A high tibial osteotomy (HTO) is a surgical procedure used to treat certain knee conditions, particularly early-stage osteoarthritis or specific knee deformities. The surgery involves cutting and reshaping the upper part of the tibia (shinbone) to relieve pressure on the damaged or arthritic part of the knee joint.

The main goal of an HTO is to shift the body weight away from the damaged part of the knee to a healthier area, thereby reducing pain and slowing down the progression of osteoarthritis. This procedure is often considered for younger, active individuals who have damage or misalignment primarily on one side of the knee, particularly in the inner (medial) portion.

The surgery is typically performed under anesthesia, and the surgeon will make an incision in the knee area. They'll then use specialized instruments to cut the bone, often creating a wedge-shaped opening to realign the bones. This may involve removing a small section of bone or inserting a bone graft. The bones are then secured in the new position using plates, screws, or other fixation devices.