The procedure is also used to treat other knee conditions such as osteonecrosis, osteochondritis dissecans, varus or valgus malalignment, chondral resurfacing, and posterolateral instability.
Two techniques are available to perform high tibial osteotomy: closing wedge osteotomy and opening wedge osteotomy. The surgeon chooses the most appropriate technique for the patient.
In closing wedge osteotomy, the surgeon makes an incision in front of the knee and removes a small wedge of bone from the upper part of the tibia. The gap created is filled by bringing the bones together, which relieves the pressure on the damaged area. The surgeon uses plates and screws to hold the bones in place during the healing process.
In opening wedge osteotomy, an incision is made below the kneecap, and a wedge-shaped cut is made in the bone. The gap created is filled with bone graft, and plates and screws may be used to support the surgical site while it heals. This procedure increases the angle of the knee joint to alleviate painful symptoms.
Complications of high tibial osteotomy include infection, skin necrosis, non-union, nerve injury, blood vessel injury, failure to correct varus deformity, compartment syndrome, and deep vein thrombosis or blood clots.