High Tibial Osteotomy in Boca Raton, Boynton Beach & Delray Beach, FL
High tibial osteotomy (HTO) is an advanced joint preservation procedure designed to treat knee pain caused by uneven wear and malalignment of the leg. When arthritis or cartilage damage affects only one side of the knee, abnormal alignment can place excessive pressure on the damaged compartment, leading to pain, swelling, and progressive joint deterioration. High tibial osteotomy works by carefully cutting and realigning the upper portion of the tibia (shinbone) to shift weight-bearing forces away from the damaged area and onto healthier cartilage. Dr. William P. Toole is a board-certified, fellowship-trained orthopedic sports medicine specialist providing advanced knee preservation procedures for patients throughout Boca Raton, Boynton Beach, and Delray Beach. Through detailed evaluation and individualized surgical planning, Dr. Toole helps patients reduce pain, improve alignment, preserve their natural knee, and maintain an active lifestyle without immediately resorting to joint replacement.
What is High Tibial Osteotomy?
High tibial osteotomy is a surgical procedure performed to relieve pressure on the damaged site of an arthritic knee joint. It is usually performed in arthritic conditions affecting only one side of your knee and the aim is to take pressure off the damaged area and shift it to the other side of your knee with healthy cartilage. During the surgery, your surgeon will remove or add a wedge of bone either below or above the knee joint depending on the site of arthritic damage.
Indications for High Tibial Osteotomy
High tibial osteotomy is commonly performed for osteoarthritis that is isolated to a single compartment (unicompartmental osteoarthritis). It is also performed for treating a variety of knee conditions such as gonarthrosis with varus or valgus malalignment, osteochondritis dissecans, osteonecrosis, posterolateral instability, and chondral resurfacing.
High Tibial Osteotomy Procedure
The goal of the surgery is to release the involved joint compartment by correcting the malalignment of the tibia and maintain the joint line perpendicular to the mechanical axis of the leg. There are two techniques that may be used: closing wedge osteotomy and opening wedge osteotomy. Your surgeon determines the choice of the technique based on your requirement.
Closing Wedge Osteotomy
Closing wedge osteotomy is the most commonly used technique. In this procedure, your surgeon makes an incision in front of the knee and removes a small wedge of bone from the upper region of the tibia (shinbone). This manipulation brings the bones together and fills the space left by the removed bone. Your surgeon then uses plates and screws to bind the bones together while the osteotomy heals. This procedure unloads the pressure off the damaged joint area and helps to transfer some of the weight to the outer part of the knee, where the cartilage is still intact.
Opening Wedge Osteotomy
In this procedure, your surgeon makes an incision in front of the knee, just below the kneecap and makes a wedge-shaped cut in the bone. Bone graft is used to fill the space of the wedge-shaped opening, and if required, plates and screws can be attached to further support the surgical site during the healing process. This realignment increases the angle of the knee to relieve the painful symptoms.
Complications of High Tibial Osteotomy
Complications following high tibial osteotomy may include infection, skin necrosis, non-union (failure of the bones to heal), nerve injury, blood vessel injury, failure to correct the varus deformity, compartment syndrome, and deep vein thrombosis or blood clots.
Why Choose Dr. William Toole for High Tibial Osteotomy in Boca Raton, Boynton Beach & Delray Beach?
Correcting knee alignment requires advanced expertise in biomechanics, cartilage preservation, and reconstructive knee surgery. Dr. William P. Toole is a fellowship-trained orthopedic surgeon specializing in sports medicine and joint preservation techniques for active individuals and patients with early arthritis or cartilage injury. He carefully evaluates each patient’s alignment, cartilage condition, imaging studies, and activity goals to determine whether high tibial osteotomy is appropriate. When indicated, Dr. Toole uses precise surgical planning to restore mechanical alignment, redistribute joint forces, and protect remaining healthy cartilage. His goal is to help patients maintain their natural knee for as long as possible while reducing pain and improving long-term function.
High Tibial Osteotomy FAQs
What is a high tibial osteotomy?
A high tibial osteotomy is a surgical procedure that involves cutting and realigning the upper part of the tibia (shinbone) to shift weight away from the damaged portion of the knee joint. This helps reduce pain and slow the progression of arthritis.
Why is high tibial osteotomy performed?
HTO is typically performed for patients with arthritis affecting only one compartment of the knee, especially when malalignment causes uneven wear on the joint. It can also be used for conditions such as osteochondral injury, instability, or cartilage damage associated with alignment issues.
Who is a candidate for this procedure?
Candidates are often younger or active patients with knee pain caused by isolated compartment arthritis and leg malalignment who want to preserve their natural joint and delay or avoid knee replacement surgery.
How does the surgery correct knee pain?
By shifting the mechanical axis of the leg, high tibial osteotomy redistributes pressure from the damaged cartilage area to healthier portions of the knee, reducing pain and improving joint mechanics.
What are the types of high tibial osteotomy?
Two main techniques are used: opening wedge osteotomy, where a bone gap is created and filled, and closing wedge osteotomy, where a small piece of bone is removed to realign the knee. The choice depends on patient anatomy and correction needs.
How is high tibial osteotomy performed?
The surgeon makes an incision near the upper shinbone, performs a precise bone cut, and adjusts alignment. The bone is then stabilized with plates and screws while it heals in the corrected position.
What conditions can it treat?
HTO is used for unicompartmental knee osteoarthritis, varus or valgus malalignment, osteochondritis dissecans, and other cartilage-related conditions affecting one side of the knee joint.
What is recovery like after surgery?
Recovery involves a period of protected weight-bearing, followed by physical therapy to restore strength, motion, and function. Healing continues gradually over several months.
Will I need physical therapy?
Yes. Physical therapy is essential to regain knee mobility, rebuild muscle strength, and ensure proper recovery following realignment surgery.
Can high tibial osteotomy delay knee replacement?
For the right candidates, HTO can significantly delay the need for knee replacement by preserving the natural joint and reducing stress on damaged cartilage.
What are the risks of this surgery?
Potential risks include infection, delayed bone healing, nerve or blood vessel injury, blood clots, and incomplete correction of alignment, though careful planning helps reduce these risks.
Schedule a High Tibial Osteotomy Consultation in Boca Raton, Boynton Beach & Delray Beach
If knee pain, arthritis, or alignment problems are limiting your ability to stay active, Dr. William Toole can help determine whether high tibial osteotomy is an appropriate joint preservation option. Patients throughout Boca Raton, Boynton Beach, and Delray Beach rely on Dr. Toole for advanced knee preservation techniques designed to restore alignment, reduce pain, and protect long-term joint health. Contact our office today to schedule a consultation and learn more about your treatment options.
