High Tibial Osteotomy

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Some indications for the high tibial osteotomy are listed below.

  • Medial compartment arthritis. This is a form of arthritis found in the knee that can actually cause the knee to collapse.
  • Being bowlegged (knees forming outwards, placing pressure on the inside of the knee).
  • Being knock-kneed (knees forming inwards, placing pressure on the inside of the knee)

In any of these situations, the cartilage in the knee can be become worn down or destroyed, which causes the bones to grind against each other, leading to severe pain and complications with walking.


Those having this procedure done should expect to be admitted for an overnight stay the day of the procedure. The general idea of the procedure is to straighten the tibia and angle the bone so that the pressure that has been causing the patient pain is actually moved to another part of the patient’s bone, thus allowing for cartilage to grow in the space where the bone was removed and therefore proving a new cushion.

In order to do this, the tibia is cut and pins are placed into the tibia and extending the exterior of the leg. The patient tightens the pin under the guidance of their physician until the bone is in the necessary place and shape to make the knee properly aligned. The pins are then “locked in” until the bone heals. At this point, the pins are removed and the patient is completely mobile. The procedure is done in the hopes of relieving the pain of the patient so that they may return to normal functioning.

The faster way of doing this procedure is done by inserting a plate into the tibia in very close proximity to the knee. A part of the tibia is actually cut out and it is for this reason that the procedure is risky. The removal of bone so close to the knee makes a future knee replacement more difficult and in some cases impossible. It is also not as accurate as the slower procedure.


As with any surgery, there is a risk for infection. The most common form of infection found in this particular procedure is a superficial infection that tends to be found on the outside of the incision and easily dealt with. Some rarer complications that may occur following this procedure include deep infection, nerve damage,e and reflex sympathetic dystrophy.