Introduction

Medial opening wedge high tibial osteotomy (HTO) is surgical treatment option for the management of medial compartment knee osteoarthritis.1 High tibial osteotomy (HTO) is a widely performed procedure to treat medial knee arthrosis. Many techniques have been developed (i.e. closing wedge, opening wedge, dome and “en chevron” osteotomies), but opening (medial) and closing (lateral) wedge osteotomies are the most commonly used. The goal of the treatment is to relieve medial compartment knee pain and slow down the arthritic progression. The surgery is described as a biomechanical intervention designed to alter dynamic knee joint loading, with the aim of improving patient function and decreasing pain This is achieved by a partial unloading of the medial compartment with a slight overcorrection 3-5 degree of the mechanical axis. Some studies showed that regenerative process began after realignment. HTO was considered as an option to treat an isolated medial compartment Osteoarthritis (OA) in Varus knees, which was reported by Jackson in 1958. This surgery was not popular until Coventry reported good results in 19732, HTO became more popular in young active patients after improvement in surgical technique, fixation devices, and patient selection with fewer complications. Although overall HTO results show the effectiveness of the procedure there are still some debated issues about osteotomies. These include the choice between opening or closing wedge tibial osteotomy, the graft selection in opening wedge osteotomies, the type of fixation, the comparison with uni-compartmental knee arthroplasty (UKA) and whether HTO affects a subsequent total joint replacemen(TKR)

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Dr Manish J. Choudhary

Junior Resident, Department of Orthopaedics, KMCH, Katihar