What is High Tibial Osteotomy (HTO)?
High Tibial Osteotomy (HTO) is a surgical procedure used to treat knee osteoarthritis or malalignment by redistributing weight-bearing forces across the knee joint. It is particularly effective for individuals with early-stage arthritis affecting only one side of the knee. By realigning the tibia (shinbone), HTO helps relieve pressure on the damaged cartilage, potentially delaying the need for total knee replacement.

Causes for High Tibial Osteotomy
HTO is commonly recommended for individuals experiencing knee pain due to:

• Medial knee arthritis – When arthritis affects the inner part of the knee, causing pain and stiffness.
• Knee malalignment (bow-legged condition) – Uneven weight distribution leads to excessive stress on one side of the knee.
• Previous knee injuries – Trauma or ligament damage can alter knee alignment over time.
• Active lifestyle – Younger, active individuals who want to continue engaging in sports and physical activities may benefit from HTO.

Symptoms Indicating the Need for HTO

• Persistent pain on the inner side of the knee.
• Swelling and stiffness, especially after activity.
• Difficulty walking or performing weight-bearing movements.
• Progressive worsening of knee function.

Diagnosis of Knee Malalignment and Arthritis
A healthcare provider will conduct a physical examination, assess medical history, and use imaging tests such as X-rays, MRI, or CT scans to evaluate the knee joint’s condition and determine whether HTO is the appropriate treatment.

High Tibial Osteotomy Procedure
HTO involves making a controlled cut in the tibia to realign the knee joint and secure the new position using metal plates and screws. The procedure helps shift the body’s weight to the healthier part of the knee, reducing stress on the damaged area. It can be performed using two main techniques:

• Opening wedge osteotomy – A small gap is created in the tibia and filled with bone graft material.
• Closing wedge osteotomy – A section of bone is removed, and the tibia is realigned.

Recovery and Rehabilitation

• Initial recovery – Patients typically use crutches and a knee brace for a few weeks.
• Physical therapy – Strengthening and mobility exercises help restore function and prevent stiffness.
• Return to activities – Light activities can be resumed within a few months, while high-impact sports may take longer.

Benefits of High Tibial Osteotomy

• Delays or prevents the need for knee replacement surgery.
• Reduces knee pain and improves function.
• Preserves natural joint structure.
• Allows active individuals to maintain their lifestyle.

When to Consider HTO
If you are experiencing chronic knee pain due to arthritis or malalignment and wish to maintain an active lifestyle, consult an orthopedic specialist to determine if High Tibial Osteotomy is the right option for you.