Get your surgery for free by claiming a refund from your local health board. The clinic helps patients with the documents needed to claim a refund after following the EU directive route for medical treatment abroad. It applies to patients who are insured under the systems of one of the EU countries and may not get the surgery due to long waiting times.
Our clinic works with highly professional and educated surgeons. They have 10-20 years of experience in the field of orthopaedic surgery. They each perform 500 surgeries per year. Moreover, our surgeons are members of various prestigious surgical societies both Lithuanian and international. Our joint replacement surgeon S. Tarasevicius is an author of 150 scientific publications in different medical journals. Find more information about our surgeons here.
Our clinic works according to the highest standards set by the European Union. This helps to guarantee the quality of medical service.
During your entire stay in Lithuania you will receive personal care as well as transport to and from the clinic, hotel, and airport. You will not have to worry about a thing. You will be assisted from the moment of plane landing in Vilnius or Kaunas airport till your departure.
We have no waiting line so we can schedule your surgery as soon as you are ready to do so.
Everyone in our clinic speaks English, including nurses, assistants and the surgeon.
2-3 hour regular flights operate from all main airports in the UK & Ireland. Lithuania is closer than you thought. You can find the list of direct flights here. Please note that airlines constantly add new flights and new destinations, therefore feel free to contact us if you need help choosing the flight that suits you best.
Lithuania has been a part of the EU and NATO since 2004. Lithuania has one of the fastest growing economies in the whole region and the second fastest internet speed in the world. Lithuanian medical schools have trained many medical professionals who are highly appreciated and employed by many foreign hospitals, among which hospitals in the UK. Our clinic works according to the highest standards set to the medical institutions by the European Union.
Open wedge high tibial osteotomy, also known as high tibial osteotomy (HTO) or knee osteotomy, is an orthopaedic surgical procedure aimed to correct misaligned knees. It is usually indicated for those patients who have early-stage osteoarthritis and damaged articular surfaces on one side of the knee joint. The fundamental goals of the procedure are to realign the axis of the leg and knee to transfer weight from the arthritic part of the knee to a healthy surface. Knee osteotomy relieves pain, significantly improves knee function, and delays or prevents the need for knee replacement.
High tibial osteotomy effectively manages several knee conditions, including knee osteoarthritis, varus malalignment with medial side overload, osteochondritis, osteonecrosis on medial side, and some posterolateral instability.
High tibial osteotomy can be a suitable option in treating knee osteoarthritis if damage is in just one area of the joint. It preserves the existing knee structures and slows down the progression of arthritis in the knee. For this reason it allows patients to continue with their active daily life without total knee replacement or at least postpone the need of artificial joint.
Healthy vs. knee joint affected by osteoarthritis
High tibial osteotomy is ideal for active, non-obese patients who are younger than 60 years old. Good candidates have pain only on one side of the knee which gets worse mostly when being active. The candidates should be able to straighten the leg and bend the knee to at least 90-120 degrees. Some patients however are not suitable for a high tibial osteotomy. General contraindications include: inflammatory arthritis (an autoimmune condition), obesity (BMI>35), and ligament instability.
To determine if a patient is suitable for high tibial osteotomy not only MRI, but also long leg x-rays are needed to reliably assess the axis of the knee and know if it can be fixed.
In some cases high tibial osteotomy can be suitable for older patients if arthritis damage is in just one area and a person has been leading an active lifestyle like doing professional sports or lifelong sporting activities.
High tibial osteotomy patients preserve the native knee joint and cartilages by correcting the alignment of the upper and lower leg bones.
Firstly, a prospective patient should schedule an initial consultation with an orthopaedic surgeon. During the first consultation, the surgeon performs a medical examination, evaluates the knee joint, and determines the best treatment plan. The surgeon may ask to have certain imaging tests performed, like a knee X-ray, long leg standing X-ray, a CT scan and MRI. Before surgery, patients also have to see their anaesthesiologist to discuss the anaesthesia choices
High tibial osteotomy procedure takes approximately 2 hours to complete. It can be performed under general or spinal anaesthesia. During surgery, a surgeon uses an arthroscope (a special miniature camera) to look inside the joint and evaluate the condition of the cartilage, ligaments, and menisci. Then, the surgeon makes a 6-7 cm incision to access the shin bone to make a cut and create the wedge opening on medial side. In case if opening is more then 10mm, a bone graft is required to fill the osteotomy site. It helps the bone to heal where it was cut. After desired correction of the axis, the bone is fixated with dedicated medical implants (plate and screws). Such alteration changes the weightbearing axis and shifts the weight from the damaged arthritic part of the cartilage to a healthy side, thus relieving pain. After the surgery is finished, the surgeon closes the incision, bandages the leg, and places it in a hinged brace. In some case, when the patient’s health state is good enough, two legs may be operated during one surgery.
Recovery can be divided into 4 phases. Each of them has different goals and recovery exercises.
During the first 2 weeks, patients are encouraged to rest and keep the leg elevated to control swelling. Hinge brace has to be used at all times, including sleeping, but it can be removed during exercise. Exercises include heel slides when laying on the back or sitting, knee flexion, and soft stretching.
Weeks 2 to 6 are dedicated to non-weight bearing strengthening. During this time, patients continue to only walk with the crutches to allow for bone healing. The patients should be able to flex the knee fairly easily and fully extend it by the end of 6 weeks. Recovery exercises include straight leg raises when lying down, stretching hamstrings and calves, and increasing muscle strength and endurance.
Weeks 6 to 12 are dedicated to increase and improve weight-bearing. During this time, patients should progress from partial weight bearing to walking without crutches. By this time, patients should have full and pain free knee range of motion. The goals of this phase is to increase cardiovascular strength and regain balance. Exercises include stationary biking or elliptical trainer, standing stretches, hip strengthening exercises, sit-to-stand exercises and others.
During 3 to 6 months post-surgery, patients should be ready to return to regular activities. The goals are to continue cardiovascular strength, further improve balance, and progress to sport-specific training. Exercises include sit-to-stand exercises, kickbacks, lunges, using wobble boards to improve balance, biking, and treadmill for quick walking, and others.