Closing or Opening Wedge High Tibial Osteotomy: Watch Out for the Slope

Abstract

In recent years, there has been a renewed interest in high tibial osteotomies. The development of new instruments and better fixation devices has significantly simplified the surgical procedure. This technique frequently is used to correct alignment in the frontal plane. However, changes in the sagittal plane after high tibial osteotomy have not been appropriately investigated. Changes in posterior tibial slope may have a profound influence on biomechanics, kinetics, and kinematics of the knee joint. Laboratory and clinical studies suggest that an increase in posterior tibial slope decreases tibial sag and forces on the posterior cruciate ligament whereas decreases protect the anterior cruci..