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High Tibial Osteotomy

If a single compartment, either the medial or lateral, of the knee is involved by osteoarthritis and symptomatic a high tibial osteotomy can be performed.

Wear involves thinning of the cartilage and the joint space on that side collapses. This results in the bow-legged or knock-kneed appearance. Paradoxically this increases the amount of body weight going through the worn-out compartment with every step and unloads the well preserved compartment.

Collapse of the medial compartment of the knee. Osteoarthritis on the  left side of the knee.

In order to shift the body weight or load onto the well preserved compartment of the knee without replacing the knee a high tibial osteotomy can be performed to re-align the lower limb.

In this surgery a cut is performed of the proximal tibia just below the knee. The angle of the tibia is adjusted slightly thus realigning the long axis of the leg and thus transferring the body weight onto the unaffected compartment of the knee.

The advantage of this procedure is that the patient can return to all sports without restriction after the surgery. The knee is also ligamentously and kinematically preserved.

This surgery is only appropriate if a single compartment is involved.