MeetDr Rewat LaxmanD'Orth, DNB Orthopaedics

High Tibial Osteotomy for Early Arthritis of the Knee

high tibial osteotomy for early arthritis of the knee

What is High Tibial Osteotomy for Early Arthritis of the Knee?

High tibial osteotomy is a joint preservation surgery performed to realign a knee joint which has undergone degenerative changes in one side of the knee due to early-stage arthritis.

What is the Benefit of High Tibial Osteotomy?

A high tibial osteotomy is usually performed in relatively younger patients who have painful knee symptoms that prevent them from doing their work or participating in sports. The surgery helps relieve knee pain by shifting the weight off from the damaged part of the knee. It can help delay or prevent the need for total knee replacement.

What happens if Early Arthritis of the Knee is left Untreated?

There will be worsening degenerative changes and deformity in the knee joint leading to loss of mobility and function at which point a total knee replacement may be needed to relieve painful knee symptoms.

Preparation for High Tibial Osteotomy

  • You must inform your doctor about your current health condition, medications, and allergies.
  • You may have to undergo a physical exam and laboratory tests to ensure there are no contraindications for the surgery.
  • You must avoid smoking or drinking as these activities slow down the healing of tissue after surgery.
  • You may be asked to avoid eating or drinking anything 8 to 12 hour before the surgery.

What to expect during High Tibial Osteotomy?

The surgery may be performed under spinal anaesthesia. An incision is made over the knee joint. The underlying tissues are separated. Nerves and blood vessels are identified and protected. A wedge is created in the upper part of the shinbone (tibia) using surgical saw instruments. The joint alignment between the shinbone and the thighbone is reconfigured so that the weight bearing part of the knee is shifted from the degenerated tissue to healthy tissue. Bone grafts as well as plates and screws may be used to hold the bone in the proper position. Incision is then closed in layers with sutures. A bandage is then applied and you will be transferred to the recovery room.

Recovery after High Tibial Osteotomy Surgery

The high tibial osteotomy can be performed as a day surgery or patients may be discharged after one or two days. You will be discharged home when you can safely get out of bed, walk with the assistance of a walker or crutches and use the stairs safely. You will be instructed on physical therapy exercises to help you recover quickly. Crutches may have to be used for 1 month or 6 weeks. Fully bearing weight on the knee may take about 2 months.