What is a High Tibial Osteotomy?

High tibial Osteotomy or HTO is a procedure to correct mal-alignment of the knee. In this procedure depending upon the deviation the upper part of tibia (leg bone) is surgically fractured (osteotomy) & realigned to give normal alignment back to the knee.

Which type of Knee problems are treatable with high tibial osteotomy?

Unicompartmental Knee osteoarthritis where only one side of the knee is damaged can be offloaded to relieve pain with an HTO

What is the basis of an HTO?

The weight bearing axis (mechanical axis) of the knee normally falls just outside the centre point of the knee. Due age related wear & tear most commonly the inner side of the knee wears off leading to shifting of the mechanical axis to the inner side of the knee. This deviation leads to either bowing legs & pain on the inner side of the knee. With an HTO our aim is to correct the mechanical axis of the lower limb to a correct alignment which relieves  the pain.

How is this correction done surgically?

Once the deviation is calculated the amount of correction is determined & the same is done surgically on the leg bone & to maintain the gap a plate or a fixator is applied. This gap usually heals within a period of 2-3 months leading to completely normal leg alignment.

What is the advantage of an HTO over UKR?

Since the correction is done away from the joint this surgery truly preserves the original knee joint & giving it another 8 to 10 years lease of life. There is no replacement of the joint at all maintaining all the natural functions of the existing knee joint.

Similar to the medial compartment isolated lateral or very rarely  patellofemoral osteoarthritis can also be tackled with Partial Knee Replacement

What is the ideal age group for  undergoing an HTO?

Any person with significant bowing of the Knee & pain can undergo this surgery but usually this is needed for a person between 40 to 60 years of age.

So HTO helps is alleviating knee pain arising due to bow legs without undergoing replacement of the Knee