Optimising Recovery and Rehabilitation After High Tibial Osteotomy for Knee Osteoarthritis

Optimising Recovery and Rehabilitation After High Tibial Osteotomy for Knee Osteoarthritis


High Tibial Osteotomy (HTO) is a surgical procedure that can offer significant relief for patients suffering from knee osteoarthritis, particularly those who are active and wish to delay or avoid knee replacement surgery. This article provides a detailed look at what HTO involves, the recovery process, and what patients can expect during their rehabilitation.

Understanding HTO Surgery

HTO surgery involves cutting the shin bone (tibia) and repositioning it to shift the weight-bearing load away from the damaged area of the knee. This redistribution helps to alleviate pain and improve joint function by optimising the biomechanical alignment of the knee.

Step-by-Step Process of HTO

  1. Preparation: Patients undergo pre-surgical assessments, including imaging tests to determine the exact alignment and structural requirements.
  2. Anaesthesia: General anaesthesia is administered to ensure comfort and painlessness during the procedure.
  3. Surgical Procedure:
    • An incision is made along the knee to expose the tibia.
    • The bone is carefully cut according to pre-planned measurements.
    • The tibia is then realigned, and the new position is secured with a metal plate and screws.
    • The incision is closed and dressed.
  4. Immediate Post-Operative Care: Patients typically spend a few days in the hospital to manage pain and begin early mobilisation under supervision.

Recovery Timeline

  • Initial Weeks (1-6 weeks): Focus on reducing swelling and pain with medications and ice. Weight-bearing is often limited, and mobility may be assisted with crutches.
  • Intermediate Phase (6-12 weeks): Gradual increase in weight-bearing activities. Physical therapy plays a crucial role in restoring strength and range of motion.
  • Long-term Rehabilitation (3-6 months): Continued strengthening exercises and gradual return to daily activities. Patients may start to engage in low-impact sports.

Rehabilitation Process

Rehabilitation is critical for a successful outcome post-HTO. It typically involves:

  • Physical Therapy: Aimed at restoring knee mobility, strength, and stability through tailored exercises.
  • Home Exercise Program: Patients are often prescribed exercises to perform at home to enhance their recovery.
  • Regular Follow-ups: Ongoing assessments with the surgical team to monitor healing and adjust rehabilitation plans as needed.

Returning to Sports

Returning to sports, requires careful management:

  • Gradual Resumption: Sports activities should be resumed gradually, and only after achieving sufficient knee strength and mobility.
  • Protective Bracing: Wearing a knee brace during activities can provide additional support during the early stages of return to sport.
  • Listening to the Body: Any signs of pain or discomfort should be taken seriously to avoid setbacks.

Alternative Treatments

For those considering other options, treatments may include:

  • Non-surgical Management: Including physiotherapy, anti-inflammatory medications, and lifestyle modifications.
  • Other Surgical Options: Such as arthroscopic debridement or knee arthroplasty for more advanced cases.

FAQs: All You Need to Know About HTO Recovery

  1. What should I expect immediately after HTO surgery? Expect mild to moderate pain, controlled with medications, and limited mobility initially.

  2. How long before I can walk normally? Most patients can walk without crutches within 6 to 8 weeks post-surgery.

  3. Will I need a knee brace during recovery? Yes, a knee brace is often recommended during the initial stages of rehabilitation.

  4. What are the risks of HTO surgery? Risks include infection, nerve damage, and issues with bone healing.

  5. Can HTO cure my osteoarthritis? HTO does not cure osteoarthritis but can significantly alleviate symptoms and improve joint function.

  6. When can I return to jiu-jitsu after HTO? Returning to competitive sports may take up to 6 months or more, depending on the success of the rehabilitation.


High Tibial Osteotomy can be a life-changing procedure for those suffering from knee osteoarthritis, particularly athletes who are keen on maintaining an active lifestyle. Understanding the surgery, recovery expectations, and rehabilitation process is crucial for anyone considering this option. For more information and personalised advice, visit mskdoctors.com, where expert care meets cutting-edge treatment solutions in orthopaedics and sports medicine.