Skip to main content
SpringerLink
Log in

Osteotomy around the knee: evolution, principles and results

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

This article summarises the history and evolution of osteotomy around the knee, examining the changes in principles, operative technique and results over three distinct periods: Historical (pre 1940), Modern Early Years (1940–2000) and Modern Later Years (2000–Present). We aim to place the technique in historical context and to demonstrate its evolution into a validated procedure with beneficial outcomes whose use can be justified for specific indications.

Materials and methods

A thorough literature review was performed to identify the important steps in the development of osteotomy around the knee.

Results

The indications and surgical technique for knee osteotomy have never been standardised, and historically, the results were unpredictable and at times poor. These factors, combined with the success of knee arthroplasty from the 1980s onward, led to knee osteotomy being regarded as an irrelevant surgical option by many surgeons. Despite its fluctuating reputation, this article demonstrates the reasons for the enduring practice of osteotomy, not least because achieving the appropriate alignment is now recognised as the foundation step when planning any surgical intervention.

Conclusions

With appropriate patient selection, accurate pre-operative planning, modern surgical fixation techniques and rapid rehabilitation, osteotomy around the knee is now an effective biological treatment for degenerative disease, deformity, knee instability and also as an adjunct to other complex joint surface and meniscal cartilage surgery.

Level of evidence

V.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10
Fig. 11
Fig. 12
Fig. 13
Fig. 14

Similar content being viewed by others

References

  1. Adams W (1879) On subcutaneous osteotomy. Br Med J 2:604–606

    Article  PubMed  CAS  Google Scholar 

  2. Aglietti P, Buzzi R, Vena LM, Baldini A, Mondaini A (2003) High tibial valgus osteotomy for medial gonarthrosis: a 10- to 21-year study. J Knee Surg 16:21–26

    PubMed  Google Scholar 

  3. Aglietti P, Menchetti PP (2000) Distal femoral varus osteotomy in the valgus osteoarthritic knee. Am J Knee Surg 13:89–95

    PubMed  CAS  Google Scholar 

  4. Ahlberg A, Scham S, Unander-Scharin L (1968) Osteotomy in degenerative and rheumatoid arthritis of the knee joint. Acta Orthop Scand 39:379–388

    Article  PubMed  CAS  Google Scholar 

  5. Amendola A, Panarella L (2005) High tibial osteotomy for the treatment of unicompartmental arthritis of the knee. Orthop Clin North Am 36:497–504

    Article  PubMed  Google Scholar 

  6. Appel H, Friberg S (1973) Effect of osteotomy on pain in idiopathic osteoarthritis of the hip. Acta Orthop Scand 44:710–718

    Article  PubMed  CAS  Google Scholar 

  7. Babis GC, An KN, Chao EY, Rand JA, Sim FH (2002) Double level osteotomy of the knee: a method to retain joint-line obliquity. Clinical results. J Bone Joint Surg Am 84-A:1380–1388

    Google Scholar 

  8. Badhe NP, Forster IW (2002) High tibial osteotomy in knee instability: the rationale of treatment and early results. Knee Surg Sports Traumatol Arthrosc 10:38–43

    Article  PubMed  Google Scholar 

  9. Bae DK, Song SJ, Yoon KH (2009) Closed-wedge high tibial osteotomy using computer-assisted surgery compared to the conventional technique. J Bone Joint Surg Br 91:1164–1171

    Article  PubMed  CAS  Google Scholar 

  10. Bauer GC, Insall J, Koshino T (1969) Tibial osteotomy in gonarthrosis (osteo-arthritis of the knee). J Bone Joint Surg Am 51:1545–1563

    PubMed  CAS  Google Scholar 

  11. Benjamin A (1969) Double osteotomy for the painful knee in rheumatoid arthritis and osteoarthritis. J Bone Joint Surg Br 51:694–699

    PubMed  CAS  Google Scholar 

  12. Benzakour T, Hefti A, Lemseffer M, El Ahmadi JD, Bouyarmane H, Benzakour A (2010) High tibial osteotomy for medial osteoarthritis of the knee: 15 years follow-up. Int Orthop 34:209–215

    Article  PubMed  Google Scholar 

  13. Bhan S, Dave PK (1992) High valgus tibial osteotomy for osteoarthritis of the knee. Int Orthop 16:13–17

    Article  PubMed  CAS  Google Scholar 

  14. Bonnin M, Chambat P (2004) Current status of valgus angle, tibial head closing wedge osteotomy in media gonarthrosis. Orthopade 33:135–142

