High tibial osteotomy (HTO) is a surgical procedure in which the bone at the upper end of the tibia (shin bone) is cut and realigned. It is usually performed in arthritic conditions affecting only one side of your knee and the aim is to take pressure off the damaged area and shift it to the other side of your knee where there is still healthy cartilage. Occasionally,
A distal femoral osteotomy (DFO) can be used to straighten the knee when the deformity is mostly in the femur rather than the tibia.
The ideal patient is a less than 60 years old, a non-smoker, has a BMI <40 with knee arthritis
Nicotine products of any kind are especially detrimental to the success of High Tibial O
High tibial osteotomy is commonly used for patients with osteoarthritis that is isolated to a single compartment (unicompartmental osteoarthritis). It is also performed for treating mechanical axis malalignment, osteochondritis dissecans, posterolateral instability, and chondral resurfacing.
Dr Klar recommends that crutches be used for 3 weeks after your surgery. Usually, hinged knee brace will be fitted after the operation and this is worn for 4 weeks on average. Controlled progressive weight bearing is needed on the operated limb as per Dr Klar’s instructions.
You can be discharged from hospital when the pain is controlled with tablets, you can safely ambulate with crutches and you are tolerating a normal diet. This is usually around day 3 after the procedure.
Risks and complications
Following high tibial osteotomy, risks and complications may include:
- Skin necrosis
- Non-union (failure of the bones to heal)
- Nerve injury
- Blood vessel injury
- Over or under correction of the mechanical axis of the limb
- Compartment syndrome of the leg
- Deep vein thrombosis or blood clots in the leg or lung
- Complex regional pain syndrome
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