High tibial osteotomy

At Spire Clare Park Hospital in Farnham, on the Surrey/ Hampshire, we have several orthopaedic surgeons who carry out high tibial osteotomy routinely. They work within our laminar flow theatres to reduce the risk of infection. With the support of our physiotherapists, you will be up and about and ready to go home within a couple of days.

Ask your GP for a referral to the orthopaedic team Spire Clare Park Hospital. Alternatively, contact the Patient Information Advisers on 01252 895 490, info@spireclarepark.com or fill out the enquiry form on the right-hand side of this page. 

High tibial osteotomy

Sometimes arthritis of the knee in a young or middle-aged patient is best treated by an operation that alters the way forces cross the knee, taking pressure off the damaged joint surface. Typically people have bowed legs and get more wear of the articular cartilage on the inside of the knee.

Osteotomy means to surgically break the tibia under control. After the tibia is broken it can be realigned into a better position and allowed to heal. Once healed, the force of the body is transmitted mainly through undamaged cartilage, and patients will have less pain and swelling. For the operation to be effective the arthritis needs to be confined to one area of the knee only. The rest of the joint must be healthy.

Before suggesting an osteotomy, our orthopaedic consultants prefer to try and control your symptoms with physiotherapy, anti-inflammatory medication and, possibly, key-hole surgery. If these techniques are not successful then an osteotomy would be considered.
Osteotomy is usually not suitable for patients much over the age of 60.

What happens during high tibial osteotomy surgery

Under general anaesthetic, a 15 cm incision is made over the upper part of the tibia (shin bone). The bone is cut almost all the way across using X Rays to guide the cut. The alignment of the tibia is then carefully adjusted by opening this cut in the bone until the desired alignment is reached. The bone is then fixed with a plate that is held in place with screws. This is a called on opening wedge osteotomy. The triangular gap in the bone will fill in with new bone over the next few months post surgery.

Most patients are ready to go home after 48 hours. The plate and screws are made of titanium and are very strong so you can partially bear weight on the operated leg with crutches. After six weeks, if the x-rays show the tibia is healing well you can progress to full weight bearing and dispense with your crutches as the discomfort settles

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