    Article  PubMed  CAS  Google Scholar 

  15. Brett AL (1935) Operative correction of genu recurvatum. J Bone Joint Surg Am 17:984–989

    Google Scholar 

  16. Brinkman JM, Lobenhoffer P, Agneskirchner JD, Staubli AE, Wymenga AB, van Heerwaarden RJ (2008) Osteotomies around the knee: patient selection, stability of fixation and bone healing in high tibial osteotomies. J Bone Joint Surg Br 90:1548–1557

    Article  PubMed  Google Scholar 

  17. Brittain HA (1948) Treatment of genu valgum; the discarded iron. Br Med J 2:385–387

    Article  PubMed  CAS  Google Scholar 

  18. Brouwer RW, Bierma-Zeinstra SM, van Raaij TM, Verhaar JA (2006) Osteotomy for medial compartment arthritis of the knee using a closing wedge or an opening wedge controlled by a Puddu plate. A one-year randomised, controlled study. J Bone Joint Surg Br 88:1454–1459

    Article  PubMed  CAS  Google Scholar 

  19. Cass JR, Bryan RS (1988) High tibial osteotomy. Clin Orthop Relat Res 230:196–199

    PubMed  Google Scholar 

  20. Coventry MB (1965) Osteotomy of the upper portion of the tibia for degenerative arthritis of the knee. A preliminary report. J Bone Joint Surg Am 47:984–990

    PubMed  CAS  Google Scholar 

  21. Coventry MB (1969) Stepped staple for upper tibial osteotomy. J Bone Joint Surg Am 51:1011

    PubMed  CAS  Google Scholar 

  22. Coventry MB (1973) Osteotomy about the knee for degenerative and rheumatoid arthritis. J Bone Joint Surg Am 55:23–48

    PubMed  CAS  Google Scholar 

  23. Coventry MB (1984) Upper tibial osteotomy. Clin Orthop Relat Res 182:46–52

    PubMed  Google Scholar 

  24. Coventry MB (1985) Upper tibial osteotomy for osteoarthritis. J Bone Joint Surg Am 67:1136–1140

    PubMed  CAS  Google Scholar 

  25. Coventry MB, Ilstrup DM, Wallrichs SL (1993) Proximal tibial osteotomy. A critical long-term study of eighty-seven cases. J Bone Joint Surg Am 75:196–201

    PubMed  CAS  Google Scholar 

  26. DeMeo PJ, Johnson EM, Chiang PP, Flamm AM, Miller MC (2010) Midterm follow-up of opening-wedge high tibial osteotomy. Am J Sports Med 38:2077–2084

    Article  PubMed  Google Scholar 

  27. Di Stefano S, Cohen J (1991) Incomplete nondisplaced tibial osteotomy for treatment of osteoarthritic knee pain. Contemp Orthop 23:455–468

    PubMed  Google Scholar 

  28. Dugdale TW, Noyes FR, Styer D (1992) Preoperative planning for high tibial osteotomy. The effect of lateral tibiofemoral separation and tibiofemoral length. Clin Orthop Relat Res 274:248–264

    PubMed  Google Scholar 

  29. Engel GM, Lippert FG III (1981) Valgus tibial osteotomy: avoiding the pitfalls. Clin Orthop Relat Res 160:137–143

    PubMed  Google Scholar 

  30. Flecher X, Parratte S, Aubaniac JM, Argenson JN (2006) A 12–28-year followup study of closing wedge high tibial osteotomy. Clin Orthop Relat Res 452:91–96

    Article  PubMed  Google Scholar 

  31. Fujisawa Y, Masuhara K, Shiomi S (1979) The effect of high tibial osteotomy on osteoarthritis of the knee. An arthroscopic study of 54 knee joints. Orthop Clin North Am 10:585–608

    PubMed  CAS  Google Scholar 

  32. Gaasbeek RD, Nicolaas L, Rijnberg WJ, van Loon CJ, van Kampen A (2010) Correction accuracy and collateral laxity in open versus closed wedge high tibial osteotomy. A one-year randomised controlled study. Int Orthop 34:201–207

    Article  PubMed  Google Scholar 

  33. Gaasbeek RD, Welsing RT, Verdonschot N, Rijnberg WJ, van Loon CJ, van Kampen A (2005) Accuracy and initial stability of open- and closed-wedge high tibial osteotomy: a cadaveric RSA study. Knee Surg Sports Traumatol Arthrosc 13:689–694

