I Have Knee Arthritis — Is There an Option Other Than Knee Replacement?

23/05/2026

Question: Doctor, what exactly is a high tibial osteotomy?

High tibial osteotomy is a joint-preserving surgical procedure designed to reduce the load on the damaged inner side of the knee. It is commonly performed in patients who have arthritis predominantly affecting the medial (inner) compartment of the knee along with bow-legged alignment.

The main goal of the surgery is to shift the body weight away from the worn cartilage area toward the healthier part of the knee. In selected patients, this can significantly reduce pain and delay the need for knee replacement surgery.

Question: So is this surgery an alternative to total knee replacement?

In certain patients, yes.

Especially in younger and active individuals, high tibial osteotomy can be an excellent alternative to total knee replacement. Instead of replacing the joint, we try to preserve the patient's own knee and improve its biomechanics.

For many active patients in their 40s or 50s, preserving the native joint for as long as possible is often preferable.

Question: Which patients are good candidates for this procedure?

The ideal candidates are generally:

Patients with arthritis mainly limited to the inner side of the knee,
Individuals with bow-legged alignment (varus deformity),
Active patients who want to maintain their lifestyle,
Relatively younger individuals with good knee motion.

It is particularly valuable for patients who still wish to remain physically active.

Question: How is the surgery performed?

During the procedure, a controlled correction is made in the upper part of the tibia, which is the shin bone.

In simple terms, we realign the leg to redistribute the forces passing through the knee. After the correction, the bone is stabilized using special plates and screws.

Modern surgical planning allows us to perform these corrections with a very high degree of precision.

Question: Is the recovery process difficult?

The first few weeks require controlled rehabilitation, but most patients are able to stand and walk with assistance shortly after surgery.

Crutches are typically used for a period of time, and physical therapy plays a critical role in restoring strength, motion, and normal walking mechanics.

Question: When can patients return to normal life?

This depends on several factors, including bone healing, the amount of correction performed, and adherence to rehabilitation.

In general:

Office work may be possible within 4–6 weeks,
More active lifestyles may require several months.

Question: Can patients return to sports afterward?

Yes — this is actually one of the major advantages of high tibial osteotomy.

Many patients are able to return to activities such as:

Walking,
Cycling,
Swimming,
Light jogging.

Of course, high-impact sports should always be evaluated individually.

Question: Does this surgery completely eliminate the need for knee replacement in the future?

Not necessarily, and it would not be accurate to promise that.

However, in properly selected patients, high tibial osteotomy can delay knee replacement surgery for many years — sometimes 10 to 15 years or even longer.

Question: Are there risks associated with the surgery?

As with any surgical procedure, there are potential risks, including:

Infection,
Blood clots,
Delayed bone healing,
Under- or over-correction,
Hardware-related issues.

That said, when performed in appropriate patients with modern techniques, success rates are generally very high.

Question: Finally, what would you like patients to know?

Knee arthritis does not always mean immediate knee replacement surgery.

Especially in younger and active patients, joint-preserving procedures should always be considered carefully. High tibial osteotomy can be a powerful treatment option that improves quality of life while preserving the patient's natural knee joint for many years.