Advancing osteoarthritis in one of the compartments of the knee can lead to the knee developing a valgus (bowing in) or varus (bowing out) alignment. A high tibial osteotomy performs a cut to the upper part of the tibia (shinbone) and reshapes this bone to correct the alignment.

Phase oneThe first phase of your recovery will be focused on managing your pain and allowing the reshaped part of the tibia to heal and strengthen. For this purpose, you will be required to not bear any weight through the operated leg for six weeks after surgery and you may also be placed in a knee brace over the same period. Your physiotherapist will educate you on how to use elbow crutches to get around independently. Although you will be non weight-bearing during this time, your physiotherapist will guide you through some initial activation exercises for your gluteal, quadriceps and hamstrings which will help to support your knee and prevent excessive muscle wasting post-operatively. Regular stretching of the knee will be encouraged to regain full range of motion as quickly as possible.

Phase twoThe second phase of your recovery will focus on enabling you to return to a normal gait pattern, increase your knee range of motion as quickly as possible and strengthen your hip and knee muscles. Under normal circumstances, you will be able to weight bear and discard your knee brace at six weeks post-surgery. Your physiotherapist will advise you how to start gradually increasing the weight you are taking on your operated leg. Your physiotherapist will prescribe appropriate strengthening exercises involving resistance and loading exercises, particularly targeting the quadriceps muscles. As your muscle strength improves, our physiotherapists will introduce some weight-bearing exercises such as wall slides, squats and lunges.

Phase three - The third phase will begin once you have built enough strength and flexibility in your operated leg to start more complex movements. Typically, the initial part of this phase will involve increasing the vigour of existing exercises such as squats, lunges and leg press. Your physiotherapist will guide you as appropriate but under normal circumstances once the strength of your operated leg is satisfactory you will be able to gradually build your exercise tolerance to normal activities such as walking and cycling.

The Game Ready Ice Machine, electric muscle stimulator, AlterG anti-gravity treadmill, Hydro Physio aqua-jogger, sports exercise equipment such as the Concept2 rower, plus Circle’s Return to Sport Assessment Service may help rehabilitation following a high tibial osteotomy

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Circle Health Group, 1st Floor, 30 Cannon Street, London, EC4M 6XH