Deformity correction

Bowleg correction with SADO

Bowlegs (genu varum) bow outward at the knee, and many patients have both angular and rotational deformity. Correcting the angle alone with a high tibial osteotomy can bring the knees together yet leave the overall alignment looking unnatural. Dr. Donghoon Lee therefore developed SADO — Simultaneous Angular and Derotational Osteotomy — correcting both in one operation.

Who it suits

  • Bowlegs combined with rotational deformity
  • Patients wanting both better appearance and healthier knee loading

Technique highlights

  • Angular and rotational correction in one operation — a technique developed by Dr. Lee
  • Internal fixation only — no external fixator
  • Minimally invasive with cosmetic suture; no cast or brace afterwards
  • Fast recovery, averaging 4-6 weeks

Surgical steps

  • Measure angle and torsion on standing radiographs and CT.
  • Osteotomy with simultaneous angular and rotational adjustment to the planned values.
  • Internal fixation and cosmetic wound closure.
  • Begin weight-bearing and physiotherapy to plan, without a cast.

Recovery & aftercare

  • Average 4-6 weeks to normal daily activity.
  • No cast or brace after surgery.

Risks & things to consider

  • Bone lengthening is major surgery. Outcome and recovery time depend on bone quality, age, weight and how disciplined the patient is with rehabilitation, so identical results cannot be guaranteed.
  • Daily physiotherapy is mandatory through both the lengthening and consolidation phases. Skipping it risks joint stiffness, muscle contracture or delayed bone healing.
  • Disclose all medical conditions, regular medication, previous bone surgery and drug allergies at the consultation, and stop smoking before and after surgery as instructed — nicotine measurably slows bone healing.
  • Bowleg correction is not simply about making the knees touch — the underlying deformity must be treated for legs that are both attractive and healthy.

Frequently asked questions

How is SADO different from a standard HTO?

A high tibial osteotomy corrects the angle only; SADO corrects angle and rotation together, giving a more natural result when both are present, with internal fixation and no external frame.

Other procedures in this area

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