Abstract
The first proposal of high tibial osteotomy to align a varus knee caused by osteoarthritis was ascribed to Steindler in the 1940. The technique was followed by many surgeons because it re-established the load equilibrium in the medial and lateral compartment, reduced the progression of the osteoarthritis and improved the clinical symptoms.
However, as a result of the quick spread of total knee replacement and unicondylar arthroplasty this corrective operation was forgotten. In recent years osteotomies were resumed for two main reasons: (a) the increased diagnosis of knee osteoarthritis in patients of middle age; and (b) the improvement of the technique and improvement of long-term results.
The authors analysed the literature regarding the main techniques utilised in the correction of the axial and torsional deformities of osteoarthritic knee (linear or cuneiform osteotomies). The results of these various methods are similar. This could be due to the importance of common biological effects (early and late) related to the mechanical effect however it is obtained. In conclusion, the authors suggest that osteotomy must be resumed and applied with revised indications (patients in so-called middle age and unicondylar osteoarthritic knee).
