HTO or knee replacement?
Both treatments can relieve pain from knee osteoarthritis, but they work differently. A high tibial osteotomy (HTO) corrects the alignment and keeps your own joint. A knee replacement resurfaces the worn joint with implants.
How an HTO works
An HTO changes the angle of the upper shinbone so that the load line moves away from the worn inner side of the knee. Your own cartilage, menisci and ligaments are kept. If it becomes necessary later, a knee replacement remains possible.
How a knee replacement works
A partial (unicompartmental) knee replacement replaces only the worn part of the joint; a total knee replacement replaces all joint surfaces (knee arthroplasty). The implants remain in the body.
Who each is usually considered for
- HTO is more often considered for
- Bow legs with wear mainly on the inner side of the knee, a joint that is otherwise well preserved, and the wish to stay active with your own knee.
- A knee replacement is more often considered for
- Advanced wear, wear in several parts of the knee, marked stiffness, or when correcting the alignment alone would not relieve the pain.
Preserving the knee: what does the evidence say?
UniPlasty is also a device for HTO (high tibial osteotomy) treatment. A study on HTO treatment (22 patients, 31 knees) reported 87.1% without knee replacement at 10 years. This is general osteotomy evidence, not a UniPlasty-specific success rate.
The aim of realignment is to preserve the native joint and potentially delay replacement. Individual suitability and outcomes differ.
Read the studyLau et al. · Journal of Orthopaedic Translation, 26 (2021), 60–66 · DOI: 10.1016/j.jot.2020.03.003
Frequently asked questions
Can I still have a knee replacement after HTO?
Yes. A later knee replacement remains possible if it becomes necessary; the previous operation is taken into account in the planning.
Which option is right for me?
That depends on where and how far the wear has progressed, the alignment of the leg, your age and activity goals, and your general health. Only an orthopaedic assessment can tell.
More about bow legs and HTO
- Bow legs (varus knee): causes, symptoms and treatmentWhat bow legs are, why they can overload the inner knee and how they are treated.
- Who is HTO for?The patient groups that may benefit from a knee-preserving HTO, and when other options fit better.
- Opening wedge, closing wedge and gradual opening wedgeOpening-wedge, closing-wedge and gradual opening-wedge HTO compared in one table.
- Recovery after HTO with UniPlastyA typical recovery timeline: walking, correction, weight bearing, work, exercise and removal.
Questions about UniPlasty?
Contact the Response Ortho team. Treatment suitability requires an orthopaedic consultation.
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