Hyderabad: A new technique called the High Tibial Osteotomy (HTO) knee surgery, which doctors claim will provide relief to patients suffering from severe arthritis, is
aimed at delaying joint replacements at an early stage.
With arthritis being highly prevalent even among the
young people today, this procedure-HTO knee surgery (a stop
gap operation) helps such patients avoid knee transplants
early in their life.
Demonstrating the technique here today, Orthopaedic
Surgeon Prof Dr Karl P Benedetto from Austria and Dr K
Raghuveera Reddy, shoulder and knee surgeon, Sai Institute of
Sports Injury and Arthrosocpy (SIASA) said that arthritis of
the knee joint is caused due to damage of the cartilage.
Unlike the fracture of a bone, the damage of the
cartilage does not heal on its own. Continued usage of the
knee by ignoring the pain leads to gross denigration of the
cartilage and severe arthritis. As a result the normal
alignment of the knee changes leading to a bow legged
appearance. This bow leg deformity can lead to progressive
worsening of the arthritis and pain felt on the inner aspect
of the knee, they said.
The ultimate solution for such condition is total knee
joint replacement. However, knee joint replacement is not
suggested at the active age of 40-50 years, as the replaced
knee joint prosthesis can wear out in 10-15 years, requiring
another knee joint replacement by the age of 50-60 years,
which can have its own complications, the doctors said.
Therefore HTO knee surgery is indicated for such young
people particularly those in the age group of 40-55 years with
arthritis of the knee and is often used as a stop gap
operation to delay joint replacement, they said.
Various studies have shown that the majority of the pain
can be relieved for up to 10-15 years but after that period a
knee replacement may be required.
High Tibial Osteotomy involves a surgical break in the
shin bone just below the knee joint to change the alignment of
the leg. HTO is used to relieve the pressure on the inner
arthritic bearing of the knee and to redistribute the forces
around the knee. Studies have shown that cartilage will
regenerate to good extent after realignment of joint axis by
Soon after operation, patients are allowed to move the
knee but they may need to restrict the amount of weight
through the lege by using the crutch for six weeks.
The restriction on the actiity folowing a HTO are also
often less than that following a knee joint replacement. One
can lead a very active lifestyle (jogging, squatting on ground
play etc) by effective rehabilitation post HTO.
The SISA Institute which organised the fourth annual
workshop today demonstrated this technique live to
orothopaedic surgeons from across the country by performing
this knee constructive surgeries by Prof Dr Karl P Benedetto,
Dr Raghuveer Reddy and Dr Anant Joshi from Mumbai.
Conventional osteotomy method was performed by a modern
osteotomy technique (medical opening wedge) in this workshop.
The workshop was aimed at exchanging information on the
most recent advances and technologies in the field of knee