Last updated: 02/17/2009

Varus malalignment correction with osteotomy through the high tibia (HTO) is a proven and satisfactory operation. Success rates are high when the patient has a small angle deformity (<10°). Knees with more severe deformity have less satisfactory results....

Tibial osteotomy for the less common valgus deformity is less satisfactory. Research indicates that only a few individuals are able to return to their previous level of high sports activity after a knee osteotomy, whether done with an ACL repair or not. However, more than half of patients in one study were able to return to leisure sports activities. Reports also indicate that those individuals who had osteotomy without ACL reconstruction had no differences in results with respect to measures of stability. It may take up to a year for the knee to be fully aligned and adapted to its new position after surgery. Most patients, more than 50%, gain stability and are able to walk further than they could walk before osteotomy. However, according to one report, 13% of patients had severe pain or needed a total knee replacement after five years. In one European review, the results were better. Osteoarthritis was arrested in 105 cases (69%), with 47 cases showing deterioration. The main factors associated with further deterioration were insufficient correction and persistence of malalignment.