This chapter explores the utilization of High Tibial Osteotomy (HTO) within the framework of the Knee Health Promotion Option (KHPO) for treating knee osteoarthritis (OA). HTO serves as a fundamental treatment approach, especially in advanced OA cases, showcasing initial success. However, this chapter delves into the comprehensive analysis of HTO, examining survivorship rates, patient-reported outcomes, long-term implications, concerns regarding revision surgeries, and comparisons with other treatment modalities like unicompartmental knee arthroplasty (UKA). Additionally, the chapter discusses advancements in technology, such as patient-specific instrumentation (PSI), and the synergistic effects of the Arthroscopic Cartilage Regeneration Facilitating Procedure (ACRFP) with HTO in optimizing knee health management. The study emphasizes the crucial need for ongoing research efforts to enhance the efficacy of HTO while navigating its limitations in managing knee OA. Through a multidisciplinary approach encompassing surgical advancements, tailored treatment plans, and precise assessments, this chapter provides a roadmap for healthcare practitioners to optimize patient outcomes and revolutionize the management of knee OA within the realm of the KHPO.