osteotomy delays replacement by 5–10 years in 70–80% of cases.
Lifestyle changes post-surgery?
Follow weight-bearing instructions, attend physiotherapy, avoid high-impact activities for 6–12 months, and maintain follow-ups.
Conclusion
Osteotomy is an effective joint-preserving procedure to correct alignment, relieve pain, and delay joint replacement, with a high success rate in suitable candidates. India’s top hospitals (Apollo, Fortis, AIIMS) provide affordable care, typically covered by insurance. Understanding the procedure, costs, recovery, risks, and FAQs helps patients approach surgery confidently. Consult an orthopedic surgeon for personalized guidance.
Looking for Best Hospitals for Osteotomy
Note: we are not promoting any hospitals
we are not promoting any hospitals we sourced all the details from google and hospitals website, please verify and start with your surgery here we go the list includes government, budget and superspeciality hospitals accreditation bodies are the National Accreditation Board for Hospitals and Healthcare Providers (NABH) and the Joint Commission International (JCI)
- click on your city and schedule your surgery now done in good hands.
| City | Minimum Price (₹) | Maximum Price (₹) |
|---|---|---|
Agra |
1,50,000 |
3,50,000 |
Ahmedabad |
2,00,000 |
4,00,000 |
Ajmer |
1,50,000 |
3,50,000 |
Aligarh |
1,50,000 |
3,50,000 |
Allahabad |
1,50,000 |
3,50,000 |
Amritsar |
1,75,000 |
3,75,000 |
Aurangabad |
1,75,000 |
3,75,000 |
Bangalore |
2,00,000 |
4,00,000 |
Bareilly |
1,50,000 |
3,50,000 |
Belgaum |
1,75,000 |
3,75,000 |
Bhopal |
1,75,000 |
3,75,000 |
Bhubaneswar |
1,75,000 |
3,75,000 |
Bikaner |
1,50,000 |
3,50,000 |
Chandigarh |
2,00,000 |
4,00,000 |
Chennai |
2,00,000 |
4,00,000 |
Coimbatore |
2,00,000 |
4,00,000 |
Dehradun |
1,75,000 |
3,75,000 |
Delhi |
2,00,000 |
4,00,000 |
Dhanbad |
1,50,000 |
3,50,000 |
Durgapur |
1,50,000 |
3,50,000 |
Faridabad |
2,00,000 |
4,00,000 |
Ghaziabad |
2,00,000 |
4,00,000 |
Gorakhpur |
1,50,000 |
3,50,000 |
Guntur |
1,75,000 |
3,75,000 |
Gurgaon |
2,00,000 |
4,00,000 |
Guwahati |
1,75,000 |
3,75,000 |
Gwalior |
1,50,000 |
3,50,000 |
Hyderabad |
2,00,000 |
4,00,000 |
Indore |
1,75,000 |
3,75,000 |
Jabalpur |
1,50,000 |
3,50,000 |
Jaipur |
2,00,000 |
4,00,000 |
Jalandhar |
1,75,000 |
3,75,000 |
Jamshedpur |
1,75,000 |
3,75,000 |
Jodhpur |
1,50,000 |
3,50,000 |
Kanpur |
1,50,000 |
3,50,000 |
Kochi |
2,00,000 |
4,00,000 |
Kolkata |
2,00,000 |
4,00,000 |
Kollam |
1,75,000 |
3,75,000 |
Lucknow |
1,75,000 |
3,75,000 |
Ludhiana |
2,00,000 |
4,00,000 |
Madurai |
1,75,000 |
3,75,000 |
Mangalore |
1,75,000 |
3,75,000 |
Meerut |
1,50,000 |
3,50,000 |
Moradabad |
1,50,000 |
3,50,000 |
Mumbai |
2,00,000 |
4,00,000 |
Mysore |
2,00,000 |
4,00,000 |
Nagpur |
1,75,000 |
3,75,000 |
Nashik |
1,75,000 |
3,75,000 |
Navi Mumbai |
2,00,000 |
4,00,000 |
Noida |
2,00,000 |
4,00,000 |
Patna |
1,50,000 |
3,50,000 |
Pune |
2,00,000 |
4,00,000 |
Raipur |
1,75,000 |
3,75,000 |
Rajkot |
1,75,000 |
3,75,000 |
Ranchi |
1,50,000 |
3,50,000 |
Surat |
2,00,000 |
4,00,000 |
Thane |
2,00,000 |
4,00,000 |
Vadodara |
1,75,000 |
3,75,000 |
Varanasi |
1,50,000 |
3,50,000 |
Visakhapatnam |
1,75,000 |
3,75,000 |
Disclaimer
This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.