Arthroscopy Techniques (Apr 2021)

A Right Angle Guide for Distal Tuberosity Osteotomy With Medial Open Wedge High Tibial Osteotomy for Varus Knee Osteoarthritis

  • Akira Sasaki, M.D.,
  • Takehiko Sugita, M.D.,
  • Nobuyuki Itaya, M.D.,
  • Toshimi Aizawa, M.D.,
  • Naohisa Miyatake, M.D.,
  • Seiya Miyamoto, M.D.,
  • Ikuo Maeda, M.D.,
  • Masayuki Kamimura, M.D.,
  • Atsushi Takahashi, M.D.,
  • Hideaki Nagamoto, M.D.

Journal volume & issue
Vol. 10, no. 4
pp. e1007 – e1016

Abstract

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Medial open wedge high tibial osteotomy (OWHTO) is usually performed with proximal tuberosity osteotomy or setting the osteotomy line proximal to the tuberosity. However, OWHTO can result in patellofemoral complications due to postoperative patella infera. A new OWHTO technique, biplanar osteotomy with a distal tuberosity osteotomy, was reported in 2004 to prevent postoperative patella infera. To ensure that the 2 osteotomy lines maintain perpendicular, we describe the OWHTO procedure with a distal tuberosity osteotomy technique using a TriS Medial HTO Plate System (Olympus Terumo Biomaterials Corp., Tokyo, Japan) and a right angle guide we developed. In this Technical Note, we describe the procedure and advantages, risks, and limitations, as well as the pearls and pitfalls based on our experience.