High Tibial Osteotomy

HTO include the choice of opening vs. closing wedge HTO, graft selection in opening wedge HTO, type of fixation, comparative advantages over unicompartmental knee arthroplasty and the influence of HTO on subsequent knee arthroplasty 6) . Preoperative Assessments 1. Indications and ContraindicationsAppropriate patient selection is a key to a successful HTO.Primary or secondary medial compartment degenerative arthritis is the most common indication for HTO.The ideal candidate for HTO is an individual who is between 60 to 65 years of age with isolated medial osteoarthritis with a varus deformity and good range of motion (ROM) and without ligamentous instability 6) .Poor prognostic factors include severe joint destruction (≥Ahlback grade III), ≥65 years of age, advanced patellofemoral arthritis, <90 o of ROM, ≥15 o of flexion contracture, joint instability and ≥1 cm lateral tibial thrust, ≥20 o of correction, and rheumatoid arthritis [7][8][9] .Most authors agree that HTO is more appropriate than unicompartmental knee arthroplasty for overweight patients, but the influence of body mass index on the results of HTO remains controversial 8,10) . Preoperative Planning 1) Patient assessmentPatient's age, career, level of activity, previous history of surgery on the knee, and expectation should be taken into consideration before deciding upon surgery.Closing wedge HTO may be more High Tibial Osteotomy