High Tibial Osteotomy

High tibial osteotomy (HTO) using conventional surgical technique and cast immobilization was compared to HTO using an osteotomy jig, rigid internal fixation, and early motion. Fifteen patients (19 knees) had conventional HTO. The mean preoperative femoral-tibial angle was 2.5 degrees of varus, and the mean postoperative angle was 6.5 degrees of valgus. Two knees were undercorrected and eight knees (42%) had associated complications. Twenty patients (21 knees) had HTO utilizing the new surgical technique and postoperative management. The mean preoperative femoral-tibial angle was 2.3 degrees varus, and the mean postoperative angle was 7.6 degrees valgus. One knee was undercorrected (less than 4 degrees valgus) and one knee (5%) had an intraoperative intraarticular fracture. High tibial osteotomy with an osteotomy jig to provide accurate correction, and rigid internal fixation to allow early motion, is an attractive alternative to conventional HTO.