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High Tibial Osteotomy


What is a High Tibial Osteotomy

A high tibial osteotomy seems like a medical tongue twister, intentionally complicated to confuse the average person. In fact, the title is a descriptive one, detailing the operation itself. In medical jargon, the suffix 'otomy' means 'to cut or incise' and 'osteo' refers to bone. An osteotomy is therefore the cutting of a bone. The location of the cut is also stated as the tibia is the shin bone in the lower leg.

Osteotomy is a surgical procedure designed to change the alignment of a specific bone. Osteotomies are performed all throughout the body, one of the more common being the operation that corrects severe bunions in feet.

Osteotomies can be used to correct unwanted angulation or rotation of the bone. In osteoarthritis, it is the angle that is important and the angle that needs correcting.


Indications for High Tibial Osteotomy

 A High Tibial Osteotomy is used to treat unicompartmental osteoarthritis of the knee. Unicompartmental means the arthritis only affects one part of the knee. In this case, either the inside half, or outside half of the knee.

Once the smooth cartilage lining of the joint starts to wear away, the angle at the knee joint can begin to change. If the inside of the knee is being worn (the most common occurrence) the result is becoming "bow-legged". If the outside of the knee is being worn, the knee becomes "knock-kneed".

This slight change in angulation results in all of the body's weight being taken through the affected side. This results in dramatically increased wear on the already worn side, but good preservation of the unaffected side.

A High Tibial Osteotomy aims to realign the bones to restore even weight bearing between the inside and outside of the knee. It does not make the affected side "unworn", it just stops it from taking the overwhelming majority of the weight.


High Tibial Osteotomy - What is Involved?

There are two ways to perform a high tibial osteotomy, an opening wedge or a closing wedge.

An opening wedge cuts the bone, increases the angle and fixes it in its new position filling the gap with a bone graft.

A closing wedge osteotomy removes a wedge of bone to achieve the change of angle.

Either way an osteotomy is a major operation, effectively fracturing the main weight bearing bone of the lower leg and surgically fixing it afterwards.

The rehabilitation is lengthy and involves a prolonged period avoiding all weight bearing through the leg. Pain, stiffness and swelling are all experienced after the operation.

Having this surgery (for most people) requires a significant period off work and a major disruption to lifestyle. Mobility will be limited for 6 weeks and it will take 3 - 6 months to resume full activity.


Why Have A High Tibial Osteotomy?

 A high tibial osteotomy is a time saving operation. It is generally performed on people too young to have a total knee replacement. Knee replacements wear out quickly when placed in young people so the osteotomy is performed to try and provide increased function and relieve pain until the person is old enough to have a total joint replacement.

It is important to note that an osteotomy does not address the wear on the affected side. It decreases the load on that half of the knee but it will remain worn and therefore cause some pain. This makes it somewhat different to a knee replacement that directly aims to relieve pain.


Should I Have A High Tibial Osteotomy?

 This is a question that has many variables. The decision can only be made by you after discussing your particular medical history with an orthopedic surgeon who specializes in high tibial osteotomies.

Good candidates have a tolerance of pain, are active, not overweight and have a good understanding of why the procedure is being performed and therefore have appropriate expectations.

This operation is not for everyone but for many people it will let them delay a total knee replacement for many valuable years.

Want to know more?

  • Unloader Knee Braces
    A non-surgical option for the treatment of unicompartmental knee osteoarthritis. Worth considering prior to High Tibial Osteotomy surgery
  • High Tibial Osteotomy
    For information on High Tibial Osteotomy, a common precursor to total knee replacement.

