Narrative review of HTO for the varus knee covering patient selection criteria, preoperative planning (coronal and sagittal alignment), surgical techniques (opening vs. closing wedge and alternatives), outcomes data, and complications — with specific guidance on combining HTO with ACL reconstruction, meniscal transplant, or cartilage resurfacing.
When you see a varus knee with medial compartment arthrosis in a patient under 65 with preserved ROM, think HTO — but also assess tibial slope on the lateral view, because concurrent ligamentous instability changes both your technique selection and your slope target.
Opening wedge is preferred when slope modification is needed; reserve closing wedge for high nonunion-risk patients (e.g., heavy smokers).
Narrative review of HTO for the varus knee covering patient selection criteria, preoperative planning (coronal and sagittal alignment), surgical techniques (opening vs. closing wedge and alternatives), outcomes data, and complications — with specific guidance on combining HTO with ACL reconstruction, meniscal transplant, or cartilage resurfacing.
When you see a varus knee with medial compartment arthrosis in a patient under 65 with preserved ROM, think HTO — but also assess tibial slope on the lateral view, because concurrent ligamentous instability changes both your technique selection and your slope target.
Opening wedge is preferred when slope modification is needed; reserve closing wedge for high nonunion-risk patients (e.g., heavy smokers).