Proximal Tibial and Distal Femoral Osteotomy
High tibial osteotomy (HTO) for the treatment of varus gonarthrosis isolated to the medial compartment of the knee was first described by Jackson et al in 1958 1 and popularized by Coventry. 2 Valgus-producing HTO for medial joint gonarthrosis has evolved from a lateral closing wedge to a medial opening wedge, and both techniques are recognized as joint-preserving alternatives to unicompartmental and total knee arthroplasty, specifically in younger patients. 3, 4 Many studies have shown good patient-reported outcomes and survivorship following limb realignment with an HTO for medial joint gonarthrosis. 5, 6 A varus-producing distal femoral osteotomy (DFO) can be performed to unload the lateral compartment with valgus malalignment, which also provides good results.
