Knee Replacement Alternatives : High Tibial Osteotomy

Many of you are searching for knee replacement alternatives.  Your knee pain from arthritis is starting to interfere with your quality of life. You have searched Google, you have spoken to friends.  You have heard about gel injections, stem cells, platelet rich plasma (PRP) injections as well as various supplements which promise you a painless life despite arthritis in your knee.

Your physician may have recommended a knee replacement — but you’ve heard scary things about them and you are actively seeking an alternative to a knee replacement, and one that has the potential of giving you many years of pain relief.

All the knee replacement alternatives listed above share one thing in common.  They do NOT possess the ability to alter the natural history of your arthritis.  That means that they will not slow the progression of your arthritis.  They might make you feel better temporarily, but that should be your only expectation.

Osteoarthritis, by definition, is a disease which worsens with the passage of time… period.

For many of you, the osteoarthritis is only in one “compartment” or one side of your knee.  It may be on the medial or the inner side, or it may be on the lateral of the outer side of your knee.  Osteoarthritis usually begins in only one compartment.

As arthritis in that single compartment begins to progress your leg may become bowed — or you may have been born with bowed legs.  When the leg bows outward it places a lot of stress on the cartilage on the inside of the knee.  That stress will cause an overload of the cartilage and arthritis on that side of the knee will worsen.  That will cause further loss of cartilage, and the bowing outward will worsen as well.  It becomes a viscous cycle.

Knee Replacement Alternative:

High Tibial Osteotomy

One knee replacement alternative that has stood the test of time and has been improved upon over the last 20 years is a procedure we call a high tibial osteotomy.  What that basically means is that we partially cut the tibia near the knee and we move the knee into a  normal position.  This eliminates the bowing — and this also takes the pressure off, or significantly decreases the pressure on the inner side of the knee where your arthritis is.  Less pressure should equal less pain.

As opposed to the alternatives we mentioned previously, a high tibial osteotomy can delay the progression of arthritis.  It will not eliminate arthritis, but in the right person, you will have another 7-10 years or more with your knee.

A tibial osteotomy has been a good alternative to a knee replacement for over 20 years.  It is more appropriate to consider in young, active patients, and in people with arthritis limited to one side of the knee.

If you have arthritis on one side of the knee and are looking for an alternative to a knee replacement, talk to your doctor about the option of a high tibial osteotomy.