Joint Action28 Sep 2025

Can knee realignment slow down osteoarthritis? A discussion with Dr Trevor Birmingham and Dr David Parker

High tibial osteotomy (HTO) is a limb realignment surgery which is intended for people who have medial compartment osteoarthritis (OA), but are not suitable candidates for total knee replacement due to younger age, less severe disease and greater physical demands. The aim of HTO is to correct alignment, thereby shifting load away from the more involved knee compartment and limit progression of knee OA.

On this week's episode of Joint Action, we are joined by Dr Trevor Birmingham and Dr David Parker to discuss high tibial osteotomy surgery, who it is suitable for and the risks involved.

Professor Trevor Birmingham is a physiotherapist and Canada Research Chair in Musculoskeletal Rehabilitation at the University of Western Ontario in London, Canada. He leads research on musculoskeletal health, often combining clinical outcomes with biomechanical, imaging and biological measures in cohort studies and randomized trials. He co-directs the Wolf Orthopaedic Biomechanics Lab at the Fowler Kennedy Sport Medicine Clinic and is a founding member of the Bone and Joint Institute and the Collaborative Graduate Training Program in Musculoskeletal Health Research at Western University.

Dr David Parker is an experienced orthopaedic knee specialist and co-founder of the Sydney Orthopaedic Research Institute (SORI). He is passionate about sport and is actively involved with international orthopaedic and sports medicine organisations and has extensive experience with athletes of all levels from recreational to elite. Dr Parker has authored over 100 peer-reviewed publications and many textbook chapters and has been awarded the Australian Orthopaedic Association Prize for Research.

RESOURCES

Journal articles

Total knee replacement after high tibial osteotomy: time-to-event analysis and predictors

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