High Tibial Osteotomy (HTO) — Knee Osteotomy (Closing or Opening Wedge)

University of New Mexico (UNM) Sports Medicine · Will Curtis MD, Dustin Richter MD, Christopher Shultz MD, Gehron Treme MD…

Weight-Bearing

Closing wedge: WBAT (may need crutches 2-6 wks); Opening wedge: 50% PWB x 6 weeks; Both: full WB at 6 weeks

Key Restrictions

Brace unlocked per surgeon-set arc x 6 weeks; no pivoting/twisting/hopping/jumping/running until 6 weeks post-op; leg press max 50% BW x 0-6 weeks

Timeline & Phases

0-6 wks: WB per type, brace per surgeon, quad sets, SLR, heel slides, aquatic therapy, stationary bike, leg press (50% BW max); 6 wks: FWB, D/C brace, gait normalization, isokinetics, treadmill walk/retro, proprioception; 12 wks: sport-specific drills, plyometrics, quad symmetry <=15%; 4-6 months: full return to sport (pivoting/squatting/twisting/running)

Notes

PT starts 3-10 days post-op, 1-2x/week for 12+ weeks; WB and brace arc differ by osteotomy type; monitor for patellofemoral symptoms; revised 2025

Surgeon / Author

Will Curtis MD, Dustin Richter MD, Christopher Shultz MD, Gehron Treme MD, Andrew Veitch MD

Published

2025