Opening wedge high tibial osteotomy: a novel technique for harvesting autograft bone

High tibial osteotomy can provide 10 to 15 years of consistent pain relief and improved function for most patients with unicompartmental knee arthritis. However, some studies have reported less predictable results, with deteriorating survivorship after 10 years of follow-up. Therefore, it is paramount to carefully select patients and to understand that technical errors during surgery often lead to poor outcomes. It is well established that obese patients, as well as undercorrected osteotomies, often lead to early failure, with rapid degeneration of the arthritic compartment. Although many surgical techniques describing high tibial osteotomies have been previously published, most techniques share similar surgical principles. What differentiates our technique from others is the mode of harvesting local autograft bone to fill our osteotomy site. For several years, a specialized harvester has been used to obtain distal femoral cancellous bone. This technique is simple, efficient, reproducible, and safe. This article reviews the novel technique for opening wedge high tibial osteotomies.