HTO (High Tibial Osteotomy)

High Tibial Osteotomy (HTO) – A Salvage Option for Knee Arthritis 

For younger, active patients with arthritis confined to one part of the knee, High Tibial Osteotomy (HTO) can be an excellent temporary solution. This procedure aims to realign the leg to shift weight away from the worn area of the knee, reducing pain and slowing the progression of arthritis. 

What Does the Surgery Involve? 

HTO is a technically demanding operation. It requires: 

• Cutting the tibia (shin bone) just below the knee. 

• Shifting the bone on a hinge to correct alignment. 

• Fixing the bone with a plate and screws or a wedge device. 

Because the bone is cut, it needs time to heal—this is the main reason recovery is longer compared to joint replacement. 

Recovery Expectations 

• Extended time off work – often several months. 

• Non-weight bearing for a significant period – crutches or other aids required. 

• Painful early recovery – due to bone healing and rehabilitation demands. 

This is a major commitment, and understanding the short- to medium-term implications is essential before deciding. 

Why Consider HTO? 

For very young, high-demand patients, joint replacement may not be ideal because: 

• Joint replacements wear out over time, especially in active individuals. 

• Revision surgeries become more complex as bone stock diminishes. 

HTO preserves your natural joint and buys time—often many years—before a knee replacement becomes necessary. 

Key Points 

• HTO is not a first-line treatment; it’s considered when other options fail. 

• It can delay the need for joint replacement, preserving bone and future reconstructive options. 

• Recovery is long and challenging, but for the right patient, it can be the best solution. 

Bottom line: If you’re young, active, and have arthritis limited to one part of your knee, HTO may be worth considering. A/Prof Hazratwala performs this surgery using computer navigation, ensuring precise alignment and predictable outcomes.