I just came back from seeing an orthopedic surgeon about treatment for my knee arthritis. She suggested a high tibial osteotomy (HTO) and ticked off a bunch of reasons why this approach is a good idea for someone like me — I’m a 44-year old active, busy, adult with the start of painful knee arthritis. Everything went by so fast. Could you tell me again what are the advantages of this kind of surgery?

There are several benefits of high tibial osteotomy (HTO). Patients can return to an active, busy lifestyle, including sporting activities after healing and recovery. It’s a good middle step between conservative care and a unicompartmental knee replacement (implant replaces one side or the other of the damaged knee joint). It can help active, younger adults with the start of painful knee arthritis to stay in the game so-to-speak.

There may be a need to modify some activities such as switching from running or jogging to walking. It’s possible to have the HTO procedure along with other repair work on the knee. Two or three procedures at one time doesn’t seem to affect outcomes either. Surgeons know they can make other necessary repairs without fear of affecting the results.

Overall, it looks like the HTO procedure has good results and some excellent advantages. It’s not necessary to cut through the tibialis anterior muscle when doing the procedure like osteotomies done a little lower on the tibia or osteotomies done on the opposite side. There’s less risk of damage to the peroneal nerve. There are fewer problems with shortening of the leg. And best of all, it can improve symptoms and delay total joint replacement by preventing disease progression.