Therapy goal
Arthrosis is to be avoided, therefore a congenital or acquired leg malposition is corrected in such a way that, if the onset of arthrosis is present, it is at least prevented from progressing further. Surgical therapy is intended to distribute the weight evenly over the entire joint surface again. However, removing part of the menisci cannot sufficiently compensate for the previous misalignment, as this would lead to a renewed incorrect load, which would permanently damage the joint substance.
Surgically, the method of choice is osteotomy. An osteotomy is the cutting of the bone. This is necessary to perform the correction of the axis.
The bone is cut in two with special bone chisels and a so-called oscillating saw. A wedge is inserted into the now existing cut to correct the axis of the legs and thus create a straight leg again. Such a wedge is fixed in place with plates and screws until the leg heals.
Like a “normal” fracture, the osteotomized area must now grow back together again. This takes at least 6 – 8 weeks until full resilience is achieved. A more elegant method to treat O- legs is the so-called “epiphyseodesis”.
This is the sclerotherapy of a growth joint. However, the prerequisite is that growth still exists. Through targeted unilateral sclerotherapy of a growth plate, the bowleg grows straight until the end of growth.
In order to achieve the right time for the sclerotherapy of the bow legs and correct growth, the so-called bone age must be determined. From the bone age the body size can be determined and the exact time of the epiphyseodesis can be determined. Detailed information about the operation can be found under Surgery for bow legs
Procedure of the operation
If possible, corrective surgery is performed at the apex of the malposition. The bow of the leg is corrected at the tibial plateau. With special bone chisels and a so-called oscillating saw, the bone is cut through and a bone wedge is removed (or inserted, depending on the goal). This cut in the bone (osteotomy) must then be secured with screws, plates or bone clamps until healing is complete.Such a bone cut must then heal together like a normal bone fracture and this takes about 6 – 8 weeks before full weight bearing is possible again. Before this happens, an X-ray is taken to check whether the leg has grown back together completely and whether the movement restrictions can be completely removed and the leg can be fully loaded again.
