High Tibial Osteotomy

Osteotomy basically refers to “cutting of the bone.” In a knee osteotomy, either the shinbone or tibia or thighbone or femur is cut and reshaped so as to relieve the pressure on the knee joint.

Knee osteotomy is used when a person has early-stage osteoarthritis that has damaged just one side of his knee joint. With the help of Osteotomy, the weight could be shifted or transferred from the damaged side of the joint. This can significantly relieve pain and improve function in your arthritic knee.

The major purpose of Knee Osteotomy is to:

  • To transfer or shift weight from the part of the knee affected by arthritis to a healthier region
  • To rectify poor knee alignment
  • To prolong or extend the life span of the knee joint

Knee osteotomy is highly effective for healthy and active patients who are in the 40 -60 age group. Your orthopaedic surgeon will help you determine whether this surgical procedure is suited for you.

Before Surgery

The patient is likely to be admitted to the hospital on the day of surgery. Prior to the procedure, a doctor from the anesthesia department would evaluate the patient and review his or her medical history. Anesthesia given to the patient could be either general or spinal.

Surgical Procedure

A knee osteotomy operation generally lasts one to two hours. The surgeon will make an incision at the front of your knee, starting just below your kneecap. He will determine the exact size of the wedge using guide wires. The surgeon will cut along the guide wires using an oscillating saw and then remove the wedge of bone. He will then “close” or bring the bones together to fill the space that has been created by removing the wedge. The surgeon will insert a plate and screws to keep the bones in place until the Osteotomy heals. A most commonly used Osteotomy procedure; this is called a Closing Wedge Osteotomy.

In certain cases, the wedge of bone is “opened” and a bone graft is placed in order to fill the space until the Osteotomy heals. This procedure is known as an Opening Wedge Osteotomy.


In most cases, patients are required to stay in the hospital for 2 to 4 days after an Osteotomy. During this time, he or she will be monitored and given pain medication.

After the operation, you have to wear a brace or cast on your knee for protection until the bone heals. You will also have to use crutches for several weeks.

About 6 weeks after the operation, you will have to do follow-up visit. X-rays will be taken so that your surgeon can determine to what extent the Osteotomy has healed. The surgeon would advice you on whether it is safe to put weight on your leg, and when you can start the rehabilitation process.

During rehabilitation, a physical therapist will teach you various exercises that will help to maintain your range of motion and restore your strength. You can resume your normal, active life after 3 to 6 months.