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Osteotomy

An osteotomy is a surgical procedure to remove certain parts of the bone as treatment or prevention if that part of the bone has been destroyed or to repair the bone to good condition so it can accommodate weight as necessary, such as the bones of the knees, shins (tibia), and legs (femur). For example, an osteotomy of the knee to alleviate the pressure put on a certain part of the knee, which may have become damaged.

Purpose/Benefits
The doctor will perform an osteotomy to delay the deterioration or damage to a bone, such as cartilage or a joint bone, which can become damaged prematurely. Cutting, shaping, and repairing this bone is usually done when the patient is young and healthy, to prevent or delay the need for joint replacement down the road.
 
  1. You will undergo a physical examination as well as blood tests, chest x-ray, and an electrocardiogram (EKG) to ensure that you are healthy enough for anesthesia and surgery. X-rays of the bones that need to be treated will be taken to assess how much they need to be removed.
  2. Please let your doctor know about all medication that you are taking as some will need to be stopped before the procedure, such as aspirin, Persantin, Ticlid, Plavix, warfarin, heparin, and Fraxiparine. (These will usually need to be stopped for at least one week before the surgery or as recommended by the doctor.)
  3. Get enough rest and avoid smoking cigarettes and drinking alcohol before the procedure as these can increase your risk of complications.
  4. If you are sick or have a fever on the day before surgery, let the doctor or hospital know immediately.
  5. You will likely need to avoid food and water for at least six to eight hours before the procedure, or as recommended by the doctor.
Once general anesthesia is administered and you are asleep, the doctor will make an incision over the bone and will remove, cut, and/or reshape the bone as needed, then fasten the ends of the bones together with wires or rods to facilitate healing and provide strength and stability.
 
The extent of the surgery will determine how you feel after the procedure and how you recover. Most patients stay in the hospital for approximately two nights.
  1. The doctor usually places a cast or splint to restrict movement of the affected limb, which should remain in place for four to eight weeks. You will be given instructions for appropriate exercise even while you have the cast or splint on to help strengthen and stabilize the muscles around the surgical site, increase range of motion, and improve balance.
  2. You may need to use a walking aid, such as crutches, to avoid placing weight on the affected leg for up to two months to allow the bone to heal and strengthen.
  3. Patients can usually begin to bear weight on the affected bone after 10 to 12 weeks.
  4. Complete recovery may take six months up to one year.
  1. Inflammation of tissue around the surgical site and infection
  2. Bones do not heal together
  3. Injury to nerves or blood vessels in the area
Before the Procedure
  • The patient will be evaluated and diagnosed by the doctor before surgery is planned and the surgery will take place as soon as possible, depending on the patient’s readiness. This can be one to two days or within 24 hours.
  • It is recommended that you stay at a hotel close to the hospital for convenience in traveling to the hospital before and after the procedure, as recommended by the doctor, for physical therapy and follow-up appointments.
After the Procedure
  • You should plan to remain in Thailand for at least two weeks through the duration of your treatment. This may vary from person to person, depending on your individual health and medical condition before the procedure as well as your age. Certain factors may require a longer stay in Thailand. This does not include the time for physical therapy after the surgery.
  • When you return for your follow-up appointment you will undergo a physical examination and your wound will be checked. You will receive documentation of your treatment history, a medical certificate, follow-up appointment slips, and your “fit to fly” certificate.
  • You may travel by car if it is a four-seater and it is recommended you sit in the passenger seat with the seat reclined. If you are traveling in a van, it is recommended you sit behind the driver and recline your seat.
  • Normally patients can travel home by air. Please discuss this with your doctor to confirm that you are healthy enough to fly before making flight arrangements. If you need a walking aid, such as a walker, crutches, or cane, be sure to let the airline know in advance if you will need a wheelchair at the airport and when you get off the airplane at your destination.
    • If you are traveling in First or Business class:
      • You can recline your seat normally, but support the affected limb to keep it from dangling and to maintain it in normal alignment. Exercise your leg muscles regularly while you are in the air by flexing and pointing your toes. Take 10 consecutive long deep breaths every hour to improve blood circulation.
      • Drink at least 2,000 to 2,500 milliliters of water each day. Avoid caffeine, sedatives, and alcohol. If you have been prescribed venous thromboembolism (VTE) prophylaxis, follow your doctor’s instructions strictly.
      • If your doctor has recommended that you wear a brace or an arm sling, please keep it on for the duration of the flight, except when you recline your seat. You may take it off at that time. If you have an elastic bandage around the affected limb, you may loosen it slightly while in the air.
    • If you are traveling in Economy Class, be sure to select a seat in the exit row or a bulkhead seat.
      • You can recline your seat normally, but support the affected limb to keep it from dangling and to maintain it in normal alignment. Exercise your leg muscles regularly while you are in the air by flexing and pointing your toes. Take 10 consecutive long deep breaths every hour to improve blood circulation. Please get up and move around at least every 30 minutes.
      • Drink at least 2,000 to 2,500 milliliters of water each day. Avoid caffeine, sedatives, and alcohol. If you have been prescribed venous thromboembolism (VTE) prophylaxis, follow your doctor’s instructions strictly.
      • If your doctor has recommended that you wear a brace or an arm sling, please keep it on for the duration of the flight. If you have an elastic bandage around the affected limb, you may loosen it slightly while in the air.
This procedure can alleviate pain and prevent inflammation of the damaged bone or can help delay the need for more extensive surgery, such as joint replacement surgery.
 
What if the procedure is not performed?
Pain will persist and the condition may lead to deformity of nearby organs and bones; more extensive surgery may be required, such as bone and organ transplant.
 
Medication and lifestyle modifications, such as losing weight to reduce the deterioration of the bone, such as that of the knee.
 

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