Nephrocalcinosis

What Is an Osteotomy?

An osteotomy is a surgical procedure in which a bone is intentionally cut and then reshaped, repositioned, or realigned. The procedure may be used to correct a bone deformity, improve alignment, reduce pain, or improve mobility and function.

For people affected by GACI (Generalized Arterial Calcification of Infancy) and related conditions, osteotomy may become relevant when there are significant skeletal complications—particularly in people who develop Autosomal Recessive Hypophosphatemic Rickets Type 2 (ARHR2).

Osteotomy, ARHR2, and Bone Changes

ARHR2 is part of the ENPP1 Deficiency disease spectrum. It causes low phosphate levels due to excessive phosphate loss through the kidneys. Because phosphate is essential for normal bone mineralization, ARHR2 can lead to rickets, bone pain, slow growth, and skeletal deformities such as bowing of the legs.

People searching for information about calcification in bones may encounter these conditions, but an important distinction should be made. ARHR2 primarily affects how bones mineralize and develop, while GACI is characterized by abnormal calcification in arteries and may also involve organs, joints, and soft tissues.

In some people with hypophosphatemic rickets, medical treatment and continued growth can improve bone alignment. However, when a significant deformity persists, an orthopedic specialist may consider corrective surgery such as an osteotomy. Published reports of ENPP1-related hypophosphatemic rickets have documented the need for surgical correction of severe bone deformities in some patients.

When Might an Osteotomy Be Considered?

An osteotomy may be considered when skeletal deformities:

  • Cause significant problems with walking or mobility
  • Affect alignment of the legs or joints
  • Contribute to ongoing pain or physical limitations
  • Do not adequately improve with medical management and growth
  • Place abnormal stress on surrounding bones and joints

The decision to perform an osteotomy is individualized. An orthopedic surgeon will typically consider the person’s age, growth, bone health, degree of deformity, symptoms, and underlying condition before recommending surgery.

For individuals living with GACI, ARHR2, or ENPP1 Deficiency, orthopedic care may be one part of a larger multidisciplinary treatment plan.

Related Information: Learn more about ARHR2, ENPP1 Deficiency, GACI treatment options, and other terms in our FAQ & Glossary.