High tibial osteotomy


High tibial osteotomy is an orthopaedic surgical procedure which aims to correct a varus deformation with compartmental osteoarthritis. It is usually reserved for younger patients who are generally more active.
Angular deformities were first described by Mikulicz-Radecki in 1880. He observed that the axis of the lower extremity passes through the three joints of the hip, knee and ankle in normal individuals and the knee center deviates from this line in angular deformities of the knee. In this case, the medial compartment will bear the weight in genu varum and the lateral compartment will bear weight in genu valgum, and osteoarthritis will develop in the mentioned compartment.
High tibial osteotomy was first described by Jackson in 1958 and has nowadays become a well-established surgery. Coventry, who was a pioneer in this field, has published many reports on the results of closed wedge HTO.
was designed and introduced for open wedge high tibial osteotomies. The advantages over the conventional techniques are reducing the chance of accidental intra-articular extension of the osteotomy, eliminating the potential risk of unwanted translation or rotation of the bone, ability to readjust the alignment after surgery without the need to remove the bone screws. Since the population in most countries is becoming aged, genu varum and consequently the resulting osteoarthritis will increase, and if the patient fulfills the criteria, high tibial osteotomy is advisable.