High Tibial Osteotomy

Question 1

What are the indications for high tibial osteotomy?

Answer 1

1) young, active patient (less than 50 years) in whom an arthroplasty would fail due to excessive wear
2) healthy patient with good vascular status
3) non-obese patients
4) pain and disability interfering with daily life
5) only one knee compartment is affected
6) compliant patient that will be able to follow postop protocol

Question 2

What are the contraindications for high tibial osteotomy?

Answer 2

1) inflammatory arthritis
2) obese patient BMI>35
3) flexion contracture >15 degrees
4) knee flexion 20 degrees of correction
6) patellofemoral arthritis
7) ligament instability
8) varus thrust during gait

Question 3

What is a common complication of high tibial osteotomy?

Answer 3

Patella baja; due to elevating joint line with opening wedge or retropatellar scarring