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High tibial osteotomy as a first step in knee preservationHigh tibial osteotomy repositions the tibia to shift weight-bearing from damaged inner knee cartilage to the healthier outer compartment. For younger, active patients, the procedure preserves the natural joint and potentially extends its working life by a decade or more.High tibial osteotomy repositions the tibia to shift weight-bearing from damaged inner knee cartilage to the healthier outer compartment. For younger, active patients, the procedure preserves the natural joint and potentially extends its working life by a decade or more.
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When Knee Alignment Must Come Before Cartilage RepairCartilage repair fails in a varus knee because the weight-bearing line runs through the damaged medial compartment instead of the joint's centre. High tibial osteotomy redirects that line toward the centre; expert guidance mandates combined surgery above 3° varus and forbids isolated repair beyond 5°.Cartilage repair fails in a varus knee because the weight-bearing line runs through the damaged medial compartment instead of the joint's centre. High tibial osteotomy redirects that line toward the centre; expert guidance mandates combined surgery above 3° varus and forbids isolated repair beyond 5°.
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Distal femoral osteotomy for lateral knee cartilage damageKnock-kneed alignment directs excessive load through the outer knee compartment, accelerating cartilage wear over time. Distal femoral osteotomy corrects this by adjusting the lower thighbone angle to redistribute load and allow the damaged cartilage to survive or heal.Knock-kneed alignment directs excessive load through the outer knee compartment, accelerating cartilage wear over time. Distal femoral osteotomy corrects this by adjusting the lower thighbone angle to redistribute load and allow the damaged cartilage to survive or heal.
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High tibial osteotomy recovery and joint preservationHigh tibial osteotomy shifts load away from a damaged knee compartment and is best suited to younger, active patients with correctable medial osteoarthritis. Recovery takes months, full weight bearing depends on fixation and healing, and long-term success is strongest when arthritis remains localised.High tibial osteotomy shifts load away from a damaged knee compartment and is best suited to younger, active patients with correctable medial osteoarthritis. Recovery takes months, full weight bearing depends on fixation and healing, and long-term success is strongest when arthritis remains localised.
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Cartilage repair or knee replacementThe first split between cartilage repair and knee replacement is whether damage is a focal defect in an otherwise intact knee or diffuse wear across the joint. Joint-preserving treatment fits localised lesions, often in younger or active patients, with alignment, meniscus status and stability shaping the plan. Smaller focal defects…The first split between cartilage repair and knee replacement is whether damage is a focal defect in an otherwise intact knee or diffuse wear across the joint. Joint-preserving treatment fits localised lesions, often in younger or active patients, with alignment, meniscus status and stability shaping the plan. Smaller focal defects under about 2 to 4 cm² may still be treated with microfracture, but the SUMMIT trial showed MACI gave better 2-year pain and function for larger defects. OCA addresse...