High Tibial Osteotomy Surgery

Description of a Tibial Osteotomy


Bev on September 18, 2016:

My husband just had an HTO. He is tougher than most and was standing on the job site with crutches and his brace on that first week. Needless to say he is off crutches etc. but I think he has over done it. Regardless we have both noticed that he does look a little knocked kneed on that leg compared to the other and looks quite different from the other leg. He sees surgeon in 2 weeks and we are anxious to see what he says about that.

cindyj on September 06, 2013:

Patti. The lightning bolt pain your feeling, boy do I remember those. I will be two year's post op this Dec. The sharp pain are your nerve rndi.gs reconnecting. I still have all my hardware in my knee and have had no problems at all.

Patti on September 06, 2013:

Add Your Comment..7 wks post tibial osteomy, full weight bearing. Starting to get some pain like lightening bolts, very quick jabs. Still have a fair bit of numbness. Started biking, was a bit stiff and swelled slightly. Told to alternate biking and walking. I have successfully biked gor 30 min. Walking approx 3 city blocks and back with the offloader brace. Some pain behind the knee pinching like and on the inner aspect where the button and ACL graft is. Is this normal. I hear lots of you speaking about having the hard ware removed. Is this common? The plates really are not bothering me but at times it feels like the back of my leg has been twisted like going through a wringer washer? Also is it common to still need pain meds on occasion at 7 wks? How long ones the stiffness pursue? Sometimes I feel like my thigh doesn't communicate with my lower leg as a unit.

Terry1963 on July 31, 2013:

I had an open wedge with 12 deg correction done 8 months ago and I'm still having a lot of pain. I can not keep my leg in one postion very long have to keep shifting it. Did therapy for 3 months twice a week. My job requires heavy lifting climbing in and out of trenches and a lot of kneeing which really hurts to do. Filing for disabilty now becuse I have been off so long and don't know when I will get to go back to work. I look towards not have any more pain.

Terry M.

Terry C on July 14, 2013:

17 Months since HTO. Did Mean Green Tri in March. Did ok. Run was better than expected. 8:47/mi. Never will be 100%, but that's ok. As long as I can be active. Knee pops & things going down steps, but not painful. Still running, but my max is about a 10k. No more 13.1's. I believe if I was a little younger It wouldn't have slowed me down as it has, but at 53 and 22 years wearing a rucksak while jumping out of a perfectly good airplane, I am thankful & shouldn't complain. Just words to anyone who is having the HTO, keep the Faith. He is in control. It's not that bad....and remember...it can ALWAYS be worse!

Jen on June 05, 2013:

I am 33, about 40lbs overweight following two back to back pregnancies. Weight is a factor so I thought it was worth mentioning. I injured my meniscus a year ago. A knee scope months later didn't fix the pain. In fact, I couldn't go up the stairs in my home without feeling like someone punched my knee. A new doctor who treats NFL players recommended HTO.

Pain wise, I would have preferred to go into labor a third time. I stayed two nights in the hospital for pain management. I returned to work 11 days after the surgery. I work in IT and sit at my desk or in a conference room most of the time. I am 13 days post HTO and the pain is manageable at times and other times like in the evening it's so uncomfortable I want to cry. I can stand to balance but can't walk. I can position my leg at a 90 degree angle successfully but can't lift my foot and I don't know when I'll drive again. Again, the evening is the worst, especially the first minute to get blood circulating. It feels like an adult is hanging on my thigh when I first walk.

The biggest frustration is the dependency. I am blessed to have a husband who cares for me because I can't do anything on my own. I nearly suffered a setback after the first week when I attempted to shower on my own. Using the bathroom and balancing is a struggle, ladies.

I am taking Motrin for pain management. My doctor doesn't refill OxyContin nor Vicodin a week post op.

My foot is purple at times and my leg is a bit numb. The stitches are out and now I'm in a brace all day with the exception of bath time. I do the recommended exercises daily and will begin PT the eighth week.

I am hopeful that I will see progress soon but again I'm impatient and didn't workout out consistently for a year before my injury.

Your posts of trials and triumphs are encouraging.

Richard on February 17, 2013:

I've had a hto 3 years ago and my back, shoulders and neck have struggled ever since. Has anyone else had this problem and has anyone seen a podiatrist with regards to their gait seen having a hto.

