Gradual opening-wedge high tibial osteotomy (HTO)Freedom from
knee pain.

A high tibial osteotomy (HTO) is a knee-preserving operation for bow legs. The surgeon operates on the upper shinbone (tibia) to change its angle in a controlled way, so that the load line of the leg moves away from the overloaded inner side of the knee. Your own knee joint is kept.

In an opening-wedge HTO (OWHTO), the bone is opened on the inner side of the tibia; in a closing-wedge HTO (CWHTO), a small wedge of bone is removed from the outer side. In both, the correction is usually completed in a single step during surgery and held with a plate and screws. UniPlasty is a gradual opening-wedge HTO: the wedge on the inner side is opened step by step over the following days with a temporary external fixator and can be adjusted to follow-up X-rays. Which technique suits you depends on your individual assessment.

For some patients, yes. HTO aims to preserve the natural knee by correcting its alignment and is usually considered when the wear is limited to the inner side of the knee. When the whole joint is damaged, a partial or total knee replacement may be more suitable. Only an orthopaedic assessment can tell which option fits your situation.

An adjustable hinge system enables controlled, gradual elevation of the bone. The surgeon can fine-tune the angle during correction to realign the leg according to the treatment plan. Because the correction happens after surgery, the alignment can be checked and adjusted under weight-bearing conditions, while you stand on the leg, which is very important to see the best result.

No. UniPlasty does not work with an internal plate or screws, so nothing is left under the skin after treatment. During correction and healing, the external fixator is attached to the bone by four pins; once your surgeon confirms sufficient healing, the fixator is taken off and the pins are removed in a simple procedure.

An orthopedic specialist needs to assess your individual situation. This website cannot determine your suitability for treatment.

The original UniPlasty treatment guide describes approximately 3–4 months overall. Age, the degree of deformity and bone healing affect the schedule. Your surgeon sets your individual plan.

Explore the answers above, or contact the Response Ortho team directly about UniPlasty. Treatment suitability requires an orthopaedic consultation.

Discuss the potential benefits, risks, alternatives, daily activities during treatment and follow-up requirements.

The minimally invasive technique aims to use small incisions and limit tissue disruption: small incisions for the four 6 mm pins and, in general, an incision of around 2–3 cm for the osteotomy. Both the surgery and the pin sites can leave scars. Their appearance depends on the procedure, your skin and wound healing.

No large second operation is needed. UniPlasty does not work with an internal plate: no plate or screws are buried under the skin that would have to be taken out in a second, larger operation, as with the plate-and-screw technique. After the bone has healed, the external fixator is taken off and only its four pins need to be removed, which is a simple procedure. Your surgeon explains the anaesthesia or pain relief and where it will take place.

Supported walking can begin immediately after surgery, often as early as the next day. Most patients start putting weight on the leg shortly after the correction period, at around 3–4 weeks. Your surgeon sets how much weight you may bear and whether you need crutches, according to your correction and bone healing.

Loose-fitting trousers or other roomy clothing can accommodate the low-profile device. Choose clothing that does not rub or press on the pin sites, and discuss comfort and daily activities with your team.

Your team will show you how to care for the skin around the temporary pins. Infection can occur. Follow the cleaning instructions and contact your team about increasing pain, redness or discharge.

The device can also be used for selected valgus deformities, often called knock knees. Whether one or both legs should be treated, and in what sequence, depends on an individual orthopaedic assessment.