High Tibial Osteotomy

Price in GBP
Price in EUR
Justin, Northern Ireland
Justin, Northern Ireland
Read More
My mother was experiencing problems with some level of pain and a lack of mobility in one hip. Locally she was advised that she could not have the appropriate treatment for 22 months . At eighty years of age that was a poor option. We were advised to contact Nordorthapaedics. The clinic was comparable to any private facility in the UK. Everything about the experience at Nordorthapaedics was positive. Everything from our first contact to our journey home was professionally managed by a team of courteous individuals. I would thoroughly recommend this service.
Annette, Wales
Annette, Wales
Read More
The whole experience was excellent from making travel arrangements, all the pre-operation checks, making the payment. The clinic was so well run beautifully clean and the staff were marvellous. I would highly recommend taking a few days at the rehabilitation center as the post-op treatment received was outstanding and a great aide to recovery. I received every day physio, massage, hot and cold treatment, things that you wouldn’t get on the NHS. I can highly recommend having the operation in Lithuania it truly was a memorable experience.
Ronnie, Northern Ireland
Ronnie, Northern Ireland
Read More
Hi, I'm Ronnie Kelly from Randalstown, Northern Ireland. From my initial inquiry Jurate at Nordorthopaedics was fantastic answering all my question almost immediately. I booked the flights, gave her the dates and the rest was plain sailing. Everything was organised with professional precision. From being met at the airport, to surgery, to recovery at rehabilitation center and back to the airport every detail was covered with constant emails and messages. I couldn't recommend this Clinic and Rehabilitation Centre any higher for its total professionalism and after care.
Karen, Alberta, Canada
Karen, Alberta, Canada
Read More
Th clinic looked almost too good to be true but everything they claim is accurate. The care I received from the physician and nursing staff was very caring and excellent. Also there is the option for aftercare at a rehab facility that I highly recommend. It gives you time to recover from the surgery before the long flight home. The customer service representative Jurate is very efficient and will promptly answer any questions you have. Canada may seem like a long way from Lithuania but I feel it was totally worth the trip and I am planning to go back and have the other hip replaced.
John, Ireland
John, Ireland
Read More
This is very simple because I recommend everything about nordorthopaedics. Firstly the administration staff are very professional and helpful with any problems you may have,and I would especially mention Aurelija along with her colleague Jurate for their attention to detail. Travelling to a different country can be daunting but the trip is carefully planned with collection from airport, transport to hotel and clinics. The clinics and rehabilitation center are of the highest quality and all the staff, nurses and doctors are really caring and helpful.
Julie, Northern Ireland
Julie, Northern Ireland
Read More
Everything from airport to being picked up , hotel , hospital , loved it all it was the best decision I ever made , I tell everyone here in Ireland about it , I had the whole thing organised with Agnes help in four weeks , staff at hospital fabulous , care fabulous , doctor and anethnetist fabulous , honestly have nothing but good to say . If I need another hip I’ll be there in a heartbeat I’d never wait years here at home never . Thank you all
Ray, Spain, UK expat
Ray, Spain, UK expat
Read More
My experience from beginning to end was one of the utmost pleasure. Not just my own surgery, rotator cuff repair but that of a fellow patient who was up and walking within hours after knee surgery. All made possible by the administration staff, nursing staff and the highly qualified surgeons. Nordorthapaedic deserve a gold medal for their obvious high standards. I award them one as such. After searching the web for a suitable clinic it was an obvious choice to select this clinic. And how happy am I that I did. The high standards of cleanliness and professional care shine out.
David, England
David, England
Read More
Having been rejected by the NHS I chose to look abroad for my options. My friends all thought I was mad to consider Lithuania, nothing could be further from the truth. From my initial contact phone call I have experienced the highest standards of professionalism and service throughout . I must declare that I am quite a tough person to satisfy as I have had a career as a Quality Management Consultant and auditing suppliers. The clinic is first class. It is equal to any private hospital in the uk. I would wholeheartedly recommend the clinic to anyone in a similar position.
Michael, West Midlands, UK
Michael, West Midlands, UK
Read More
I recently had a total hip replacement at Nordorthopedics. The whole experience from the initial contact through to the rehabilitation treatment was flawless, Dr Saraunas Tarasevicius and all at the hospital were unbelievably open and efficient, putting any doubts at rest. I was up and walking with crutches the day after surgery. At the rehabilitation centre the aftercare resulted in being able to walk 2 miles with 1 crutch by the time I left for home 9 days after surgery. Jurate deserves a special mention for organising almost every aspect, nothing seemed to be much trouble. I cannot recommend Nordorthopaedics enough.
Reviews & Facebook group​
As seen on
High Tibial Osteotomy case analysis
Our patients in the media

