High Tibial Osteotomy (HTO) is a surgical procedure designed to relieve pain and improve function in patients with knee arthritis, particularly when the damage is concentrated on one side of the knee. Unlike knee replacement, HTO preserves the natural joint by realigning the tibia (shinbone) to shift weight away from the damaged area. This procedure is often recommended for younger, active patients who want to delay joint replacement surgery. By correcting the knee’s alignment, HTO can reduce pain, enhance mobility, and extend the life of the knee joint, making it a valuable option for those with early to moderate arthritis.
High Tibial Osteotomy is typically recommended for patients with unicompartmental knee osteoarthritis, where only one side of the knee is affected. Ideal candidates are usually:
However, HTO is not suitable for those with severe arthritis affecting the entire knee, inflammatory joint diseases, or poor bone health.
During an HTO, the surgeon makes a carefully calculated cut in the tibia near the knee and reshapes the bone to correct alignment. There are two main techniques:
The procedure is performed under general or spinal anesthesia and usually takes about 1-2 hours. Surgeons often use plates and screws to stabilize the bone during healing. Unlike knee replacement, HTO preserves the patient’s natural joint, making it a preferred choice for younger individuals.
Proper preparation is key to a successful HTO surgery and smooth recovery. Here’s what you can expect:
You’ll also receive instructions on fasting before surgery and medications to avoid (e.g., blood thinners). Being well-prepared helps minimize complications and speeds up healing.
Recovery from HTO is a gradual process, typically taking 6-12 months for full healing. Here’s a general timeline:
Physical therapy is crucial for regaining strength and mobility. Following your surgeon’s and therapist’s guidelines ensures the best long-term results.
While HTO is generally safe, like any surgery, it carries some risks, including:
Choosing an experienced surgeon minimizes these risks. Discuss any concerns with your doctor before proceeding.
HTO is one of several surgical options for knee arthritis. Here’s how it compares:
| Procedure | Best For | Recovery Time | Pros |
|---|---|---|---|
| HTO | Younger patients with partial knee damage | 6-12 months | Preserves natural joint, delays replacement |
| Partial Knee Replacement (PKR) | Localized arthritis in older patients | 3-6 months | Faster recovery than HTO |
| Total Knee Replacement (TKR) | Severe, widespread arthritis | 6-12 months | Long-term pain relief |
HTO is unique because it avoids artificial implants, making it ideal for active individuals who want to maintain their natural knee structure.
Studies show that HTO has a success rate of 80-90% in appropriately selected patients. Key long-term outcomes include:
Success depends on factors like proper patient selection, surgical technique, and adherence to rehabilitation. Regular follow-ups help monitor knee health over time.
1. How long will I need to use crutches after HTO?
Most patients use crutches for 4-8 weeks, gradually increasing weight-bearing as the bone heals.
2. Will I need a second surgery to remove hardware?
Plates and screws usually stay in place unless they cause discomfort, but some surgeons remove them after 1-2 years.
3. Can HTO fail?
In rare cases, the bone may not heal properly, or arthritis may progress, requiring additional surgery (e.g., knee replacement).
4. When can I drive after HTO?
Typically after 6-8 weeks, once you can comfortably bend your knee and control the car.