Terry C on February 15, 2013:

3 months post Hardware removal; 11.5 months post HTO: Doing Great! Started running on Dec 28, had a small 2 week setback on about 14 Jan. Been running again for about 2 weeks. Feels good when running, but not so good when I wake up & walk down the stairs. Creakin & Poppin!!. Am signed up for Mean Green Triathlon on March 17th. Just lookin to finish...& not be last!!!

I do wanna give all the glory to God the Father & Jesus Christ his son fo making it possible. Without them I would still be feeling sorry for myself!!!


marsfly333 on January 04, 2013:

I am five weeks post HTO. I know everyone is different but for me this has been hard. I was in the hospital 4 days, mostly due to Spinal Headache caused from my epiduaral. Spinal Headaches make you very sick, with painful headaches and vomiting. They did a blood patch on my spine to cure that. It helped and I was able to go home. The nausea stayed for two weeks, making it hard for me to eat or sit up. Having said all this, i think it put me about a week behind. The pain was pretty bad for two weeks, then it has slowly been better. I am 50% weight baring for two more weeks. I went back to work after 5 weeks, mostly because if i sit for long periods of time, i have a lot of swelling and it causes circulation problems in my foot. My therapy is going well..I can bend it and rode a stationary bike for 5 minutes..whoo hoo! Each week it gets better but this is not an easy surgery!! I know it will be worth it in the end. I am 47 and very active and this was the only way to fix and still be able to be active. (softball, volleyball, snowboarding,snowshoeing) I will not be a runner...not worth it to me.

Bilby264 on December 21, 2012:

Nine months sunce open wedge hto. My knee still stiffens up and if I have to get up in a hurry forget it. Site is still numb

And I still have diuficulty walking any distance. Is this normal?

cindyj2776 on December 21, 2012:

Well 12-20-12 one year since my surgery . I am happy to say that everything is going great!!! No problems with my knee . I am back in my heels as of two weeks ago and it feels great. I am happy to say that my Doctor did an amazing job. Went for my one year follow up and he said everything looks great. I may not return to zumba any time soon Dr says i have ver little cartlige left in my knee so if I injure it again Im looking at a knee replacement. Too young for that. I am actually going to listen to my dr. Close2225 I had some bruising for a week or two after surgery but not as bad as your sounds I would call your Dr. just to be safe. Good luck with your recovery its gonna be long but you will get thru it just be patient.

Close2205 on December 20, 2012:

Hi guys I am 3 weeks out from my hto I am 27 and was very active before the surgery. Is bruising still common this long after the surgery.? The bottom half my leg is bruised and terribly painful to touch. It actually hurts worse than the knee. Saw surgeon a week ago and he was very pleased. Just wondering if anyone else had a lot of bruising so long after operation.

terry c on December 14, 2012:

Ok...3 1/2 weeks from hardware removal. Still have pain, but just from surgery & swelling. I believe I will be able to run again, however knee is still unstable. I hit or turn knee wrong and there is a weird feeling...like a clicking in my knee. I think my racquetball days are over. Surgery was nothing! Didn't even use crutches. Signed up for Mean Green Triathlon on March 17th. Just want to finish and not be last...or even bottom 1/3. Let you know! Praise God!

terry c on November 19, 2012:

Back again. 8 1/2 months since HTO. Having my plate removed tomorrow morning. I am probably about 80% but still can't run. By the end of the day swelling is back. Back surgery went well. It was nothing compared to HTO. The HTO for me was more of an inconvenience..being so long for recovery. Hope & pray this 3rd surgery of the year goes well.

Post again in a few days.

