Joint Preservation Osteotomies in Delhi
Joint Preservation Osteotomies in Delhi help realign load, reduce pain, and preserve your native joint when arthritis or malalignment is the main problem. We perform High Tibial Osteotomy (HTO), Distal Femoral Osteotomy (DFO), Tibial Tubercle Osteotomy (TTO), and Periacetabular Osteotomy (PAO) in select, well‑indicated cases—using precise planning, stable fixation, and a clear recovery pathway. We do not provide in‑house physiotherapy; we share written protocols and coordinate with your physiotherapist for safe progression.
Precise correction • Load realignment • Native‑joint preservation • Realistic return timelines
About Joint Preservation Osteotomies
Osteotomy means “cutting the bone” to change alignment. In joint preservation, carefully planned osteotomies shift load away from the painful or damaged area, improve tracking and stability, and protect cartilage. Unlike joint replacement, osteotomy keeps your natural joint surfaces and ligaments intact. That can be a major advantage for younger or active patients who want to maintain higher activity levels and delay or avoid replacement.
Typical scenarios include varus or valgus knee malalignment with compartmental osteoarthritis, patellofemoral pain or instability from maltracking, and hip dysplasia with under‑coverage of the femoral head. In each case, the goal is the same: realign, stabilize, and optimize biomechanics so the joint functions better and hurts less.
Who Is a Candidate?
Symptoms & goals
Unicompartment knee pain, patellofemoral pain/instability, or hip pain from dysplasia—with a desire to maintain active function and delay replacement.
Imaging findings
Varus/valgus malalignment, maltracking (e.g., elevated TT‑TG), loss of joint space in one compartment, or hip under‑coverage (low LCEA).
Cartilage status
Best results when the opposite compartment/area has preserved cartilage and ligaments are functional.
General health
Non‑smoker or willing to stop, controlled diabetes, realistic rehab commitment (with your own physiotherapist).
If arthritis is end‑stage across the whole joint, joint replacement may be more appropriate; if pain is mild without malalignment, non‑surgical care remains first line.
HTO, DFO, TTO, and PAO – When and Why
High Tibial Osteotomy (HTO)
For varus knees with medial compartment osteoarthritis. Opening‑wedge HTO shifts the mechanical axis laterally, off‑loading the worn medial side. Ideal when lateral cartilage and ligaments are in good condition. Plates and wedges stabilize the correction.
Distal Femoral Osteotomy (DFO)
For valgus knees with lateral compartment overload. DFO realigns the femur to off‑load the lateral side and protect cartilage. Particularly useful in younger patients with lateral loss but good medial cartilage.
Tibial Tubercle Osteotomy (TTO)
For patellofemoral pain or recurrent instability with maltracking or abnormal TT‑TG distance. The tibial tubercle is shifted (medialized, and/or distalized) to improve patellar tracking and reduce contact stress. Screws fix the tubercle in its new position.
Periacetabular Osteotomy (PAO)
For symptomatic acetabular dysplasia (hip under‑coverage) with preserved cartilage. PAO reorients the acetabulum to improve head coverage and load distribution, often preventing accelerated wear and delaying hip replacement.
Evaluation & Planning
Accurate planning is the heart of successful osteotomy. We combine a focused exam with targeted imaging and objective measurements to quantify malalignment and define the correction angle.
- Weight‑bearing X‑rays: Alignment films (hip‑knee‑ankle), standing AP/lateral/skyline views; long‑leg films for mechanical axis.
- MRI: Cartilage and meniscus status, bone marrow edema, patellofemoral cartilage—helps refine indications and adjunct procedures.
- CT & rotational profile: For complex deformity or patellofemoral cases; TT‑TG distance, torsion, and 3D planning where needed.
- Hip dysplasia metrics (PAO): LCEA (lateral center‑edge angle), acetabular inclination, joint congruency, and Tönnis grade.
- 3D planning & guides: Digital templating, patient‑specific cutting guides, and intra‑operative checks to hit the target correction.
