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Open Wedge High Tibial Osteotomy

Osteotomy is a classic operation in the treatment of unicompartmental osteoarthrosis of the knee. It has often been presented as a possible alternative to prosthetic joint replacement, but the indications depend on the stage and articular diffusion of the degenerative changes and on the patient's profile and are very different in most cases from the indications for unicompartmental or total knee replacement. A relatively new technique of high tibial osteotomy will be illustrated in this article with careful step-by-step presentation of all the details of the operation. Compared to the Coventry lateral closing wedge osteotomy, this technique turns upside down the method of correction of the varus deformity and adds a wedge medially. It is based on a special dedicated system of instruments and plates developed by Puddu et al in the early 1990s.