    Article  PubMed  Google Scholar 

  34. Gariepy R (1964) Genu varum treated by high tibial osteotomy. In proceedings of the joint meeting of orthopaedic associations. J Bone Joint Surg Br 46:783–784

    Google Scholar 

  35. Gebhard F, Krettek C, Hufner T, Grutzner PA, Stockle U, Imhoff AB, Lorenz S, Ljungqvist J, Keppler P (2011) Reliability of computer-assisted surgery as an intraoperative ruler in navigated high tibial osteotomy. Arch Orthop Trauma Surg 131:297–302

    Article  PubMed  Google Scholar 

  36. Griffiths DL, Brockbank W (1949) Orthopaedic surgery in the 16. and 17. centuries; traction apparatus; the vidian pictures. J Bone Joint Surg Br 31B:313–317

    PubMed  CAS  Google Scholar 

  37. Gstottner M, Pedross F, Liebensteiner M, Bach C (2008) Long-term outcome after high tibial osteotomy. Arch Orthop Trauma Surg 128:111–115

    Article  PubMed  Google Scholar 

  38. Harris WR, Kostuik JP (1970) High tibial osteotomy for osteo-arthritis of the knee. J Bone Joint Surg Am 52:330–336

    PubMed  CAS  Google Scholar 

  39. Healy WL, Anglen JO, Wasilewski SA, Krackow KA (1988) Distal femoral varus osteotomy. J Bone Joint Surg Am 70:102–109

    PubMed  CAS  Google Scholar 

  40. Hernigou P, Medevielle D, Debeyre J, Goutallier D (1987) Proximal tibial osteotomy for osteoarthritis with varus deformity. A ten to thirteen-year follow-up study. J Bone Joint Surg Am 69:332–354

    PubMed  CAS  Google Scholar 

  41. Holden DL, James SL, Larson RL, Slocum DB (1988) Proximal tibial osteotomy in patients who are fifty years old or less. A long-term follow-up study. J Bone Joint Surg Am 70:977–982

    PubMed  CAS  Google Scholar 

  42. Huang TL, Tseng KF, Chen WM, Lin RM, Wu JJ, Chen TH (2005) Preoperative tibiofemoral angle predicts survival of proximal tibia osteotomy. Clin Orthop Relat Res 432:188–195

    Article  PubMed  Google Scholar 

  43. Hui C, Salmon LJ, Kok A, Williams HA, Hockers N, van der Tempel WM, Chana R, Pinczewski LA (2011) Long-term survival of high tibial osteotomy for medial compartment osteoarthritis of the knee. Am J Sports Med 39:64–70

    Article  PubMed  Google Scholar 

  44. Insall J, Shoji H, Mayer V (1974) High tibial osteotomy. A five-year evaluation. J Bone Joint Surg Am 56:1397–1405

    PubMed  CAS  Google Scholar 

  45. Insall JN, Joseph DM, Msika C (1984) High tibial osteotomy for varus gonarthrosis. A long-term follow-up study. J Bone Joint Surg Am 66:1040–1048

    PubMed  CAS  Google Scholar 

  46. Ivarsson I, Myrnerts R, Gillquist J (1990) High tibial osteotomy for medial osteoarthritis of the knee. A 5 to 7 and 11 year follow-up. J Bone Joint Surg Br 72:238–244

    PubMed  CAS  Google Scholar 

  47. Jackson JP (1958) Osteotomy for osteoarthritis of the knee. J Bone Joint Surg Br 40:826

    Google Scholar 

  48. Jackson JP, Waugh W (1961) Tibial osteotomy for osteoarthritis of the knee. J Bone Joint Surg Br 43-B:746–751

    Google Scholar 

  49. Jackson JP, Waugh W (1974) The technique and complications of upper tibial osteotomy. A review of 226 operations. J Bone Joint Surg Br 56:236–245

    PubMed  CAS  Google Scholar 

  50. Keene JS, Dyreby JR Jr (1983) High tibial osteotomy in the treatment of osteoarthritis of the knee. The role of preoperative arthroscopy. J Bone Joint Surg Am 65:36–42

    PubMed  CAS  Google Scholar 

  51. Keene JS, Monson DK, Roberts JM, Dyreby JR Jr (1989) Evaluation of patients for high tibial osteotomy. Clin Orthop Relat Res 243:157–165

