The place of osteotomy in rheumatoid arthritis

Osteotomy is technically simple without the incidence of serious complications of prosthetic joint replacement. It relieves pain in the majority of patients in whom it is indicated. Following osteotomy the range of joint movement is only increased in so far as muscle spasm is relieved by freedom from pain. Deformities and soft tissue imbalance can be corrected. Hypertrophic rheumatoid synovium regresses dramatically and rapidly after double osteotomy even if the joint is not opened. In those patients in whom pain is relieved, function improves, strength increases and the radiographic changes of disuse reverse with improved bony structure.