High Tibial Osteotomy


Knee pain has become a common problem with both young and elderly population. Elderly population is most commonly diagnosed with degenerative/Osteoarthritis which becomes debilitating with time. Arthritis when diagnosed early usually has good response to medical treatment and lifestyle changes.

Patients of grade I and II arthritis complaint of slight pain especially with any activity which involves crosslegged sitting, squatting or bending their knee beyond 90 degrees. Pain usually responnds well to anti-inflammatory and analgesic medications and patients continue living a normal lifestyle.


Indian patients have an inherent bowing-in at the knees, which is popularly called a VARUS deformity in medical terminology. This is because of their habit of sitting on the floor for food and religious activities. This angular bowing increases with age and activity. This leads to a subtle gradual increase in pain over years.

As this condition progresses and leads to severe deformity and pain. With deeper understanding of this mechanical change in walking, we can now offer alignment surgeries which helps us buy time before a total knee replacement surgery. Knee replecement surgery stands the last option in cases with grade 4 arthritis. These alignment surgeries are for patients with an early grade of arthritis who want to prolong the life of the normal knee. The concept is to surgically correct the alignment using an implant.


The patient is made to walk on second day of surgery and range of motion exercises are started. The pain usually settles in about 2 weeks till stitches are removed. The novel approach makes use of a special plate and screws which can be removed after 18-24 months of the surgery.

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