High Tibial Osteotomy (HTO) is a specialized knee surgery that realigns the leg to shift weight off the damaged portion of the knee joint. For patients in the Greater Los Angeles area with arthritis limited to one side of the knee, this procedure can reduce pain and extend the life of the natural joint.
Dr. Reza Jazayeri, a double board-certified orthopedic surgeon with clinical expertise in knee care, performs HTO using advanced surgical techniques. His training at NYU Hospital for Joint Diseases and the Kerlan-Jobe Orthopaedic Clinic informs a clinical approach that prioritizes preserving your native knee whenever possible.
Is HTO Right for You?
HTO is most appropriate for patients who:
- Have pain and arthritis primarily on one side of the knee
- Have a “bow-legged” (varus) alignment
- Are typically younger than knee replacement candidates (40s–50s)
- Remain active and want to continue sports, exercise, or physical work
- Have good motion in the knee without advanced arthritis in all compartments
If the arthritis is widespread, or if significant stiffness and deformity are present, other surgical options may be more suitable.
How the Surgery Works
There are two main types of HTO procedures. Both techniques aim to shift the weight-bearing line to the healthier side of the knee, reducing stress and pain where cartilage is damaged.
1. Medial Open-Wedge Osteotomy
- A small wedge-shaped gap is created on the inner side of the shinbone (tibia).
- The bone is gently opened, realigning the leg.
- The space is held in place with a plate and screws, sometimes using bone graft to assist healing.
2. Lateral Closing-Wedge Osteotomy
- A wedge of bone is removed from the outer side of the shinbone.
- The two sides are then brought together and secured with plates/screws.
Benefits of HTO
- Delays or avoids total knee replacement (often for 10+ years)
- Relieves pain from arthritis on one side of the knee
- Allows patients to stay active and maintain their natural joint
- Slows the progression of arthritis
Risks and Considerations
As with any surgery, HTO carries some risks. These include delayed bone healing, infection, blood clots, changes in leg length, or nerve and vessel injury. The procedure is not recommended for patients with severe, widespread arthritis, obesity, or limited knee motion.
Recovery and Rehabilitation
- Patients typically use crutches and limit weight bearing for the first 6 weeks.
- Physical therapy begins soon after surgery to restore motion and build strength.
- Most patients resume daily activities by 3–4 months, with full recovery taking up to 6 months.
- Long-term outcomes are best when combined with rehabilitation and healthy lifestyle habits.
Post-Operative Instructions
Your recovery starts here. Follow the tailored guidelines below to protect your repair and optimize healing.
Watch HTO with Arthrex® iBalance®
Frequently Asked Questions About High Tibial Osteotomy
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High Tibial Osteotomy (HTO) is a surgical procedure that realigns the tibia to shift weight off the damaged part of the knee. It is mainly used for patients with unicompartmental osteoarthritis, particularly when the inner side of the knee is affected.
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Good candidates for HTO are typically younger, active individuals with arthritis mainly on one side of the knee. Those with a bow-legged alignment and good knee motion without severe arthritis in other compartments are often ideal for this procedure.
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There are two main techniques for HTO: the medial open-wedge osteotomy and the lateral closing-wedge osteotomy. Both methods aim to shift the weight-bearing line to a healthier part of the knee, reducing stress on damaged cartilage.
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Recovery typically involves using crutches and limiting weight bearing for the first six weeks. Physical therapy is crucial to regain strength and motion, with most patients returning to daily activities within three to four months.
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Like any surgery, HTO has risks such as infection, delayed healing, and possible nerve injury. Dr. Jazayeri carefully evaluates each patient to minimize these risks and discusses them thoroughly before the procedure.
Why Choose Us For High Tibial Osteotomy?
We focus on High Tibial Osteotomy to help patients in the Greater Los Angeles area manage knee arthritis effectively. Dr. Reza Jazayeri, a double board-certified orthopedic surgeon, has over 15 years of experience in knee care. His training at top institutions like NYU Hospital for Joint Diseases and the Kerlan-Jobe Orthopaedic Clinic ensures you receive experienced treatment based on proven methodologies.
We prioritize your health and comfort. Dr. Jazayeri uses advanced surgical techniques and a non-surgical-first approach to explore all options before surgery.
Our team is dedicated to providing personalized care, from preoperative assessments to rehabilitation strategies. We ensure you have the best support throughout your journey.
Meet Dr. Reza Jazayeri
Dr. Reza Jazayeri specializes in sports medicine with expertise in shoulder, knee, and elbow injuries. A Southern California native, Dr. Jazayeri combines an engineering background with elite surgical training, completing his orthopedic surgery residency at the nationally ranked NYU Hospital for Joint Diseases and a sports medicine fellowship at the renowned Kerlan-Jobe Orthopaedic Clinic.
After more than 15 years caring for patients within the Southern California Permanente Medical Group, Dr. Jazayeri joined DOCS Health to expand a practice focused on personalized orthopedic and sports medicine care and surgical excellence. As Director of Longevity at DOCS Health, he leads the development and implementation of optimization protocols and regenerative medicine strategies designed to improve long-term musculoskeletal health and extend healthspan.
His published work includes a 2026 coauthored review of nutritional optimization in spine surgery in the Journal of the American Academy of Orthopaedic Surgeons. View Dr. Jazayeri’s research publications and training.
I am a hairdresser and I couldn’t work for the past 2 years. I saw Dr. Jayazeri and he did my shoulder replacement surgery. It was the best experience I’ve ever had. He is an amazing surgeon and human being. Now 5 weeks after my surgery, I’m back at work! I highly recommend Dr. Jazayeri.
Schedule Your Consultation For High Tibial Osteotomy
If you have knee arthritis on one side and want to explore High Tibial Osteotomy, schedule a consultation with Dr. Reza Jazayeri. As a double board-certified orthopedic surgeon with fellowship training in sports medicine, he brings focused expertise in knee preservation to patients throughout the Greater Los Angeles area. His practice serves Beverly Hills and surrounding communities, with virtual consultations available for patients across California.
Every patient receives the same level of care he would give to his own family and friends. Contact the office today to discuss whether HTO is right for you.
Medically reviewed by Reza Jazayeri, M.D. on
