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.
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