REHABILITATION GUIDE
Rehabilitation after high tibial osteotomy.
High tibial osteotomy (HTO). What to expect, stage by stage, with a printable copy to download.
A high tibial osteotomy realigns the shin bone to take pressure off the worn part of the knee. The bone is held with a plate while it heals. This guide explains the usual recovery. Your team will confirm your programme after surgery.
At a glance
| Weight bearing | Full weight bearing with crutches from the start, unless told otherwise |
| Walking aids | Crutches for about 4–6 weeks, then gradually reduced |
| Brace | Not usually needed |
| Bone healing check | An X-ray at follow-up, usually around 6 weeks |
| Normal daily function | Around 3 months |
Your recovery, stage by stage
Early recovery Weeks 0–6
- Walk with crutches, putting full weight through the leg unless you are told otherwise.
- Do your exercises 3–4 times a day to regain knee movement and thigh strength.
- Elevate the leg and use ice to control swelling.
- Avoid smoking, which slows bone healing.
Progressing Weeks 6–12
- After your follow-up and X-ray, crutches are usually reduced and then stopped.
- Strengthening, exercise bike and balance work progress with your physiotherapist.
Return to normal function Around 3 months
- Most people return to normal daily activities by about 3 months.
- Further strengthening continues, and return to sport or heavy work is discussed at follow-up.
Early exercises
- Ankle pumps
- Point your feet up and down briskly, 10–20 times every hour while awake. This helps circulation and reduces the risk of blood clots.
- Static quads
- Lying or sitting with the leg straight, tighten the muscle on the front of the thigh to push the back of the knee down. Hold 5 seconds, relax. Repeat 10 times.
- Straight leg raise
- Tighten the thigh muscle, then lift the straight leg about 15 cm off the bed. Hold 5 seconds, lower slowly. Repeat 10 times.
- Heel slides
- Lying on your back, slide your heel towards your bottom to bend the knee, then straighten it again. Repeat 10 times.
- Knee straightening stretch
- Rest your heel on a rolled towel so the knee is unsupported, and let it straighten for 5–10 minutes. Do not place a pillow under the knee.
Looking after yourself
- Wound care
- Keep the dressing clean and dry. Stitches or clips are usually removed at around 10–14 days. Do not soak the wound in a bath, pool or hot tub until it has fully healed.
- Swelling
- Rest with the leg raised, and use an ice pack wrapped in a towel for 15–20 minutes several times a day. Swelling can last for weeks or months and is common.
- Pain relief
- Take your pain relief regularly in the early weeks, as prescribed, particularly before exercising. Reduce it gradually as the pain settles.
- Blood clot prevention
- Follow the hospital’s advice on blood-thinning medicine and stockings. Keep moving, do your ankle exercises, and drink plenty of fluids.
When to seek urgent help
Call 999 or go to A&E if you have chest pain, sudden breathlessness or cough up blood.
Contact the hospital where you had your operation straight away (or NHS 111 out of hours) if you have:
- Pain, swelling or tenderness in the calf
- The wound becomes red, hot or increasingly painful, or leaks fluid after the first few days
- A temperature above 38°C, shivering or feeling generally unwell
- A sudden increase in pain or swelling, or you cannot put weight on the leg as advised
- New numbness, tingling, coldness or weakness in the leg or foot
Sources
This guide is based on Mr Umar’s practice and is guided by NICE and British Orthopaedic Association (BOA) guidance:
Questions about your recovery?
| Spire Regency, Macclesfield | Denise Rowbotham · 01625 507472 |
| The Alexandra, Spire Manchester, Spire Hale and Circle Cheshire | Danielle Heron · 07528 523911 |
This is general guidance. Always follow the specific instructions from your own surgical and physiotherapy team, as your programme may differ.