High tibial osteotomy (HTO) surgery is a procedure used to treat certain knee conditions, such as osteoarthritis, genu varum, and genu valgum by realigning the bones in the knee joint. This surgery aims to relieve pain and improve function in the knee joint, particularly in patients who have early-stage arthritis or specific types of knee deformities.
During the HTO surgery, Dr Shales will make an incision on the upper part of the shinbone (tibia). He will then make a series of cuts to realign the bone. This realignment shifts the weight-bearing axis of the knee joint, reducing pressure on the damaged or arthritic area. The bone is secured in its new position using metal plates, screws, or other fixation devices. The surgery typically takes a few hours, and patients may require a short hospital stay.
Before HTO surgery, patients will undergo a thorough evaluation, including physical examination, imaging tests (such as X-rays or MRI), and possibly blood tests. The surgeon will provide specific instructions on preparing for surgery, which may include discontinuing certain medications, fasting before surgery, and arranging for transportation to and from the hospital.
After surgery you will need to take some time off work and Dr Shales will be able to give you an estimate of the time frame. You may also need to spend a period of time on crutches so planning the home environment and organising travel plans is recommended.
After HTO surgery, you will wake up in recovery with your knee bandaged. After a short time you will then be transferred to the ward. Patients will need to rest and elevate the affected leg to reduce swelling and promote healing. Pain management medications will be prescribed to help manage discomfort. Physiotherapy may be initiated soon after surgery to improve range of motion, strength, and flexibility in the knee joint. Patients should expect a gradual return to normal activities over several weeks to months, depending on the extent of the surgery and individual healing factors.
Rehabilitation plays a crucial role in the success of HTO surgery. Physiotherapy exercises will be prescribed to strengthen the muscles surrounding the knee joint, improve stability, and restore functional mobility. Patients will work closely with a physiotherapist to progress through a structured rehabilitation program tailored to their specific needs and goals.
Like any surgical procedure, HTO surgery carries risks and potential complications, including but not limited to infection, blood clots, nerve or blood vessel damage, failure of bone healing, under or over-correction and persistent pain or stiffness in the knee joint. The surgeon will discuss these risks with the patient before surgery and take steps to minimize them during the procedure.
The outcomes of HTO surgery can vary depending on various factors, including the patient's age, overall health, severity of the condition, and adherence to rehabilitation protocols. In many cases, patients experience significant pain relief, improved function, and a delay in the progression of knee arthritis following HTO surgery. However, individual results may vary, and some patients may still require additional treatments in the future, such as knee replacement surgery.
High tibial osteotomy surgery is a valuable treatment option for patients with certain knee conditions, offering the potential for pain relief and improved function. By understanding the surgical process, preparing appropriately, actively participating in rehabilitation, and following post-operative instructions, patients can optimise their chances for a successful outcome.
Here are a number of the questions we often get asked.
Recovery time can vary depending on individual factors and the extent of the surgery. In general, patients can expect to return to light activities within a few weeks and resume more strenuous activities gradually over several months.
Yes, most patients will need to use crutches or a brace for a period after HTO surgery to support and protect the healing knee joint. Dr Shales will provide specific guidance on the duration and use of these assistive devices.
Initially, patients will need to avoid high-impact activities and heavy lifting to protect the healing knee joint. Over time, as strength and stability improve, patients may gradually reintroduce more activities, but some restrictions may remain in place to protect the longevity of the surgical outcome. It's essential to follow Dr Shales recommendations regarding physical activity and rehabilitation.
