High Tibial Osteotomy

High Tibial Osteotomy

A Tibial Osteotomy is an operation in which your tibia (shin bone) is surgically broken (this means that it is broken under the control of a surgeon), once broken the tibia can then be realigned into a better position. The purpose of this is to alter the way that forces cross the knee and takes pressures off of certain areas of the joint surface. Once healed, body weight is transmitted mainly through undamaged cartilage resulting in less pain and swelling for the patient.

➡ This operation is sometimes carried out when knee arthritis is present in young and middle-aged patients. It is only effective if the arthritis is confined to ONE area of the knee, the rest of the joint must be health.

An osteotomy is usually only considered as a treatment option if things such as Physiotherapy and Anti-Inflammatory medication hasn’t helped with the patients symptoms.

The Surgery

An osteotomy is carried out under General Anaesthetic. An incision (approximately 15cm) is made over the upper part of the tibia. Using X-ray images as guidance, the bone is then cut ALMOST all the way across. This cut allows the surgeon to re-align the tibia. The bone is then held in it’s new place with a plate and screws.

This is called an opening wedge osteotomy and the triangular gap in the bone will fill with new bone over the months following surgery


Post Surgical

Normally you will go home 2 days after this operation. To begin with you can partially weight bear on the leg, you will be allowed to progress to full weight bearing after 6 weeks as long as your X-Ray shows that the bone is healing. Once fully weight bearing you can stop using your crutches as soon as you have no discomfort.

Long term

Although this operation is used to improve symptoms of knee arthritis – it cannot cure it. Further surgery will almost certainly be necessary.

The plate used to hold the bone in place will need to be removed once the osteotomy has united (fully healed) – this is usually carried out around 2 years after the initial operation and as it is a much smaller procedure, can be done as a day case.

♦ Studies have shown that an Osteotomy can delay the need for a knee replacement for up to 10 years♦

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Posted in Knee Surgery.