Abstract
Introduction The goal of HTO is to re-align the mechanical axis to neutral or over corrected.
Methods I present a personal series of 22 opening wedge high tibial osteotomies in 20 patients with chronic posterior or posterolateral instability. Pre-operatively standing long leg views and a lateral view in extension are required to asses the mechanical axis and the posterior slope of the tibia. The osteotomy needs to be tailored to the pathology, remembering that increasing the posterior slope of the tibia worsens an ACL but improves a PCL deficit.
Results Sixty percent of the patients reported that knee stability was significantly better, 35% somewhat and 5% no better. All 20 patients reported that they would undergo the procedure again. Alignment was altered a mean of four degrees valgus and posterior tibial slope was increased by a mean of seven degrees.
Conclusions Simultaneous correction of knee mal-alignment and tibial slope by an opening wedge osteotomy can produce good functional and radiographic results.
In relation to the conduct of this study, one or more of the authors is in receipt of a research grant from a non-commercial source.
The abstracts were prepared by Mr Jerzy Sikorski. Correspondence should be addressed to him at the Australian Orthopaedic Association, Ground Floor, William Bland Centre, 229 Macquarie Street, Sydney NSW 2000, Australia.