Praise be to God!!

tads44 on October 21, 2012:

hiya guys i have just had a hto op 4 wks ago and im not wearing brace at home just when i go out to paper shop or into town or friends house is it better i wear brace at all times as just feeling numbness at all times is this expected as cant c surgeon until 6 week follow up period so cant ask him any questions until then

rick on October 02, 2012:

i am having this surgery Nov. 27th/2012 and would like to know from operation to being able to work again, what is the longest I could be off work(I work in a big 3 car factory). I have full cartlidge on the out side of the knee and inside is grinding(bone to bone), causing my bow-leggedness. My bio-mechanics are so out of whack I work on a factory car line and after 2 hrs. I am walking like a penguin. I'm 57 and in great physical health and want this operation to straighten me so I can walk normal. I read that 50% of patients have the plates taken out. WHY?.

cindyj2776 on September 08, 2012:

Terry C - sorry that you are having some issues. My surgery went well. Thank God! I was off crutches by month4,and done with that lovely knee brace by month 5. I slowly started back at the gym in month 6 when PT was over. The only issue I had other than the initial pain;was my leg would swell up really bad when I started finally walking on it again. Dr said it was because it wasn't used for so long. I had to wear a compression sock for a lil bit but that too is no longer an issue.We all heal differently. I think that because its such a long healing process we sometines let it get to us. My Dr said it's a 12-18 month full recovery process. Good luck with your recovery!

bilby264 on September 08, 2012:

terry c I had lumbar laminectomy surgery 20 years ago and it was an easier recovery than the hto I had 6 months ago. You need to be careful but at least you are up and walking around unaided fairly quickly. I still have one crutch after 6 mths and have sprained my back twice and pinched the nerve in the unoperated knee. I hope that your surgery went well.

CindyJ2776 on September 06, 2012:

Bwolfe- I had my ACL and HTO done at the same time. I too had a horrible arthridic knee. Can u get everything done at once?? This surgery is VERY painful... If you can have it all done at once I say go for it. I am 8 months out and Ican honestly say at 7 months is when I finally started to feel "normal" so if your gonna be in pain I say do it all at once . Good luck.

Bwolfe on September 05, 2012:

I was just told today that I tore my ACL again for the third time. My knee has been labled on of the worst this surgeon has seen. My Xray looks like the picture in this article with an arthridic ridge of bone that's 3 inches in length. My Dr. is saying he wants to perform the HTO surgery then remove the existing hardware and redo my ACL in another 8 months after I heal from the HTO. My question is this is the third time my ACL has failed what are the chances it will be successful this time and is it worth it to have the HTO surgery?

terry c on July 19, 2012:

Sorry...the last post should have said 4.5 months, not 5.5

terry c on July 19, 2012:

Ok. Approx 51/2 months after my HTO. Still gets sore every now & then. Every time I hit something sideways I have pain. Been doing extensions & curls for about 2 mos. Feels strong, but again going sideways hurts. Doc said I may need to get the plate taken out in sept/oct if it doesn't get better. He said about 50% of HTOs need plate removed. Anyone can help me with that? Does it help?

Also, being tested this year in my Faith. Have spinal stenosis, disc degeneration & arthritis in my lower lumber. Lumbar laminectomy surgery scheduled for August 10. Please pray for me.

Went from doing Kansas 1/2 Ironman last year in June to can't even walk around the block with my daughter.

flash0788 on May 02, 2012:

