High tibial osteotomy (HTO) is a procedure for treating medial compartment osteoarthritis (OA) of the varus deformed knee. Frontal and sagittal alignment after closed- and open-wedge HTO were compared radiologically in a matched-pair study. The mean intra-operative frontal plane correction (FT axis) was +7.5° for closed-wedge HTO and +8° for open-wedge HTO; it increased by +0.5° in closed-wedge HTO and decreased by −0.5° in open-wedge HTO at last follow-up. Post-operatively, tibial slope had decreased by −0.5° in closed-wedge HTO and increased significantly by +3° in open-wedge HTO. Both techniques effectively and safely corrected varus deformity. A high degree of stability of the frontal plane correction was noted, however a significant change in the tibial slope after open-wedge HTO was observed post-operatively. As no loss of correction was shown, it may be related to the surgical technique rather than to the implant used.
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