Closing Verses Opening Wedge High Tibial Osteotomy: an Evidence-Based Review

HSS Journal Article

Joseph J. Ruzbarsky, MD
Hospital for Special Surgery, New York, NY

David M. Dare, MD
Hospital for Special Surgery, New York, NY

Robert G. Marx, MD, MSc, FRCSC
Robert G. Marx, MD, MSc, FRCSC
Attending Orthopaedic Surgeon, Hospital for Special Surgery
Professor of Orthopaedic Surgery and Professor of Public Health, Weill Cornell Medical College


Knee osteoarthritis is a common and disabling disorder made worse by lower extremity malalignment [3]. Medial knee arthrosis is the most common indication for high tibial osteotomy (HTO). Surgical techniques include closing wedge osteotomy, opening wedge osteotomy, dome osteotomy, progressive callus distraction, and chevron osteotomy [4, 7]. Opening and closing wedge osteotomies are the most common.While lateral closing wedge HTO was once considered standard of care, both techniques have advantages and disadvantages, and neither has proven clinical superiority [3]. Technique selection, therefore, is largely driven by surgeon preference.

This article appears in the HSS Journal: Volume 11, Issue 3.
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About the HSS Journal

HSS Journal, an academic peer-reviewed journal, is published twice a year, February and September, and features articles by internal faculty and HSS alumni that present current research and clinical work in the field of musculoskeletal medicine performed at HSS, including research articles, surgical procedures, and case reports.


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