    PubMed  Google Scholar 

  52. Kettelkamp DB, Wenger DR, Chao EY, Thompson C (1976) Results of proximal tibial osteotomy. The effects of tibiofemoral angle, stance-phase flexion-extension, and medial-plateau force. J Bone Joint Surg Am 58:952–960

    PubMed  CAS  Google Scholar 

  53. Koshino T, Morii T, Wada J, Saito H, Ozawa N, Noyori K (1989) High tibial osteotomy with fixation by a blade plate for medial compartment osteoarthritis of the knee. Orthop Clin North Am 20:227–243

    PubMed  CAS  Google Scholar 

  54. Krackow KA (2004) Proximal tibial osteotomy: where did you go? J Arthroplasty 19:5–8

    Article  PubMed  Google Scholar 

  55. Levy M, Pauker M, Lotem M, Seelenfreund M, Fried A (1973) High tibial osteotomy: a follow-up study and description of a modified technic. Clin Orthop Relat Res 93:274–277

    Article  PubMed  Google Scholar 

  56. Little LS (1871) A case of bony ankylosis of the knee-joint, treated by subcutaneous section of the bone. Med Chir Trans 54:247–252

    PubMed  CAS  Google Scholar 

  57. Lobenhoffer P, Van Heerwaarden R, Staubli A, Jakob R (2009) Osteotomies around the knee: indications-planning-surgical techniques using plate fixators. Georg Thieme Verlag, Stuttgart

    Google Scholar 

  58. Macewen W (1879) Antiseptic osteotomy in genu valgum and anterior tibial curves: with a few remarks on the pathology of knock-knee. Br Med J 2:607–609

    Article  PubMed  CAS  Google Scholar 

  59. Macewen W (1880) Osteotomy, with an inquiry into the aetiology and pathology of knock-knee, bow-leg, and other osseous deformities of the lower limbs. J. & A. Churchill, London

    Google Scholar 

  60. Magyar G, Ahl TL, Vibe P, Toksvig-Larsen S, Lindstrand A (1999) Open-wedge osteotomy by hemicallotasis or the closed-wedge technique for osteoarthritis of the knee. A randomised study of 50 operations. J Bone Joint Surg Br 81:444–448

    Article  PubMed  CAS  Google Scholar 

  61. Magyar G, Toksvig-Larsen S, Lindstrand A (1998) Open wedge tibial osteotomy by callus distraction in gonarthrosis. Operative technique and early results in 36 patients. Acta Orthop Scand 69:147–151

    Article  PubMed  CAS  Google Scholar 

  62. Majima T, Yasuda K, Katsuragi R, Kaneda K (2000) Progression of joint arthrosis 10 to 15 years after high tibial osteotomy. Clin Orthop Relat Res 381:177–184

    Article  PubMed  Google Scholar 

  63. Maniscalco P (2003) High tibial osteotomy with external fixator in the varus gonarthritic knee. Acta Biomed 74:76–80

    PubMed  Google Scholar 

  64. Marti R, Van Heerwaarden R (2008) Osteotomies for posttraumatic deformities. Georg Thieme Verlag, Stuttgart

    Google Scholar 

  65. Matthews LS, Goldstein SA, Malvitz TA, Katz BP, Kaufer H (1988) Proximal tibial osteotomy. Factors that influence the duration of satisfactory function. Clin Orthop Relat Res 229:193–200

    PubMed  Google Scholar 

  66. McDermott AG, Finklestein JA, Farine I, Boynton EL, MacIntosh DL, Gross A (1988) Distal femoral varus osteotomy for valgus deformity of the knee. J Bone Joint Surg Am 70:110–116

    PubMed  CAS  Google Scholar 

  67. Meidinger G, Imhoff AB, Paul J, Kirchhoff C, Sauerschnig M, Hinterwimmer S (2011) May smokers and overweight patients be treated with a medial open-wedge HTO? Risk factors for non-union. Knee Surg Sports Traumatol Arthrosc 19:333–339

    Article  PubMed  Google Scholar 

  68. Miller BS, Downie B, McDonough EB, Wojtys EM (2009) Complications after medial opening wedge high tibial osteotomy. Arthroscopy 25:639–646

    Article  PubMed  Google Scholar 

  69. Miller BS, Joseph TA, Barry EM, Rich VJ, Sterett WI (2007) Patient satisfaction after medial opening high tibial osteotomy and microfracture. J Knee Surg 20:129–133