Well, I had my closing wedge HTO about 6 1/2 weeks ago. I must admit I was not looking forward to this surgery. All in all, while no vacation, it was not as bad as I had feared. Had surgery on a Thursday morning and went home the next morning. If I had it to do over I might have tried to stay in the hospital at least for the rest of Friday to have better pain management but once settled in my trusty recliner I was alright. Had my staples out on day 7 (what a difference that made, those things are very uncomfortable)went back to docs around week 6 and xrays looked good so he let me start partial weight bearing (probably helped with it being a closing wedge and the internal metal plate they put in with 5 screws) and can . Also, I am allowed to do some stationary bike with no resistance which actually feels pretty good. One thing he allowed me to do leading up to week 6 was work on range of motion stuff and that helped a lot too. Now working on getting the muscles back in shape and slowly building up stamina. I am able to make due with one crutch now except for longer walks like from the parking garage to my office at work when I use 2 (mainly for balance and fear of tripping over something) I won’t really know if it was worth it until I am recovered enough to at least walk normally but I am hoping this does the trick. A few tips I would give is to try an unloader brace first. If that helps then you will supposedly have a good idea how the osteotomy will work for you. Drink lots of water, take fiber or stool softener daily (pain meds clog you up pretty good) and wean yourself off of meds instead of going cold turkey and don’t take the meds any longer than you have to. If you need them for pain then you need them for pain, just make sure to start weaning off as soon as you are able (only you can tell when that you no longer need them). They affected my mood greatly after taking them for a few weeks so I weaned myself off of them completely by 4 ½ to 5 weeks. Good luck to all!

terry c on April 10, 2012:

Bilby..Drink more water first of all. I know the first 2-3 weeks I didn't drink enough & I was cramping everywhere. For the pain, are you sleeping in your brace? My doc had me sleep in my brace for the first 5 weeks and my leg was fine. Now I have been working it out by myself (bending it) and sleeping w/out the brace & when I wake up, my leg is sore also. Nothing major, but when I sleep I guess I am doing something to it to make it throb. When I wake up and start my day it's ok...even when I am working on it there is no pain. In the morning I am easily bending it 90 degrees w/ no pain. At the end of the day I can get to 90 but w/some discomfort. I still am non-weight bearing which is driving me up a wall, but hopefully he will allow me to start in 2 more weeks...8 weeks post-op.

Good Luck & God Bless!!

Bilby264 on April 07, 2012:

I am 4.5 weeks post op now. I could not sleep due to cramps in left leg now I am so exhausted I am sleeping but when I wake in the morning my leg is so stiff and sore I am in agony. Has this happened to anyone else or should I consult my surgeon?

bilby264 on April 03, 2012:

I am 4 weeks post op from a hto on my left leg which I had because of severe arthritis. I saw my surgeon last Friday and he is happy with my progress.I not not seeing a physio as yet as my surgeon wants me to try to bend my knee myself. I am finding the recovery difficult andI am still in pain when I try to move my leg. My leg is still swollen and numb at the site of the hto although the incision on my knee is healing very well. I am finding it difficult to sleep due to leg pain and I am sure this is contributing to my depression. It is good to listen to the experiences of other people and I know it will be better in the long run.


terry c on March 30, 2012:

Four weeks post HTO. Doing great, but ready to start walking without crutches. Been back to work 1 week after w/no problems. No pain at all. Once in awhile I do get a sharp pain where my plate is. I get my x-ray on Wednesday the 4th (about 5 weeks after). I believe the doc will allow me to start putting weight on it. I hope to be off crutches 2 weeks after that, Lord willing. He says I'll start rehab then and move into strength training. I believe I will be able to start swimming after I am full weight bearing. Then hopefully start biking a few weeks after that. My goal is running by June-July time frame and my first Sprint Triathlon by September.

Again, I thank my Lord & Savior Jesus Christ. I pray for all those going through this surgery.

Geoff on March 20, 2012:

I had a tibial osteotomy in 1982 and have now developed an asymmetrical gait, can anyone direct me to any information which might indicate a direct correlation between the 2

terry c on March 12, 2012:

Day 11 after HTO. Went back to work 1 week after surgery. Got my stitches out on day 8. I'm allowed to let gravity bend my knee now. I'm about 45 degrees (1/2 way to normal)Scheduled for X-ray on 4 April..about 5 weeks after surgery.

Just praising God for virtually no pain, & no complicatios up to this point. Only problem I do have is my foot still swells up after being up most of the day..but was told that is normal.

