This operation is done to reduce pain by changing the pressure placed on the damaged joint surface (the arthritic part of the knee) and transferring the pressure to the more normal cartilage and bone of the other less affected side of the knee.
A wedge of bone is cut out below the knee, making the knee “knock-kneed” instead of “bow legged”.
Reasons for a high tibial osteotomy
A high tibial osteotomy is usually performed for people who have osteoarthritis of the knee joint after many years of wear and tear or an old injury. It is usually performed on younger patients (30 to 60 years) who have osteoarthritis on the inside of their knee. This surgery is preferable to a total knee replacement when the patient is young and intending to return to an active lifestyle.
High tibial osteotomies have a 70% chance of giving good pain relief which means that just under one third of patients do not have the result from surgery they expect. It is therefore necessary to be very sure of the risks of surgery to make an informed decision before proceeding.
Surgery is performed at the Mater Private Hospital and the length of stay is two to three days.
The potential complications of surgery are infection, deep vein thrombosis (blood clots), non union of bone, damage to lateral vessels and nerves and failure of the operation to relieve the patient’s symptoms.
The surgery involves cutting the bone below the knee and making the knee valgus (knock kneed). A metal plate and screws are applied to the bone to keep it stable. A drain is inserted and absorbable (dissolving) sutures are used to close the wound. The knee is wrapped in bandages and a brace applied.
The drain will usually be removed the day after surgery. The patient will require a brace and use crutches for six weeks.
The patient will see Dr Wood two weeks after discharge to check the wound and be given a referral to a physiotherapist to begin physiotherapy of the knee.
The patient should be able to return to work after three months (depending on the type of work the patient does). It takes six months to fully recover.