We will explain your measurements and show how the correction changes the load line through your joint.
Technique, Fixation & Pain Control
Most osteotomies are performed through small to moderate incisions with careful soft‑tissue protection. We use rigid fixation (plates, locking screws, wedges) to stabilize the correction and allow controlled early movement. Bone graft or substitutes may be used for opening‑wedge gaps.
Anesthesia
Regional nerve blocks plus light general or spinal anesthesia reduce nausea and speed early mobilization.
Pain strategy
Multimodal—paracetamol, anti‑inflammatories (if appropriate), and short‑course opioids only if required. Ice/compression for swelling control.
Protection & braces
Hinged knee brace after HTO/DFO when indicated; patella‑tracking brace after TTO; hip precautions after PAO. Written protocols provided. We do not provide in‑house physiotherapy.
Recovery & Return to Activity
Recovery depends on the osteotomy type, fixation stability, bone quality, and adherence to your external physiotherapy plan. We provide a clear, phase‑based protocol and coordinate with your physiotherapist; we do not provide in‑house physiotherapy.
- Week 0–2: Elevation, swelling control, wound care; toe‑touch to partial weight‑bearing as advised; early range‑of‑motion within limits.
- Week 3–6: Gradual ROM, quadriceps/hip activation; progress weight‑bearing per X‑ray and fixation stability.
- Week 6–12: Strength and gait training; stationary cycling, pool work (if available); brace wean when safe.
- Month 3–6: Low‑impact activities; graded outdoor walking/cycling; return to desk work typically 3–6 weeks, more for manual work.
- Beyond 6 months: Light jogging or sport‑specific drills when criteria met; heavy impact sports are individualized.
Your plan may differ—bone healing and alignment goals guide the pace. Expect regular reviews with X‑rays to confirm progress.
Benefits, Risks & Durability
Potential benefits
Less pain, improved function, better patellar tracking or hip coverage, and delay or avoidance of joint replacement.
Possible risks
Infection, blood clots, nerve or vessel irritation, under/over‑correction, nonunion/delayed union, stiffness, hardware irritation (occasionally removed later).
Durability
When well‑indicated and well‑healed, osteotomy benefits can last many years. If replacement is needed later, prior correction often improves replacement alignment.
Cost & Insurance
Costs vary by procedure (HTO, DFO, TTO, PAO), implants and grafts, facility and anesthesia fees, imaging, and length of stay. Many insurers cover osteotomy when medically indicated. We verify benefits and provide a transparent estimate before scheduling your Joint Preservation Osteotomies in Delhi.
- Insurance pre‑authorization & benefits check
- Clear estimate of out‑of‑pocket costs
- Cashless/financing options where applicable
How to Prepare
Medical optimization
Control sugars/blood pressure; stop smoking (critical for bone healing); discuss anticoagulants with your physician.
Prehab (external)
We provide written prehab aims (ROM, swelling control, quad/hip activation) and coordinate with your physiotherapist. We do not provide in‑house physiotherapy.
Home set‑up
Prepare a safe sleeping and walking path; arrange support for early days; consider a shower chair and raised seating.
Work & transport
Plan time off and transport for early reviews; desk workers often return in 3–6 weeks depending on side and aids.
Footwear & braces
Bring supportive footwear; we will guide braces and orthotics if indicated post‑op.
Where to Consult Dr. Neelabh
BLK Hospital
A-4-6, Pusa Rd, Near Rajendra Place Metro Station, New Delhi-110005
🕓 4:00 PM – 6:00 PM
Timings may vary—please call +91‑9810117204 to confirm.
FAQs
How do I choose between HTO and knee replacement?
Will plates/screws need removal later?
Can I sit cross‑legged or squat after osteotomy?
How long until I can walk without aids?
Do you provide physiotherapy?
What if osteotomy doesn’t relieve pain?
Considering Joint Preservation Osteotomies in Delhi?
Book a consultation. We’ll confirm your diagnosis, show your alignment on X‑rays, and build a practical plan that matches your goals.