Knee Osteotomy

Knee osteotomy involves the cutting and realignment of either the upper end of the shinbone or the lower end of the thighbone to achieve optimal weightbearing axis for the lower limb.

The key to knee preservation is to achieve optimal weightbearing alignment to ensure ideal environment for the structures under stress.


  • High tibial osteotomy
  • Distal femoral osteotomy
  • Double level osteotomy
  • Femoral and Tibial Derotational Osteotomy


  1. O’Donnell, Ciara & Dadah, Hashim & Bin Abd Razak, Hamid Rahmatullah & Wilson, Adrian & Khakha, Raghbir. (2023). Clinical Outcomes Following Use of Tranexamic Acid in High Tibial Osteotomy: A Systematic Review. Cureus. DOI: 10.7759/cureus.49556.
  2. Betzler, Brjan & Singh, Sandip & Liau, Matthias Yi Quan & Koh, Don & Lee, Kong Hwee & Bin Abd Razak, Hamid Rahmatullah. (2023). No significant post-operative limb length difference following medial opening wedge high tibial osteotomy in a multi-ethnic Southeast Asian population. Journal of experimental orthopaedics. 10. 89. DOI: 10.1186/s40634-023-00654-4.
  3. Koh DTS, Soong J, Yeo W, Tan MWP, Teo SJ, Wilson A, Lee KH. Large Versus Small Opening Wedge High Tibial Osteotomies Performed With a Protective Wire Over the Lateral Hinge: Incidence of Lateral Hinge Fracture and Early Clinical Outcomes. Am J Sports Med. 2023 Mar;51(3):672-677. DOI: 10.1177/03635465221148496.
  4. Koh, Don & Lee, Kong Hwee. (2022). Vancomycin-soaked femoral head allograft in opening wedge high tibia osteotomy enables earlier postoperative recovery and reduces infection rates compared to allogenic bone chips. Knee Surgery, Sports Traumatology, Arthroscopy. 30. 1-9. DOI: 10.1007/s00167-022-06885-9.
  5. Betzler, Brjan & Muhammad Ridzwan Chew, Aiman Haziq Bin & Bin Abd Razak, Hamid Rahmatullah. (2021). Intra-articular injection of orthobiologics in patients undergoing high tibial osteotomy for knee osteoarthritis is safe and effective – a systematic review. Journal of Experimental Orthopaedics. 8. 83. DOI: 10.1186/s40634-021-00387-2.
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