High Tibial Osteotomy (Knee Realignment Surgery)

High tibial osteotomy realigns a bow-legged knee. The shin bone is cut just below the joint and opened or closed by a few degrees so that body weight shifts from the worn inner side of the knee to the healthier outer side. The bone is held with a plate while it heals.

It reduces pain and can postpone a knee replacement by 10 years or more in most suitable patients, while allowing a return to heavy work and impact sport, which replacements do not tolerate well. It does not regrow cartilage, recovery is slower than after partial knee replacement, and arthritis may still advance eventually.

What High Tibial Osteotomy (Knee Realignment Surgery) involves

Planning relies on full-length standing X-rays from hip to ankle, which show the weight-bearing line and allow the surgeon to calculate the exact correction in degrees and millimetres. The operation usually starts with an arthroscopy to inspect the cartilage and treat meniscal tears. For a medial opening wedge, a cut of about 8 cm is made on the inner upper shin. Under X-ray control, guide wires are placed and the bone is sawn across, leaving an intact hinge on the outer side. The cut is gradually levered open to the planned gap, the alignment is checked with a long rod or cable over the hip and ankle, and a locking plate is fixed across the gap. Larger gaps may be filled with bone graft or a substitute.

Who is a good candidate for High Tibial Osteotomy (Knee Realignment Surgery)?

Best for active people with malalignment and damage on one side of the knee.

• Age roughly under 60 to 65 and physically active
• Inner-side knee pain with bow-leg alignment and early to moderate arthritis
• Healthy outer compartment and kneecap joint on imaging
• A good range of movement and stable ligaments, or combined with ligament reconstruction
• Cartilage or meniscus repair procedures that need the load taken off them

It is usually not the right choice if:

• Arthritis throughout the knee, or inflammatory arthritis
• Smokers, because bone healing is significantly impaired
• Marked obesity, relative to the surgeon's limits
• A very stiff knee or loss of more than about 10 to 15 degrees of straightening
• Older, low-demand patients, who usually do better with a knee replacement

Technique options

• Medial opening wedge: Most common. Precise adjustment and no fibula cut.
• Lateral closing wedge: A wedge is removed from the outer side. Heals quickly; alters the shape of the upper tibia more.
• Distal femoral osteotomy: The cut is made in the thigh bone instead, for knock-knee alignment with outer-side wear.
• Patient-specific guides: 3D-printed cutting guides from a CT scan to reproduce the planned correction.

What happens during your treatment

Surgery takes 60 to 90 minutes under spinal or general anaesthetic, with 1 to 3 nights in hospital. You start moving the knee straight away, and walk with crutches and partial weight on the leg from the first day.

Preparing for your trip

Plan for 10 to 14 days in Istanbul. Your surgeon reviews photographs and your medical history before you book, and you meet in person the day before surgery for examination, marking and consent with a professional interpreter.

• Stop smoking and nicotine at least four weeks before and after surgery; it is the single biggest avoidable cause of wound problems
• Tell the team about every medicine and supplement you take; blood thinners, some herbal products and hormone treatment may need to be paused on your doctor's advice
• Arrange for someone to travel with you or to be reachable, and keep the first days at home free of work and lifting
• Book a changeable return flight; your surgeon confirms when you are fit to fly

Recovery and results

Crutches are needed for about 6 weeks, building to full weight as X-rays show healing. Driving is possible at 6 to 8 weeks. Office work resumes at 3 to 6 weeks, manual work at 3 to 4 months, and running or sport at 6 months or later. Bone union takes about 3 months. The plate can cause irritation and is often removed after 12 to 18 months. Blood clot prevention is given for several weeks; discuss timing of flights with your surgeon.

• Back to everyday activity: 6 weeks on crutches; 3 to 6 months to sport
• When results show: Pain relief develops over 3 to 6 months
• How long they last: About 10 years or more in most patients

Safety, risks and revision policy

Complications occur in a minority, and most are manageable.

• Delayed or failed bone healing, sometimes needing grafting
• Fracture of the hinge with loss of correction
• Under-correction or over-correction of alignment
• Infection
• Blood clots in the leg or lung
• Injury to nerves or vessels near the knee, including numbness beside the scar
• Plate irritation requiring removal
• Compartment syndrome, which is rare

Every written proposal arranged through Clinic-Y states what the clinic covers if a correction is needed. Ask for it before you book, not after.

Cost of High Tibial Osteotomy (Knee Realignment Surgery) in Türkiye

Clinic-Y does not publish a single price for High Tibial Osteotomy (Knee Realignment Surgery), because the honest figure depends on your case. What moves it:

• Plate system and any bone graft substitute
• Arthroscopy or cartilage procedures in the same operation
• Patient-specific guides and CT planning
• Physiotherapy and follow-up X-rays
• Plate removal later

Send your photographs or reports and you receive written, all-inclusive proposals from suitable teams, side by side. Reviewing your case is free.

Frequently Asked Questions