What Do We Do In Conjunction With Osteotomies

In this final installment of his series on osteotomies, Dr. Grant Garcia highlights the complementary procedures performed alongside an osteotomy to ensure high success rates and prevent long-term surgical failure.

Here is a summary of the description and key points discussed in the video:

• Conjoint Procedures for Joint Preservation: In younger patients without widespread arthritis, an osteotomy is often combined with other restorative procedures to maximize healing. These combined interventions include meniscus replacements (transplants), meniscus root repairs, and various advanced cartilage restoration techniques.
• Enhancing Outcomes: Dr. Garcia shares that an osteotomy can actually optimize the outcome of a secondary procedure. For example, a medial meniscus transplant performed on a patient who also undergoes an osteotomy yields results that are just as good—and sometimes better—than the same transplant done on someone with naturally straight legs, because the bone cut physically takes the heavy loading off the new tissue.
• The Risk of Skipping the Osteotomy: When treating conditions like a chronically dislocating kneecap, skipping a necessary tibial tubercle osteotomy due to its surgical complexity or a lack of surgeon experience often leads to total failure of the repair. Because patients typically only have one or two good chances to successfully rebuild a joint, getting the structural realignment right the first time is essential.
• Managing Recurrent ACL Tears (The Dog Analogy): For patients experiencing recurrent ACL failures, Dr. Garcia explains a unique procedure that alters the "posterior slope" of the shin bone. By cutting the front of the bone and flattening it, surgeons can significantly reduce the physical stress placed on a reconstructed ACL graft. He notes that this technique is actually the standard way ACL tears are treated in veterinary medicine for dogs (often known as a TPLO or similar slope-altering osteotomy), and it drastically drops the re-tear rate in human patients.