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Understanding Osteotomy



The knee is made up of 3 compartments; the inner (medial), the outer (lateral) and the front compartment (the knee cap area). Although you might think you have a totally straight leg very few people truly do. Most people (80%) are a little bow legged or what we call varus. 20% are a little knock kneed or what we call valgus.

As we get into our late 30s and 40s it is very common for people to start developing problems with their knees. Most commonly people get a tear of their meniscus or shock absorber which often occurs on the inside of the knee. They present to their doctor and complain of well localised pain to the inside of the knee, worsened with any activity. Often the knee locks up, it swells, and frequently the knee feels as though it will give way.

There are literally thousands of patients who are in a situation where they would benefit from a realignment procedure. The most common scenario is a patient who is bow-legged and has pain on the inside of the knee. We take special x-rays and an MRI to work out where the damage is located. We then use a computer program to plan out the surgery. 90% of the time we operate in the upper shin or Tibia and make a very precise cut with a precision saw to open a gap or wedge which shifts the lower shin over in relation to the upper shin.This straightens up the knee and moves the forces from a damaged area to good area of the knee, where the joint surface and shock absorber are undamaged.


The results shown in this procedure are compelling and the surgery makes a lot of sense. The procedure is all about taking the force and weight away from a damaged part of the knee and placing those forces through the undamaged area.

After the operation

We then check with x-rays and, if we are happy, fix the bone with a very strong plate that allows the patient to start walking immediately. The technique is performed in 45 min through a 4 cm incision.

We us a combination of different anesthetic techniques during the procedure so patients usually have very little or no discomfort for 24 hours. Then the hard work starts with the rehab. Most patients stay in hospital for 2 or 3 nights. Braces are not routinely used and patients are up and walking the same or next day. Because of the strong plate, it is possible for the knee to take your full weight from day 1.


Mr Adrian Wilson
Consultant Knee Surgeon
BSc (Hons) MBBS FRCS (Eng) FRCS (Tr & Orth)

Mr Wilson is a consultant knee surgeon. He qualified with a BSc in Biochemistry from Manchester University in 1989 and then went on to study medicine at St Bartholomew’s medical school, graduating in 1994. He joined the North West Thames Orthopae
dic training scheme in 1999. During his 6 year training rotation, he worked at several premier teaching hospitals including the Chelsea & Westminster and the Royal National Orthopaedic hospitals. He completed his training in Australia with a 12 month fellowship in knee surgery at The Brisbane Orthopaedic Sports Medicine Centre. In 2005 Mr Wilson was appointed as a consultant to the North Hampshire Hospital where he is now the clinical lead for knee surgery.
Mr. Wilson’s London practice is located at 9 Harley Street, a center of excellence in diagnostic and outpatient treatment.

For more information or to book an appointment please call 0207 079 2100