What actually happens during a high tibial osteotomy operation?

Planning before the day

The correction is calculated in advance from long-leg standing X-rays, which show exactly how much the leg needs to be realigned. An MRI may be used to check the cartilage, meniscus and ligaments. You meet the anaesthetic team, review your medicines, and are advised on stopping smoking, blood sugar control and preparing your home for crutches.

In the operating theatre

• Anaesthesia is usually spinal or general, often with a nerve block for pain relief
• An arthroscopy may be done first to inspect the joint and treat other problems if needed
• A cut of a few centimetres is made over the upper shin
• Under X-ray guidance, the bone is partly cut, leaving a hinge of intact bone
• In an opening-wedge osteotomy, the cut is gently opened to the planned angle; in a closing-wedge, a small wedge of bone is removed
• A plate and screws hold the new position; the gap may be filled with bone graft or a substitute
• The wound is closed and a dressing, and sometimes a brace, applied

In hospital

Most patients stay one or a few nights. The physiotherapist helps you stand and walk with crutches, usually with limited weight on the leg at first. Pain relief, ice and elevation help control swelling, and blood clot prevention is started. You go home once you can move safely and pain is manageable with tablets.

The first weeks

Early recovery focuses on wound healing, reducing swelling, regaining knee movement and protecting the bone while it heals. Follow-up X-rays check that healing is progressing. How quickly you increase weight-bearing depends on the technique, the fixation and your bone quality, and is guided by Dr. Gelber at each visit.