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J Am Acad Orthop Surg, Vol 13, No 4, July/August 2005, 279-289.
© 2005 the American Academy of Orthopaedic Surgeons
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High Tibial Osteotomy

John M. Wright, MD, Heber C. Crockett, MD, Daniel P. Slawski, MD, Mike W. Madsen, MD and Russell E. Windsor, MD

Dr. Wright is Orthopaedic Surgeon, New West Sports Medicine and Orthopaedic Surgery, The Nebraska Joint Replacement Center, Kearney, NE. Dr. Crockett is Orthopaedic Surgeon, New West Sports Medicine and Orthopaedic Surgery. Dr. Slawski is Orthopaedic Surgeon, New West Sports Medicine and Orthopaedic Surgery. Dr. Madsen is Orthopaedic Surgery Resident, The Hospital for Special Surgery, New York, NY. Dr. Windsor is Attending Orthopaedic Surgeon, The Hospital for Special Surgery.

None of the following authors or the departments with which they are affiliated has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Wright, Dr. Crockett, Dr. Slawski, and Dr. Madsen. Dr. Windsor or the department with which he is affiliated serves as a consultant to or is an employee of Zimmer.

Reprint requests: Dr. Wright, The Nebraska Joint Replacement Center, Suite 102, 3219 Central Avenue, Kearney, NE 68847.

High tibial osteotomy is effective for managing a variety of knee conditions, including gonarthrosis with varus or valgus malalignment, osteochondritis dissecans, osteonecrosis, posterolateral instability, and chondral resurfacing. The fundamental goals of the procedure are to unload diseased articular surfaces and to correct angular deformity at the tibiofemoral articulation. Although the clinical success of total knee arthroplasty has resulted in fewer high tibial osteotomies being done during the past decade, the procedure remains useful in appropriately selected patients with unicompartmental knee disease. Renewed interest in high tibial osteotomy has occurred for a number of reasons. These include the prevalence of physiologically young active patients presenting with medial compartment osteoarthritis; the advent of new techniques for performing the procedure (ie, improved instrumentation and fixation plates for medial opening wedge osteotomy, dynamic external fixation for medial opening wedge osteotomy, and improved instrumentation for lateral closing wedge osteotomy); and the need to concomitantly correct malalignment when performing chondral resurfacing procedures (ie, autologous chondrocyte transplantation, mosaicplasty, and microfracture).




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C. Mina, W. E. Garrett Jr, R. Pietrobon, R. Glisson, and L. Higgins
High Tibial Osteotomy for Unloading Osteochondral Defects in the Medial Compartment of the Knee
Am. J. Sports Med., May 1, 2008; 36(5): 949 - 955.
[Abstract] [Full Text] [PDF]


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