High tibial osteotomy is a surgical procedure where the bone of the upper tibia is cut and re-angled to change the limb alignment.
Opening wedge high tibial osteotomy
Usually a high tibial osteotomy is performed to correct a varus (bow-legged) deformity, and the correction is made via an 'opening wedge'. Occasionally a closing wedge is indicated, and the site and degree of correction is nowadays determined by computer evaluation of weight-bearing full leg X-rays.
Laminar spreaders open the wedge of a high tibial osteotomy, and then the bone is held in the new position with a plate and screws until new bone fills the gap.
High tibial osteotomies in the young active patient. Wolcott M, Traub S, and Efird C. Int Orthop. 2010 Feb; 34(2): 161–166.
High Tibial Osteotomy Lee DC and Byun SJ. Knee Surg Relat Res. 2012 Jun; 24(2): 61–69..
Release of the medial collateral ligament is mandatory in medial open-wedge high tibial osteotomy. Seitz AM, Nelitz M, Ignatius A, Dürselen L. Knee Surg Sports Traumatol Arthrosc. 2018 Sep 29. doi: 10.1007/s00167-018-5167-0. [Epub ahead of print].