Proximal tibial osteotomy

The indications for proximal tibial osteotomy are disabling osteoarthritis that must be mostly unicompartmental, minimal bone loss, and good stability. In the 60s we saw the development of osteotomy and in the 70s we saw the development of total knee replacement. These days we're seeing the two operations being put in proper perspective. At the moment we do about 100 upper tibial osteotomies a year and close to 800 knee replacements, either unicompartmental or bicompartmental. We have had 30 years of experience with proximal tibial osteotomy, and we know it relieves pain while preserving bone stock and not involving any intra-articular foreign bodies. Only time and long-term follow-up will tell us whether our 1 to 8 ratio should change in the future.