An osteotomy is a bone-cutting procedure to realign and reshape your bones and joints. Your jaw, elbow, spine, shoulder, hips, knees, legs, toes and feet are common surgical sites. There are many surgical techniques and variations of techniques. Your surgeon will discuss the best option for your specific bone problem to get you up and moving again with less pain and discomfort.
An osteotomy is a surgical procedure that involves cutting bone (and sometimes adding bone tissue) to reshape or realign your bones.
Your surgeon can perform osteotomies on bones all over your body, including your jaw, elbow, spine, shoulder, hips, knees, legs, toes and feet. It’s a treatment for problems at your joints — the area where two or bones meet.
There are many types of osteotomy methods and variations of methods. They're often named after the surgeon who created the method or by how the bone is cut and reshaped or adjusted.
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Your surgeon performs an osteotomy to:
Your surgeon may order some routine tests to check your general health. These may include:
First, you’ll receive anesthesia. Your surgeon may choose to:
Next, your surgical team uses an antibacterial solution to sterilize the area around the surgical site. A surgical cloth drapes the site.
Your surgeon makes a cut through your skin. They use guide wires to outline the area of bone to remove (often wedge-shaped, but depends on the procedure). A special surgical saw removes the outlined area of bone.
After your surgeon removes the section of diseased or damaged bone, the gap in your bone is closed by bringing the bone edges together. Depending on your specific osteotomy procedure, sometimes a bone graft is inserted into the space where the bone was removed. Pins, screws, staples, plates or rods hold the bone in place or realign the bone as it heals. This metal may be temporary or may be permanently placed.
An osteotomy can fix many different types of bone and joint problems. These include:
A jaw osteotomy realigns the bones of your lower jaw (mandible) or upper jaw (maxilla) with the rest of your head and/or teeth. Jaw osteotomy fixes problems such as open bite, trouble chewing or swallowing, excessive teeth wear, receding chin, overbite or underbite. You may need to wear braces before or after surgery to realign your teeth with your jaw.
Terms or types of jaw osteotomy procedures include:
A chin osteotomy reshapes your chin. Your surgeon usually performs a chin osteotomy to correct a vertically short chin, lengthen your chin or shorten a narrow chin. This surgery brings your chin forward or in other directions and is an alternative approach to a chin implant in some cases.
Chin osteotomies involve cutting your jaw bone and moving it. Your surgeon makes an incision through your mouth. Your lips may lose feeling for up to a few months.
An elbow osteotomy fixes elbow joint issues that cause alignment problems in your lower arm. Your arm hangs either too close to your body (cubitus varus) or is angled too much away from your body (cubitus valgus). These abnormal positions change the carrying angle of your elbow. There are many different osteotomy techniques, depending on the exact problem.
A spinal osteotomy corrects the alignment of the curves of your spine. Your spine’s natural curves help align your body’s center of gravity over your pelvis. Your pelvis is the bone structure in the lower part of your torso. If one or more spinal sections has too much of a curve or not enough of a curve, your spine becomes out of line. This can cause pain, make you tired and put pressure on internal organs. The goal of a spinal osteotomy is to achieve balance, relieve pain, and prevent recurrence or worsening of the deformity.
Your surgeon may consider osteotomy to correct an angle problem, such as a permanent forward bend that causes your chin to rest on your chest. This happens in ankylosing spondylitis. This is a type of arthritis that, in severe cases, causes areas of your spine to fuse together.
The main types of spinal osteotomy procedures are:
A hip osteotomy reshapes your hip socket (acetabulum) and/or head of your thighbone (femur head). This is your ball-and-socket hip joint. Your surgeon cuts, reshapes or partially removes bone tissue to realign the weight-bearing surfaces of the joint.
The main types of hip osteotomy procedures are:
A knee osteotomy involves cutting and reshaping one of the bones that meet under your kneecap — your shinbone (tibia) or thigh bone (femur). It’s usually done to correct damage from arthritis. The surgery realigns your knee joint, shifting the weight and the pressure from your knee’s damaged side to the healthy side. Osteotomy of the knee is usually done in the early stages of osteoarthritis when the damage is only on one side of the knee joint.
The location of the knee osteotomy depends on where the damage is. For example, in a high tibial osteotomy, cartilage damage tends to be on the inside of your knee. The surgery involves removing either a wedge of bone from the outside of your knee or opening up a wedge of bone on the inside of your knee, creating a straighter leg and preventing the progression of arthritis.
Some types of knee osteotomies include:
A big toe (hallux) osteotomy removes bone from your big toe to straighten it. A heel (calcaneus) osteotomy is a procedure to reshape your foot to fix flat feet or a higher-than-normal arch.
A few of the specific osteotomy techniques that treat foot problems include:
The risks of an osteotomy include:
Recovery depends on the type of osteotomy, the specific surgical technique, the amount and severity of your bone damage and your strength and motivation.
It takes time for your bone to heal. You’ll feel soreness at the site of your surgery.
You may need a cast, splint or crutches to limit bone and joint movement, keep weight off the operative bone and allow your bones to heal in the correct position. You’ll typically wear the cast or splint or use crutches for weeks to a couple of months.
Physical therapy will begin soon after your surgery, even if you’re in a cast or splint. Physical therapy increases your joint strength and movement.
You may need to use crutches for several months if your surgery was on your knee or hip. You’ll have physical therapy to regain your strength and balance.
If you’ve had jaw osteotomy, your jaw is wired shut and you’ll be on a liquid diet for six weeks. If you’ve had an osteotomy on your big toe, you can’t wear shoes or drive for two to six weeks.
You can help the healing process by:
Your outcome depends on your general health, the severity of your bone problem, your specific procedure and the expertise of your surgeon. Your surgeon will discuss your specific surgery and what to expect. Don’t hesitate to ask your surgeon questions or express any concerns.
A note from Cleveland Clinic
There are many osteotomy procedures and variations of procedures to realign and reshape your bones and joints. Your surgeon will discuss your specific bone or joint problem and available options. Depending on your exact bone issue, sometimes you can begin with conservative treatments. These might include rest, ice, anti-inflammatory and pain medications and corticosteroid injections. If these treatments fail to manage your joint problems or can’t be considered, know that your orthopaedic surgeon is waiting to help you. They have surgical options to improve your ability to move and relieve your pain and discomfort.
Last reviewed by a Cleveland Clinic medical professional on 04/05/2022.
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