    PubMed  Google Scholar 

  70. Miniaci A, Ballmer FT, Ballmer PM, Jakob RP (1989) Proximal tibial osteotomy. A new fixation device. Clin Orthop Relat Res 246:250–259

    PubMed  Google Scholar 

  71. Muller W, Jani L (1971) Experiences with 75 high tibial osteotomies. Reconstr Surg Traumatol 12:53–63

    PubMed  CAS  Google Scholar 

  72. Myrnerts R (1980) High tibial osteotomy with overcorrection of varus malalignment in medial gonarthrosis. Acta Orthop Scand 51:557–560

    Article  PubMed  CAS  Google Scholar 

  73. Nagel A, Insall JN, Scuderi GR (1996) Proximal tibial osteotomy. A subjective outcome study. J Bone Joint Surg Am 78:1353–1358

    PubMed  CAS  Google Scholar 

  74. Nakamura E, Mizuta H, Kudo S, Takagi K, Sakamoto K (2001) Open-wedge osteotomy of the proximal tibia with hemicallotasis. J Bone Joint Surg Br 83:1111–1115

    Article  PubMed  CAS  Google Scholar 

  75. Naudie D, Bourne RB, Rorabeck CH, Bourne TJ (1999) The Install Award. Survivorship of the high tibial valgus osteotomy. A 10- to -22-year followup study. Clin Orthop Relat Res 367:18–27

    Article  PubMed  Google Scholar 

  76. Nelissen EM, van Langelaan EJ, Nelissen RG (2010) Stability of medial opening wedge high tibial osteotomy: a failure analysis. Int Orthop 34:217–223

    Article  PubMed  CAS  Google Scholar 

  77. Niemeyer P, Koestler W, Kaehny C, Kreuz PC, Brooks CJ, Strohm PC, Helwig P, Suedkamp NP (2008) Two-year results of open-wedge high tibial osteotomy with fixation by medial plate fixator for medial compartment arthritis with varus malalignment of the knee. Arthroscopy 24:796–804

    Article  PubMed  Google Scholar 

  78. Niemeyer P, Schmal H, Hauschild O, von Heyden J, Sudkamp NP, Kostler W (2010) Open-wedge osteotomy using an internal plate fixator in patients with medial-compartment gonarthritis and varus malalignment: 3-year results with regard to preoperative arthroscopic and radiographic findings. Arthroscopy 26:1607–1616

    Article  PubMed  Google Scholar 

  79. Noyes FR, Goebel SX, West J (2005) Opening wedge tibial osteotomy: the 3-triangle method to correct axial alignment and tibial slope. Am J Sports Med 33:378–387

    Article  PubMed  Google Scholar 

  80. Odenbring S, Egund N, Hagstedt B, Larsson J, Lindstrand A, Toksvig-Larsen S (1991) Ten-year results of tibial osteotomy for medial gonarthrosis. The influence of overcorrection. Arch Orthop Trauma Surg 110:103–108

    Article  PubMed  CAS  Google Scholar 

  81. Odenbring S, Egund N, Knutson K, Lindstrand A, Larsen ST (1990) Revision after osteotomy for gonarthrosis. A 10–19-year follow-up of 314 cases. Acta Orthop Scand 61:128–130

    Article  PubMed  CAS  Google Scholar 

  82. Odenbring S, Tjornstrand B, Egund N, Hagstedt B, Hovelius L, Lindstrand A, Luxhoj T, Svanstrom A (1989) Function after tibial osteotomy for medial gonarthrosis below aged 50 years. Acta Orthop Scand 60:527–531

    Article  PubMed  CAS  Google Scholar 

  83. Ogata K (1984) Interlocking wedge osteotomy of the proximal tibia for gonarthrosis. Clin Orthop Relat Res 186:129–134

    PubMed  Google Scholar 

  84. Pachelli AF, Kaufman EE (1987) Long-term results of valgus tibial osteotomy. Orthopedics 10:1415–1418

    PubMed  CAS  Google Scholar 

  85. Paley D (2002) Principles of deformity correction. Springer, New York

    Google Scholar 

  86. Pape D, Rupp S (2007) Preoperative planning for high tibial osteotomies. Oper Tech Orthop 17:2–11

    Article  Google Scholar 

  87. Pennington TH (1994) Osteotomy as an indicator of antiseptic surgical practice. Med Hist 38:178–188

    Article  PubMed  CAS  Google Scholar 

  88. Pongsoipetch B, Tantikul C (2009) Open-wedge high tibial osteotomy in varus knee osteoarthritis: a 5-year prospective cohort study. J Med Assoc Thai 92(Suppl 6):S109–S114

