Osteotomy; tibia
CPT4 code
Name of the Procedure:
Osteotomy; Tibia
Common names: Tibial Ostectomy, High Tibial Osteotomy (HTO)
Summary
An osteotomy of the tibia involves surgically cutting and reshaping the shinbone (tibia) to correct alignment issues, reduce pain, and improve function, often used to treat arthritis or deformities.
Purpose
The procedure addresses misalignment of the tibia, knee arthritis, or conditions causing uneven weight distribution. The goal is to relieve pain, prevent further joint damage, and improve mobility.
Indications
- Unilateral knee arthritis
- Knee deformities (e.g., bow-legged or knock-knee)
- Knee pain not responding to conservative treatments
- Suitable candidates: generally younger, active patients without advanced arthritis in multiple knee compartments.
Preparation
- Fast for 8-12 hours before surgery.
- Adjust or stop certain medications (e.g., blood thinners).
- Pre-operative imaging (X-rays, MRI).
- Blood tests and physical examination.
Procedure Description
- The patient is given general or spinal anesthesia.
- The surgeon makes an incision on the inner side of the knee.
- Specialized surgical tools are used to cut and partially remove or wedge the tibia.
- The bones are realigned and secured with plates, screws, or a bone graft.
- The incision is closed with sutures or staples.
Duration
Typically takes 1 to 2 hours.
Setting
Performed in a hospital operating room or specialized surgical center.
Personnel
- Orthopedic surgeon
- Surgical nurses
- Anesthesiologist
Risks and Complications
- Infection
- Blood clots
- Damage to nerves or blood vessels
- Non-union or delayed healing of bone
- Need for additional surgeries
Benefits
- Pain relief
- Improved joint function and mobility
- Delay or prevention of total knee replacement
- Benefits typically realized within 6 months to a year post-surgery.
Recovery
- Hospital stay of 1-2 days.
- Pain management with medications.
- Use of crutches or walker for several weeks.
- Physical therapy for several months.
- Full recovery typically within 6 months to a year.
Alternatives
- Non-surgical treatments (physical therapy, medications, injections)
- Knee arthroscopy
- Total or partial knee replacement
- Pros: Less invasive, quicker recovery.
- Cons: May not provide as lasting or effective results for certain conditions.
Patient Experience
During the procedure, the patient will be under anesthesia and feel no pain. Post-surgery, there will be pain and swelling managed with medications. Expect initial mobility restrictions and gradual return to normal activities through rehabilitation.