High tibial osteotomy is a surgical procedure where the bone of the upper tibia is cut and re-angled to change the limb alignment.

laminar spreaders opening the bone during high tibial osteotomy


Laminar spreaders open the wedge of a high tibial osteotomy.

high tibial osteotomy

The re-aligned bone is held in the new position with a plate and screws until new bone fills the gap.


Opening wedge high tibial osteotomy

Usually a high tibial osteotomy is performed to correct a varus (bow-legged) deformity, and the correction is made via an 'opening wedge'. Occasionally a closing wedge is indicated, and the site and degree of correction is nowadays determined by computer evaluation of weight-bearing full leg X-rays. We have a Q&A looking into all the issues in more detail.


High tibial osteotomy

Key issues with high tibial osteotomy.

An explanation of different kinds of osteotomy around the knee

Realignment osteotomy for knee pain

Osteotomy is the procedure of cutting a bone and realigning it to improve anatomy and function. This course by Adrian Wilson, FRCS, focuses on surgical realignment of the femur or tibia in patients whose knee symptoms can be alleviated by altering the forces through one or other side of the knee joint.

Article explaining how an elderly person's life was changed by a bilateral knee osteotomy.



High tibial osteotomies in the young active patient. Wolcott M, Traub S, and Efird C. Int Orthop. 2010 Feb; 34(2): 161–166.

High Tibial Osteotomy Lee DC and Byun SJ. Knee Surg Relat Res. 2012 Jun; 24(2): 61–69..

Release of the medial collateral ligament is mandatory in medial open-wedge high tibial osteotomy. Seitz AM, Nelitz M, Ignatius A, Dürselen L. Knee Surg Sports Traumatol Arthrosc. 2018 Sep 29. doi: 10.1007/s00167-018-5167-0. [Epub ahead of print].

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Useful forum discussions

eBook - Knee arthritis interventions when you are too young for a total knee replacement

Easy-to-read book about the various options for people with knee arthritis to try and prevent or delay knee replacement.


List - Who's Who in Osteotomy for knee pain?

A useful list of world experts in knee osteotomy.