    PubMed  Google Scholar 

  89. Prodromos CC, Andriacchi TP, Galante JO (1985) A relationship between gait and clinical changes following high tibial osteotomy. J Bone Joint Surg Am 67:1188–1194

    PubMed  CAS  Google Scholar 

  90. Ranieri L, Traina GC, Maci C (1977) High tibial osteotomy in osteoarthrosis of the knee (a long term clinical study of 187 knees). Ital J Orthop Traumatol 3:289–300

    PubMed  CAS  Google Scholar 

  91. Rinonapoli E, Aglietti P, Mancini GB, Buzzi R (1988) High tibial osteotomy in the treatment of arthritic varus knee. A medium term (small) review of 61 cases. Ital J Orthop Traumatol 14:283–292

    PubMed  CAS  Google Scholar 

  92. Rinonapoli E, Mancini GB, Corvaglia A, Musiello S (1998) Tibial osteotomy for varus gonarthrosis. A 10- to 21-year followup study. Clin Orthop Relat Res 353:185–193

    Article  PubMed  Google Scholar 

  93. Ritter MA, Fechtman RA (1988) Proximal tibial osteotomy. A survivorship analysis. J Arthroplasty 3:309–311

    Article  PubMed  CAS  Google Scholar 

  94. Ronn K, Reischl N, Gautier E, Jacobi M (2011) Current surgical treatment of knee osteoarthritis. Arthritis 2011:454873

    Article  PubMed  Google Scholar 

  95. Rudan JF, Simurda MA (1990) High tibial osteotomy. A prospective clinical and roentgenographic review. Clin Orthop Relat Res 255:251–256

    PubMed  Google Scholar 

  96. Rudan JF, Simurda MA (1991) Valgus high tibial osteotomy. A long-term follow-up study. Clin Orthop Relat Res 268:157–160

    PubMed  Google Scholar 

  97. Salzmann GM, Ahrens P, Naal FD, El-Azab H, Spang JT, Imhoff AB, Lorenz S (2009) Sporting activity after high tibial osteotomy for the treatment of medial compartment knee osteoarthritis. Am J Sports Med 37:312–318

    Article  PubMed  Google Scholar 

  98. Saragaglia D, Blaysat M, Inman D, Mercier N (2011) Outcome of opening wedge high tibial osteotomy augmented with a Biosorb(R) wedge and fixed with a plate and screws in 124 patients with a mean of ten years follow-up. Int Orthop 35:1151–1156

    Article  PubMed  Google Scholar 

  99. Schallberger A, Jacobi M, Wahl P, Maestretti G, Jakob RP (2011) High tibial valgus osteotomy in unicompartmental medial osteoarthritis of the knee: a retrospective follow-up study over 13–21 years. Knee Surg Sports Traumatol Arthrosc 19:122–127

    Article  PubMed  Google Scholar 

  100. Schroter S, Gonser CE, Konstantinidis L, Helwig P, Albrecht D (2011) High complication rate after biplanar open wedge high tibial osteotomy stabilized with a new spacer plate (Position HTO plate) without bone substitute. Arthroscopy 27:644–652

    Article  PubMed  Google Scholar 

  101. Seal PV, Chan RN (1975) Tibial osteotomy for osteoarthrosis of the knee. Acta Orthop Scand 46:141–151

    Article  PubMed  CAS  Google Scholar 

  102. Shim JS, Lee SH, Jung HJ, Lee HI (2011) High tibial open wedge osteotomy below the tibial tubercle: clinical and radiographic results. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-011-1453-9

  103. Shoji H, Insall J (1973) High tibial osteotomy for osteoarthritis of the knee with valgus deformity. J Bone Joint Surg Am 55:963–973

    PubMed  CAS  Google Scholar 

  104. Smith TO, Sexton D, Mitchell P, Hing CB (2011) Opening- or closing-wedged high tibial osteotomy: a meta-analysis of clinical and radiological outcomes. Knee 18:361–368

    Article  PubMed  CAS  Google Scholar 

  105. Sprenger TR, Doerzbacher JF (2003) Tibial osteotomy for the treatment of varus gonarthrosis. Survival and failure analysis to twenty-two years. J Bone Joint Surg Am 85-A:469–474

