High Tibial Osteotomies for the Treatment of Osteoarthritis of the Knee

JBJS Rev. 2022 Jan 12;10(1). doi: 10.2106/JBJS.RVW.21.00127.


»: A high tibial osteotomy (HTO) is a joint-preserving procedure that can be used to treat symptomatic unicompartmental cartilage disorders in the presence of limb malalignment.

»: Appropriate patient selection and careful preoperative planning are vital for optimizing outcomes.

»: Based on past literature, correction of varus malalignment to 3° to 8° of valgus appears to lead to favorable results. Recently, there has been growing awareness that it is important to consider soft-tissue laxity during preoperative planning.

»: Although there has been a recent trend toward performing opening-wedge rather than closing-wedge or dome HTOs for unicompartmental osteoarthritis, current data suggest that all 3 are acceptable techniques with varying complication profiles.

»: Based on current evidence, an HTO provides pain relief, functional improvement, and a high rate of return to sport, with reported survivorship ranging from 74.7% to 97.6% and 66.0% to 90.4% at 10 and 15 years, respectively.

MeSH terms

  • Humans
  • Knee Joint / surgery
  • Osteoarthritis, Knee* / complications
  • Osteotomy / methods
  • Tibia / surgery
  • Treatment Outcome