I just hope & pray for anyone who has had, or will have this surgery!!

terry c on March 06, 2012:

day 05 after HTO. Been out, sitting up all day, feeling great. I am really thinking it all depends on your surgeon. My biggest problem is sleeping, because I usually sleep on my stomach. I am going back to work on Thursday, 1 week after surgery. No reason not to. I pray Laurie that your surgery goes as well as mine has so far.

Cindy2776 on March 06, 2012:

Laurie I wish I could say your Dr is right, but I too thought I would be back at work in two weeks after having an HTO.Sorry but I took 6 weeks off from work. This surgery is VERY painful and you can not do anything. the first three weeks were the worst if your job has short term disability I highly recommend you take advantage of it. Good luck

terry c on March 03, 2012:

Day 3 after surgery. Was released about 30 hours after surgery. Did ok for awhile. Then took my pain meds & went into a depression. Shook that off now with God's grace & doing fine. I am gonna try not to take any more meds...especially the strong stuff. Sitting on computer now with virtually no pain...about 30-40 mins.

My surgeon said he has done about 150 of these. Only one guy took longer than 4 months to heal. Don't know how mine will turn out but again, I turn to my savior Jesus Christ!

Terry C on February 28, 2012:

Oh...and one last thing. Many people, atheletes have their leg broken everyday, without medication. And yes, they usually are back to school the next couple of days or so, so I think it is realistic to think that...but I will see. Thanks again!!

terry c on February 28, 2012:

First of all IhadHTO, I appreciate your honesty. I have read all kinds of things with this surgery. From not that bad, if you take your meds, to people like you who say it's the worst they ever had. I choose the first one! I guess I'll just have to experience it for myself(not that I want to!) I also believe that I am in good hands. My faith is not in my doctor, but the one who made my doctor be able to do what he does...Jesus Christ my savior. I'll let you know next week. Maybe when we are both back to 100% again, if we can get back that far, we can link-up and go for a run!! I pray for your speedy recovery!!

IhadHTO on February 27, 2012:

Sorry to say. If you are expecting to return to work in a week or ten days - that's not going to happen. I have a very high tolerance to pain and could only last maybe 1 or 1 1/2 hours sitting up. You will see that you need to spend a lot of tie on your back to keep the knee elevated. Keeping it elevated helps with the swelling and therefore the pain. I can't believe the DR said you would be able to work in a week or 10 days. I don't want to sugar coat anything here but it is extremely painful! Remember you are having your leg bone cut almost completely through with a bone saw. Not much different then having a traumatic fracture of the same bone, do you think you would be back to work in a week?

Terry C on February 27, 2012:

My doc said all depends on your pain tolerence. Said most can expect 1 week to 10 days. I have mine scheduled for Thursday. I am shooting for the next Thursday to return to work, but we will see. Good thing for me is I am a teacher, so if I can stand it just 2 days, we will be on Spring Break the next week and I won't have to take a leave of Absence.

Laurie on February 27, 2012:

Will be going for surgery the end of June. Doctor said I would be back to work in a few days. Is this correct?

IhadHTO on February 25, 2012:

Had HTO. 6 weeks ago today. Let me first start by saying I have had 6 shoulder surgeries and thought that was the most painfull surgery. Let me tell you I was so wrong! First two weeks were a blur. Needed a lot of pain meds. I was non weight bearing for four weeks. Been doing some light hobbling around for two weeks. It's still painfull but can deal with it. I'm told 8 weeks is a turning point by my PT. feels like he's going to be right. Most of the numbness is gone now. I'm told I can gain 10 to 12 years on knee replacement. Have no regrets for the surgery just want to let you guys know what to expect.

Terry C. on February 25, 2012:

Due for an HTO on Thursday, March 1st. I am a 52 year old Triathlete. My surgeon says I could be back competing in maybe 6 months. Is this true? My surgeon does pro atheletes, so I know I have one of the best. He also says this will buy me at least 10 more years before a knee replacement. This sound mostly right?

