Introduction: One of the problems of high tibial valgus osteotomy is the loss of achieved correction, which, in turn, is associated with the deterioration of the patient’s symptoms.

Aim: The aim of the present retrospective study is the correlation of certain parameters of axial alignment of the knee joint with the possibility of varus recurrence, after high tibial osteotomy, with stable fixation.

Material – Method: For this purpose we studied 33 patients (37 knees), that had undergone high tibial osteotomy between 1989 and 1997. All the above patients had a follow up of at least 2 years, with a mean of 35 months. The axial parameters that were studied were the femoral condyle-femoral shaft angle, the tibial plateau-tibial shaft angle, the post operative valgus correction and the post operative medial joint space widening.

Results: Loss of femorotibial angle equal to or more than 3 degrees was regarded as recurrence. This was observed in 9 knees (24%). The possibility of recurrence was strongly associated (Logistic Regression Analysis), on the one hand, with a post operative valgus correction of less than 6 degrees, and, on the other hand, with a femoral condyle-femoral shaft angle of more than 84 degrees (varus orientation of the articular surface of femoral condyles).

Conclusion: It seems that both undercorrection of the femorotibial angle and varus orientation of the femoral condyles in the frontal plane do not allow the shift of the weight bearing axis of the lower extremity towards the lateral compartment and, thus, constitute risk factors for recurrence of the varus deformity.