Biomechanics of high tibial osteotomy

Open-wedge high tibial osteotomy (OWHTO) is used for the treatment of unicompartmental (medial) osteoarthritis in varus knees, especially in young to middle-aged, active patients. The procedure represents a relevant alternative to unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA). Advantages of OWHTO include joint preservation (delay of TKA) and a higher functionality e.g., a higher range of motion postoperatively. However, HTO is more challenging and requires extensive planning. Due to limited resources and methods, the biomechanical effects of the different HTO variants are not comprehensively considered in the planning process.

Therefore, a workflow for easy and fast simulation of (OW)HTO biomechanical outcome could substantially support the planning process, and may help to find individualized targets for (OW)HTO cutting parameters. Together with our clinical partners (MUM-LMU, Munich), we perform simulation analyses of knee kinematics and loading after different OWHTO variants. With the simulation of the biomechanical outcome, the surgeon can be supported in decision-making during the planning of the deformity correction.