A High Tibial Osteotomy (HTO) is a surgical procedure carried out to realign the leg.
The shinbone (tibia) is cut and opened up using a device to hold the bones in a more natural alignment.
This procedure can be carried out when early stage osteoarthritis has damaged one side of the knee joint in order to provide pain relief, improve function and prolong the life of the damaged knee, delaying the need for a total knee replacement.
High Tibial Osteotomy is a useful option for somebody suffering with Osteoarthritis affecting one side of the knee joint who is too young for a total knee replacement.
Unlike a total knee replacement, once a HTO has healed, there are generally no restrictions on physical activity, allowing the return to sport or even high impact exercise.
When one side of the knee joint becomes worn, the leg will change in shape, weight distribution will become difficult and further complications of hip and low back pain often appear as the body tries to cope with movement.
There are two distinct patterns:
Bow leg (genu Varus) – where the inside or medial part of the knee has worn.
Knock knee (genu valgus) – where the outside of the knee joint has worn.
In either of these cases the knee joint itself becomes stiff, making it difficult to bend the knee and this can be very painful.
Recovery from High Tibial Osteotomy
You may rely on pain relief medication for a few weeks and you will need to use crutches for a couple of weeks after the procedure.
Rehabilitation therapy is usually required to help the knee return to full function and help the body adjust to the change in biomechanics due to the realignment of the leg.
The bone has been physically cut so the length of time it takes to heal is very similar to that of a broken leg. General day to day activity is advised until this time period has elapsed.
Your consultant will want to see you again around five weeks to take some more images to make sure the bone is healing.
Alternative options to High Tibial Osteotomy
Unloader brace – A unique knee brace designed to offload the affected side of the knee.
Pain relief – Prescribed pain relief medication.
Using a walking stick or walking pole.
Waiting until the joint can be replaced with total knee replacement.