Knee Osteotomy Risks and Complications

Knee osteotomy was first widely used in the United States in the 1960s with mixed results. Since then, many improvements have been made regarding surgical tools, techniques, and patient selection.1 Having an experienced surgeon who carefully selects candidates for osteotomy, and is also technically proficient in surgical planning and techniques, can lower the chances of complications. But, as with any surgery, complications can happen. The most common complications are listed below.

  • Any major surgery involving general anesthesia poses a low risk of strokes, heart attacks, pneumonia, and blood clots. Blood clots, or deep vein thrombosis (DVT), are the most common complication of knee osteotomy or knee replacement, but only affect a small percentage of patients.
  • The surgical area can become infected. If the infection does not respond to antibiotics, another surgery or series of surgeries may be required.
  • The peroneal nerve or blood vessels that runs down the back of the leg can be damaged during surgery. The peroneal nerve can also be damaged during recovery if the cast, brace or bandages are too constricting, putting too much pressure on the back of the knee for long periods of time.
  • The bones at the osteotomy site may fail to grow together and heal.
  • Osteotomy surgery may not provide pain relief. It is unlikely, but possible, that post-surgical pain will be worse than osteoarthritic pain.
  • An under-correction or over-correction can result if the wedge of bone added or taken away was too small or too big. This means a knock-kneed person would become bowlegged or vice-versa.
  • Because a wedge of bone has been added or taken away, a patient’s legs may be different lengths after surgery.
  • Though the bones that comprise the knee joint may be better aligned, there can be complications involving the muscles, ligaments, and tendons that surround and support the joint. For example, a closed wedge tibial osteotomy can loosen the tension of the anterior cruciate ligament (ACL), which helps attach the tibia and femur.

Before electing to have knee osteotomy surgery, patients should talk to their surgeon about the potential risks and complications.


  • 1.Karolin Rönn, Nikolaus Reischl, Emanuel Gautier, and Matthias Jacobi, "Current Surgical Treatment of Knee Osteoarthritis," Arthritis, vol. 2011, Article ID 454873, 9 pages, 2011. Accessed December 28, 2011. doi:10.1155/2011/454873.