A High Tibial Osteotomy is a descriptive term used to describe an operation used to treat osteoarthritis of the knee. An osteotomy is the act of cutting a bone. 'High Tibial' details the location of this cut, the upper portion of the tibia or shin bone that forms the bottom half of the knee joint.
A high tibial osteotomy is used to treat unicompartmental osteoarthritis of the knee. This means that the arthritic wear is bound to one half of the knee – either the inside, or outside of the joint. When arthritis wears down one side of the articular cartilage covering the ends of the bones, angulation occurs. These results in a disproportionate amount of body weight being taken through the worn side. This in turn leads to an increased rate of wear and an acceleration of symptoms such as pain, stiffness and swelling.
A high tibial osteotomy looks to realign the knee to even share weight between both the inside and outside of the knee. This is achieved by cutting the bone then either taking a wedge of bone out, or adding a wedge of bone in.
This type of surgery has a long recovery period as the cut essentially fractures the main weight bearing bone of the lower leg. Even after surgically fixing the bone in its new position, it is unable to take any weight for a significant period of time. This has a major implication for work, lifestyle and everyday activities.
This operation is not suitable for everyone but can be a valuable tool for those too young for a total knee replacement.