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Correction of lower extremity malalignment has been identified as the single most important aspect of prolonging function. With the advent of new plating systems and further development in areas of joint preservation, tibial osteotomies restoring proper mechanical alignment have become more accurate, patient friendly and increasingly popular. Most commonly, this technique is utilised for the patient with medial compartment pathology and varus malalignment. A total knee arthroplasty is an extremely successful operation, with good predictability, but is not designed to allow patients to return to activities involving impact loading over a long period of time.

Patients with medial compartment arthrosis, varus malalignment who desire to return to activities such as hiking on uneven ground, tennis, or skiing are better suited for a joint preservation approach to maintain their lifestyle. A High Tibial Osteotomy (HTO) producing mechanical realignment of the load across the knee is a better option for these patients, allowing them to maintain their active lifestyle. In addition, patients who undergo reconstructive procedures for “joint preservation” (i.e. Microfracture, Abrasion, Oats, Allograft, Genzyme, or meniscal implantation) may benefit from a concomitant HTO in an effort to offload the forces around the chondral or meniscal lesion and ultimately protect the reconstruction.
Titanium metallurgy to facilitate complimentary imaging techniques and improve structural characteristics.
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