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Exostectomy is a surgical procedure aimed at the removal of an exostosis, which is a benign bony growth that typically forms on the surface of a bone. These abnormal growths are often found in areas such as the hip, knee, shoulder, and spine, but can occur anywhere in the skeletal system. The growths can develop in response to various factors, including chronic irritation or inflammation of the bone, genetic predisposition, or as a result of conditions such as osteoarthritis. In many cases, exostosis may be asymptomatic and go unnoticed; however, they can occasionally cause pain, discomfort, or restrict mobility, especially if they are located near joints or nerves. The presence of an exostosis may also lead to secondary complications like bursitis or tendinitis if the surrounding soft tissues are affected by the growth. The exact cause of exostosis is not always clear, but repetitive stress on the bones, trauma, or certain inherited conditions such as hereditary multiple exostoses (HME) can increase the likelihood of its development. Patients with HME often have multiple exostoses and are at higher risk for complications, including malignant transformation in some cases. When exostoses cause significant pain or impede function, an exostectomy is considered, typically after conservative management strategies, such as physical therapy or anti-inflammatory medications, have failed. The surgical procedure involves excising the exostosed bone while preserving as much normal bone structure and function as possible. Careful planning and assessment are crucial to ensure that there is minimal disruption to the surrounding tissues, particularly in cases where important blood vessels or nerves are present. Post-operative recovery can vary depending on the location and extent of the surgery; however, it generally involves a period of rest, followed by rehabilitation to restore mobility and strength. While exostectomy is typically a safe procedure with a low complication rate, like any surgery, it carries risks such as infection, nerve injury, or recurrence of the exostosis. Patients are usually advised to monitor for any signs of complications post-surgery, and follow-up visits are necessary to assess healing and ensure the success of the procedure. Although the long-term outlook after exostectomy is generally favorable, the recurrence of exostosis can happen, necessitating further interventions. Overall, exostectomy can significantly improve a patient's quality of life and enable them to return to their normal activities without the burden of pain and physical limitations caused by exostosis. Understanding the nature of the condition and weighing the benefits of surgery against the risks involved plays a crucial role in shared decision-making between patients and their healthcare providers.