Knee osteoarthritis can make everyday movement difficult, especially for active individuals who want to stay on their feet without committing to joint replacement. For the right patients, high tibial osteotomy (HTO) offers a way to reduce pain, improve function, and delay or avoid knee replacement surgery.
At Jonathan L. Glashow, MD Orthopedic Surgery & Sports Medicine, with locations in New York City and Miami Beach, this advanced procedure is performed with a focus on precision, long-term outcomes, and patient-centered care.
What Is a High Tibial Osteotomy?
A high tibial osteotomy is a specialized surgical procedure that realigns the knee joint. Instead of replacing the joint, the goal is to shift body weight away from the damaged area of the knee.
During the procedure, the surgeon:
- Removes or adds a wedge of bone in the upper shinbone (tibia)
- Adjusts the alignment of the knee joint
- Redistributes pressure to healthier cartilage
This change reduces stress on the arthritic portion of the knee, which can significantly decrease pain and improve mobility.
Why Alignment Matters in Knee Arthritis
In many cases of knee osteoarthritis, damage is concentrated on one side of the joint. Misalignment, often referred to as being “bow-legged” or “knock-kneed,” can worsen this uneven wear.
HTO works by correcting that imbalance.
Benefits of proper alignment include:
- Reduced pressure on damaged cartilage
- Improved joint stability
- Better overall knee function
- Slower progression of arthritis
Studies show that properly selected patients can experience significant pain relief and functional improvement, with many delaying knee replacement for 10 years or more.
The iBalance System: A Modern Approach
One of the most advanced techniques used today is the iBalance system, developed by Arthrex. This system offers a refined alternative to traditional methods that rely on metal plates and screws.
With the iBalance system:
- A specialized implant is used instead of external hardware
- The implant anchors securely into position
- The design promotes stability and healing
- There is less reliance on bulky fixation devices
This approach has become widely recognized as a gold standard in tibial osteotomy technology, offering patients a more streamlined and durable solution.
Who Is a Good Candidate?
High tibial osteotomy is typically recommended for:
- Younger, active patients with knee osteoarthritis
- Individuals with damage limited to one side of the knee
- Patients who want to stay active and delay joint replacement
- Athletes or physically active individuals
It is important to understand that while HTO can relieve symptoms, it does not cure arthritis. Instead, it slows progression and improves quality of life.
Results and Recovery
Outcomes for high tibial osteotomy are generally very positive when performed on the right candidates.
Clinical data shows:
- 80–90% of patients report meaningful pain relief
- Improved ability to return to physical activity
- Long-term durability, often extending joint life by a decade or more
Recovery involves a structured rehabilitation plan, including:
- Gradual weight-bearing
- Physical therapy to restore strength and mobility
- Ongoing monitoring to ensure proper healing
With the iBalance system, many patients benefit from stable fixation and predictable recovery progress.
Personalized Orthopedic Care Matters
At Jonathan L. Glashow MD Orthopedic Surgery & Sports Medicine, care is tailored to each patient from consultation through recovery. The practice is known for its direct, hands-on approach, where patients work closely with their orthopedic surgeon at every stage.
This includes:
- Detailed evaluation of knee alignment and joint health
- Clear discussion of treatment options
- Advanced surgical techniques using modern technology
- Comprehensive post-operative care and rehabilitation guidance
A Joint-Preserving Alternative to Knee Replacement
For patients who are not ready for knee replacement, high tibial osteotomy offers a powerful alternative. By correcting alignment and reducing stress on the joint, it can relieve pain while preserving your natural knee.
If knee osteoarthritis is limiting your activity, this procedure may provide the relief and mobility you need to stay active longer.
Schedule a consultation today with Jonathan L. Glashow, MD Orthopedic Surgery & Sports Medicine in NYC or Miami Beach to learn whether high tibial osteotomy with the iBalance system is right for you.
