Osteoarthritis of the knee is the most common joint lesion among middle-aged and elderly patients. When osteoarthrosis of the knee occurs, patients face pain and limited movement of the knee joint, with varying degrees of limitation in walking, going up and down stairs, and squatting. I often hear patients ask, “I have osteoarthritis, do I have to have a knee replacement? Many doctors and patients, especially orthopedic surgeons and joint surgeons, think of joint replacement first when they see a patient with osteoarthritis. Nowadays, joint replacement surgery is everywhere, even in private hospitals and county hospitals. Because of the varying degrees of technical excellence, the results are not as good as one would expect, complications of all kinds are numerous, and the life expectancy of artificial joints varies from 5 to 15 years. So, is there really no other way to get arthritis in the knee joint? The answer is of course no, it’s just that this technique is consciously or unconsciously ignored by everyone. The following is an introduction to the tibial high osteotomy technique for the treatment of osteoarthritis of the knee. This is a procedure that preserves your own joint, is closer to nature, is more minimally invasive, has a faster recovery, and has more guaranteed efficacy! Another outstanding feature of the technique is its low cost, which is why it has not received much attention from the majority of doctors in terms of promotion. Tibial high osteotomy can effectively treat osteoarthritis of the knee. The anatomical characteristics of our human knee joint determine that the knee normally experiences more medial force than lateral. Therefore, osteoarthritis of the knee is more likely to occur on the medial side. When the knee joint is internally rotated, the pressure on the medial side of the knee joint increases further and wear and tear increases significantly. According to statistics, the incidence of osteoarthritis in the inversion knee is four times higher than in the normal knee, and once osteoarthritis occurs, it progresses 20 times faster than in the non-inversion knee. The more the knee turns inward, the greater the stress on the inside of the joint, the greater the cartilage wear, the narrower the joint space, and the more the knee becomes turned inward, which creates a vicious cycle that develops until the cartilage wears out, the knee bones wear the bones, and the patient has difficulty walking. In patients like this one, although the medial cartilage is severely worn, the lateral compartment of the knee joint has been under relatively little stress and the cartilage is almost intact. So the surgeon corrects the inversion of the knee with a high tibial osteotomy and puts more force on the lateral joint and less on the medial. This breaks the vicious cycle of medial osteoarthritis progression and allows the arthritis to stop and gradually recover. Tibial high osteotomy is gradually returning to the mainstream in the treatment of joint disease, especially in developed countries such as Europe and Japan. In the United States, on the other hand, the promotion is relatively poor. To analyze the reason, the United States has almost all of the largest artificial joint companies in the world. Artificial joints are a huge medical industry in the United States. The strength and speed of the promotion of artificial joints can be described as a mountain. This has also deeply influenced the medical environment in China, where artificial joints have developed rapidly in recent years, and many hospitals have set up “joint surgery”, which is actually “joint replacement surgery”. In the wave of artificial joints, the voice of osteotomy has been drowned out and reduced to a non-mainstream. Japan and Korea, which are part of the same cultural circle as us, have been among the best regions for the development of high tibial osteotomies for osteoarthritis of the knee, adhering to the philosophy of preserving the patient’s own joint as much as possible. There is also a group of orthopedic surgeons in China who have consistently adhered to the high tibial osteotomy in an effort to prevent the expansion of joint replacements. There are other physicians who, with the massive adoption of arthroplasty, have found that arthroplasty does not meet the functional needs of their patients and that complications are increasing, prompting them to refocus their attention on high tibial osteotomy. Arthroplasty does not fully meet the functional needs of patients In total knee arthroplasty, the cruciate ligament inside the knee joint is cut away and replaced with a simple mechanical device. This mechanical device only works after the knee has been flexed to 70 degrees or more. Therefore, until this level of activity is reached, the knee joint is basically in a state where the cruciate ligament is missing, feeling unstable, proprioception is lost, and the joint feels unnatural. With more activity, the patient’s joints are prone to swelling and pain and increased joint wear. Older people are now becoming more and more active. This has led to a low satisfaction rate and a high rate of future revisions in relatively young elderly patients who have received artificial joint replacements. Therefore, in some countries, such as South Korea and South Africa, new health insurance policies have been introduced, whereby health insurance will not reimburse patients under 65 years of age with osteoarthritis of the knee for joint replacement. This policy curbs the trend of expanding the indications for artificial joint replacement and objectively promotes the development of high tibial osteotomy of the knee. Indications for tibial high osteotomy for osteoarthritis of the knee (which patients with osteoarthritis of the knee are suitable for surgical treatment?) 1.Patients with osteoarthritis of the knee, whose work and life are affected by knee pain and dysfunction, and for whom non-surgical treatment is ineffective. 2.Osteoarthritis on X-ray shows predominantly unicondylar lesions and is compatible with internal and external deformity. 3.Knee flexion and extension range of motion >90°. Contraindications to high tibial osteotomy for osteoarthritis of the knee (those patients with osteoarthritis of the knee are not suitable for surgical treatment?) 1. Unilateral tibial plateau depression of more than 10 mm due to loss of subchondral bone. 2.Knee flexion contracture deformity >20°, and limitation of flexion more than 90°. 3, For neurotrophic joints, infected joints, rheumatoid arthritis, bone ischemic necrosis are not suitable for high osteotomy. 4.The inter-articular compartment of the knee joint is affected bilaterally. High tibial osteotomy is to change the negative gravity line of the lower extremity, so that the negative gravity line of the knee joint returns to normal and the uninflamed lateral joint surface is involved in joint weight bearing, while the medial joint surface will be gradually repaired by rest. With nearly 30-40 years of clinical use, the procedure has been proven to last at least 15 years, which is no less than the life expectancy of a single joint replacement. The advantages include preservation of the joint, small incisions, few complications, rapid recovery, and less cost to the patient. If inflammation of the patient’s lateral joint surface also occurs after 15 to 20 years, it is still possible to change to joint replacement surgery after surgery.