High Tibial Osteotomy (HTO) is an advanced surgical technique designed for patients under 60

years of age, particularly those who are very active or involved in demanding sports. This

procedure is ideal for individuals experiencing knee pain due to early stages of osteoarthritis

and beginning loss of cartilage, as evident on X-rays.

Why Consider High Tibial Osteotomy?

When knee cartilage is worn, bones may grind against each other, causing pain and joint

deterioration. Early intervention with HTO can relieve pain, slow degeneration, and allow

patients to maintain an active lifestyle. This procedure might delay or even eliminate the need

for knee replacement surgery.

The HTO Procedure Explained

Performed at the Center for Limb Lengthening & Reconstruction, Mangal Anand Hospital,

Mumbai, the HTO involves a small incision (about 1cm) to access and realign the tibia. This

adjustment redistributes joint pressure and slows down degenerative changes. The operation

uses either external fixators or internal plates to secure the bone, supporting gradual and

precise correction.

The Benefits of HTO

• Pain Relief: Effective alleviation from chronic knee pain.

• Activity Retention: Enables continuation of an active, healthy lifestyle without

heavy reliance on pain medications.

• Degenerative Slowdown: Modifies load distribution within the knee joint, reducing

the rate of joint wear.

• Delayed Surgery: Potentially postpones the need for total knee replacement by

up to 15 years or more.

Surgical Techniques

1. Tomofix Internal Fixation: A discreet, internally applied locking plate.

2. Hexapod Fixator: An external fixator with a sophisticated six-axis correction

system, allowing for meticulous adjustment.

Recovery and Rehabilitation

Post-surgery, patients typically stay in the hospital for about five days with minimal pain due to

modern pain management techniques. Recovery involves using crutches initially, with gradual

return to normal activities. The site where bone is reshaped gradually fills with new bone,

facilitated by the chosen surgical method, ensuring that the knee’s natural shape is preserved

for future treatments if needed.

Ideal Candidates for HTO

This procedure is most suited for:

• Patients under 60 years of age with active lifestyles.

• Those experiencing unilateral knee pain with partial cartilage loss.

• Individuals seeking alternatives to total knee replacement.

At Sir Ganga Ram Hospital, under the expert care of Dr. Manish Dhawan, HTO is performed

using the latest techniques tailored to individual patient needs, ensuring optimal outcomes and

prolonged joint health