With each step, forces equal to three to eight times your body weight travel between the thigh bone (femur) and shin bone (tibia) in your knee. These forces are dampened by a meniscus on the inner and outer portion of the knee, and the ends of the bones are protected by articular cartilage.
Patients with a condition known as osteoarthritis, or degenerative arthritis, experience a successive wearing on the menisci and articular cartilage, which may develop tears. These degenerative processes limit the ability of the knee to glide smoothly and can result in popping, catching, locking, clicking and pain.
In a condition called malalignment, unbalanced forces cause excessive pressure on either in the inner (medial) or outer (lateral) portion of the knee. Degenerative arthritis and malalignment can cause the knee’s protective tissues to wear on one side more than the other in a repetitive cycle of damage. A partial or total knee replacement can correct this condition when joint damage is beyond repair.
In certain cases, however, a technique known as an osteotomy can realign the knee, taking pressure off the damaged side. A procedure known as a high tibial osteotomy wedges open the upper shin bone (tibia) to reconfigure the knee joint. The weight-bearing part of the knee is shifted from degenerative or worn tissue onto healthier tissue.
A high tibial osteotomy is generally considered a method of prolonging the time before a knee replacement is necessary because the benefits typically fade after eight to ten years. This procedure is typically reserved for younger patients with pain resulting from instability and malalignment. An osteotomy may also be performed in conjunction with other joint preservation procedures in order to allow for cartilage repair tissue to grow without being subjected to excessive pressure.
For an illustrative view of this procedure, watch the animation below.