    Google Scholar 

  106. Staubli AE, De SC, Babst R, Lobenhoffer P (2003) TomoFix: a new LCP-concept for open wedge osteotomy of the medial proximal tibia—early results in 92 cases. Injury 34(Suppl 2):B55–B62

    Article  PubMed  Google Scholar 

  107. Sundaram NA, Hallett JP, Sullivan MF (1986) Dome osteotomy of the tibia for osteoarthritis of the knee. J Bone Joint Surg Br 68:782–786

    PubMed  CAS  Google Scholar 

  108. Surin V, Markhede G, Sundholm K (1975) Factors influencing results of high tibial osteotomy in gonarthrosis. Acta Orthop Scand 46:996–1007

    Article  PubMed  CAS  Google Scholar 

  109. Takeuchi R, Ishikawa H, Aratake M, Bito H, Saito I, Kumagai K, Akamatsu Y, Saito T (2009) Medial opening wedge high tibial osteotomy with early full weight bearing. Arthroscopy 25:46–53

    Article  PubMed  Google Scholar 

  110. Tjornstrand BA, Egund N, Hagstedt BV (1981) High tibial osteotomy: a seven-year clinical and radiographic follow-up. Clin Orthop Relat Res 160:124–136

    PubMed  Google Scholar 

  111. Valenti JR, Calvo R, Lopez R, Canadell J (1990) Long term evaluation of high tibial valgus osteotomy. Int Orthop 14:347–349

    Article  PubMed  CAS  Google Scholar 

  112. van Raaij TM, Reijman M, Brouwer RW, Jakma TS, Verhaar JN (2008) Survival of closing-wedge high tibial osteotomy: good outcome in men with low-grade osteoarthritis after 10–16 years. Acta Orthop 79:230–234

    Article  PubMed  Google Scholar 

  113. Warden SJ, Morris HG, Crossley KM, Brukner PD, Bennell KL (2005) Delayed- and non-union following opening wedge high tibial osteotomy: surgeons’ results from 182 completed cases. Knee Surg Sports Traumatol Arthrosc 13:34–37

    Article  PubMed  Google Scholar 

  114. Wardle EN (1962) Osteotomy of the tibia and fibula. Surg Gynecol Obstet 115:61–64

    PubMed  CAS  Google Scholar 

  115. Wardle EN (1964) Osteotomy of the tibia and fibula in the treatment of chronic osteoarthritis of the knee. Postgrad Med J 40:536–542

    Article  PubMed  CAS  Google Scholar 

  116. Wright J, Heck D, Hawker G, Dittus R, Freund D, Joyce D, Paul J, Young W, Coyte P (1995) Rates of tibial osteotomies in Canada and the United States. Clin Orthop Relat Res 319:266–275

    PubMed  Google Scholar 

  117. Wright JM, Crockett HC, Slawski DP, Madsen MW, Windsor RE (2005) High tibial osteotomy. J Am Acad Orthop Surg 13:279–289

    PubMed  Google Scholar 

  118. Yacobucci GN, Cocking MR (2008) Union of medial opening-wedge high tibial osteotomy using a corticocancellous proximal tibial wedge allograft. Am J Sports Med 36:713–719

    Article  PubMed  Google Scholar 

  119. Yasuda K, Majima T, Tsuchida T, Kaneda K (1992) A ten- to 15-year follow-up observation of high tibial osteotomy in medial compartment osteoarthrosis. Clin Orthop Relat Res 282:186–195

    PubMed  Google Scholar 

  120. Zaki SH, Rae PJ (2009) High tibial valgus osteotomy using the Tomofix plate–medium-term results in young patients. Acta Orthop Belg 75:360–367

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Basingstoke and North Hampshire Hospitals NHS Foundation Trust, Aldermaston Road, Basingstoke, Hampshire, RG24 9NA, UK

    J. O. Smith, A. J. Wilson & N. P. Thomas

Authors
  1. J. O. Smith
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. J. Wilson
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. N. P. Thomas
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J. O. Smith.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Smith, J.O., Wilson, A.J. & Thomas, N.P. Osteotomy around the knee: evolution, principles and results. Knee Surg Sports Traumatol Arthrosc 21, 3–22 (2013). https://doi.org/10.1007/s00167-012-2206-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-012-2206-0

Keywords

Search

Navigation