Nordorthopaedics Center Of Excellence
One of the world’s leading medical technology companies and orthopaedic implant manufacturers, Smith & Nephew, have chosen Nordorthopaedics as its exclusive partner in the Baltic States and the clinic is now a Center of Excellence for this company in the region. 
Our surgeon Arnoldas Sipavicius
  • More than 10 years of working experience
  • Specialises in osteotomy surgeries and knee deformities
  • Fluent in English
  • ATLS Certificate
  • President of Kaunas Regional Scientific Society of Orthopaedics and Traumatology (KKOTMD)
  • Read more
Refund for EU patients

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. 

Rehabilitation package

One of the most important factors for a quick and full recovery after surgery is proper rehabilitation. Rehabilitation helps recover after surgery as well as prevents formation of blood clots and helps avoid most of the postoperative complications and side effects. Outpatient rehabilitation in Kaunas with a physiotherapist.

The rehabilitation clinic is equipped with modern facilities. Individual rehabilitation programs are prepared by a kinesiologist with over 20 years of experience, Prof. Laimonas Siupsinskas. This type of rehabilitation is best suited for people who are physically active, athletes and those wishing to return to sports as soon as possible.

Rehabilitation in Kaunas – € 100 / £ 86  for one 1 h physiotherapy session per day.

  • personalized rehabilitation course;
  • specialist who is also a physiotherapist for Lithuanian Men’s National Basketball Team;
  • all required medication;
  • transportation to/from the rehabilitation clinic;
  • read more about outpatient rehabilitation in Kaunas.
Our clinic
Self-catered accommodation with medical care
What sets us apart from other clinics?

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.

The clinic is equipped with modern diagnostic and surgical facilities, all analogous to those in Western European clinics. You will be looked after by professional English speaking staff. The wards are fully furnished and equipped with TV, WC and air conditioning. Free Wi-Fi is available while staying in the clinic. 
Our clinic is one of the biggest surgical centres in the Baltic region. We work with patients from various countries, among which the United Kingdom, Ireland, Norway, Sweden, Spain, Denmark, Germany, Switzerland, Canada etc. 
Despite the size of the clinic we provide our patients with personal care and assistance. The majority of big public hospitals due to high volume of patients do not have enough resources and medical personnel to pay personal attention to each patient. Whereas we are fully focused on providing exceptional care and undivided attention for our patients.
Without any additional fees patients are tended in the clinic as long as they need. It may take up to 3 days. We only discharge our patients from the clinic when they are in a good health state and ready to leave.
All inclusive price, which is twice lower than in Western European clinics.
Our clinic works with medical professionals of highest education and experience level and uses the same materials as the clinics in Western Europe.  More often than not, the quality of our clinic‘s facilities exceed the ones in Western European clinics. The price difference is only due to considerably lower average salaries and taxes – which is the main reason for medical travel everywhere around the world.

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.

You can find lots of testimonials from our previous patients online. Reading all the positive feedback on Google or Facebook can help you make a final decision. 

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.

Athletes treated at Nordorthopaedics

Our clinic uses implants based on their performance in international registries.

Being a true member of the International Society of Arthroplasty Registries, Lithuania is one of the leaders in low joint replacement revision rates, as only 9% of surgeries in Lithuania require revision in 10 years after surgery. Moreover, with the implants used at our clinic, only 4-6% of surgeries require revision in 10 years after surgery, while revision rates in some other Western countries, for example, USA, is as high as 17% in 10 years after surgery. The implants used at our clinic have been evaluated by other countries’ registries as those ensuring longest implant life, as compared to products of other manufacturers. Read more here.

What is high tibial osteotomy?

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.

What conditions does high tibial osteotomy treat?

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

Varus deformation

Who is an eligible candidate for High Tibial Osteotomy? 

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. 

What is the difference between high tibial osteotomy and knee replacement?
How to prepare for a high tibial osteotomy?
What happens during high tibial osteotomy?

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.

What happens after high tibial osteotomy?
How long does it take to recover from high tibial osteotomy?

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.

10 patients' case studies

11 reasons that make us the most popular orthopaedic clinic abroad