Perform a High Tibial Osteotomy (HTO) is a realigning, joint sparing operation for osteoarthritis and malalignment of the knee. Contrary to a knee replacement which requires resection and replacement of the worn ends of the bone and in the case of a total knee replacement, resection of the anterior cruciate ligament as well. The HTO preserves the joint and works by shifting load from the worn, arthritic side of the joint to the unworn side.
An HTO is not applicable to all arthritic knees and it is not as predictable as Total Knee Replacement (TKR), therefore, it is reserved for those who are likely to wear out a TKR. HTO is a durable treatment option if done in the right patient and if limb malalignment is corrected to the ideal angle.
There is a lot of different techniques of HTO and each one has it’s pros and cons and no technique is applicable to all situations.
When it comes to pre-operative planning HTO is a major procedure that should be undertaken under the greatest conditions. Based on a method described by Dugdale et al, PeekMed offers you a tool for HTO that measures the correction angle, i.e. the angle between the line from the center of the femoral head to the point at 62% of the medial-lateral distance of the knee, towards lateral, and a line drawn from that point to the center of the tibiotalar joint. Check it here:
With HTO it is possible to reduce knee pain by transferring weight-bearing loads to the relatively unaffected lateral compartment in varus knees and to delay the need for a knee replacement by slowing or stopping destruction of the medial joint compartment.
Surgery is not a pleasant prospect for anyone, but for some people with arthritis, it can be fundamental to the difference between a normal life or putting up with a debilitating condition. Surgery can be the key for the treatment plan and it can help to restore function to the damaged joint as well as relieve pain.