This surgery scares the heck out of me. I have been told I have a high tolerence of pain, but I have had some abcessed teeth that might suggest otherwise.I am not looking forward to it. The schedular said for pain they give time-released morphine & suggest I do the Polar Care machine...all which helps with pain. Anyone have any comments of the previous mentioned treatments/medicine...and any other thing I can expect?

Sara on February 15, 2012:

Hi, great article!

My doctor uses the same technique (open wedge) described above.. I want to have the surgery for my bow legs. But apprently the surgery will make me knock kneed, is that true? Why can't I just have straight legs? I only have mild pain but I'm scared of developing arthritis in the future which is why I want my bow legs to be corrected. Any advice for me... ? :)

flash0788 on January 30, 2012:

Just wondering about other peoples experience with HTO. I had a spiral fracture of my tibia about 10 years ago, ended up with a rod in my leg to put it back together. Had the rod removed and a follow up knee issues resulting in a knee scope and microfracture.

Now dealing with OA in the medial compartment due to a varus condition and doc wants to do a HTO. Been putting it off with an unloader brace for about 5 years now since I am only 44 but this brace, while it works, is a pain. Always chaffing and rubbing my leg raw. Anyone have any input on a comparison between the spiral fracture of a tib/fib and rod insertion and HTO? Any input would be helpful. Thanks.

mcbean (author) from A planet far, far away on January 30, 2012:

If you are lucky you might get around with a cart but I would suggest it is extremely unlikely you will be walking that far.

You will have to wait and see and hope for the best.

Good luck.

Jim on January 17, 2012:

What did you do for mobility and pain control. Have HTO scheduled for mid Feb. 2012 and 2 trips planned for June and Aug. Later trip includes golf. Think this plan is possible?

karen on September 04, 2011:

i echo what Elizabeth said, very long and painful recovery time, but well worth it in the end. had it done on left leg in May 09 by a brilliant surgeonn, had the plate removed last Oct and was then thankfully painfree. had same op on right knee 13 wks ago and all looking good, obviously feel like i've gone backwards but very confident that it will work as well this time roud, you just need lots of patience.

Tom on August 31, 2011:

I'm scheduled for an HTO in a month from now (Sept 30/11). I hope they go through with it as I've been told in the past that I only had about 1/4 of the cartilage left on the lateral side. I'm hoping it's still intact so they can align the knee so my weight is loaded on the that side.

Also...I hear recovery is long and painful. I would appreciate any insights on recovery.


Elizabeth on August 17, 2011:

I had a HTO due to fact I was too young for a knee replacement. this is a very painfull op it took 18 months to fully recover with no pain. My knee is good now with no pain, Iam a lot more active now than before.

mcbean (author) from A planet far, far away on July 15, 2011:

I'm afraid so.

You need to have half of the knee in very good condition to have a HTO. This is because it will be asked to accept a greater proportion of body weight after the operation than it is currently doing. If the 'good' half of the knee is worn the surgery could make this half rapidly deteriorate and you would be worse off - having a significantly worn medial AND lateral compartment.

Unfortunately, you can't just set a knee to "zero degrees" without asking your other compartment to increase its load.

rsebag on July 06, 2011:

I was scheduled for a high tibial osteotomy due to massive pain from genu varum (bow legged. pain in medial side of both knees. However medial cartillage in good condition. Pain due to pressure from bow leggedness.)

The surgeon started the surgery by doing a diagnostic arthroscopic surgery to check the condition of the lateral cartillage. He found the lateral cartillage contained chondromalacia damage and aborted the surgery.

I asked him, why can't he just make the tibia angle zero degrees. This would relieve the pressing due to the bowleggedness instead of loading everything on the lateral side (from varum to valgus (bow leg to knock knee) of the knee? He told me you can't do this. You must either load the weight on the medial or the lateral side.

Is this correct?

thanks a million.

hussainammer@yahoo.com on March 31, 2011:

It is very good to know the HTO. Thanks.