{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T23:46:41Z","timestamp":1792972001510,"version":"4.5.0"},"reference-count":76,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,2,8]],"date-time":"2022-02-08T00:00:00Z","timestamp":1644278400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,2,8]],"date-time":"2022-02-08T00:00:00Z","timestamp":1644278400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee Surg &amp; Relat Res"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Medial opening wedge high tibial osteotomy (MOWHTO) is a widely used surgical treatment option for medial compartmental osteoarthritis with varus deformity. It is important that proper lower limb alignment is achieved. However, there has been no consensus about an optimal alignment in MOWHTO. Most studies suggest that achieving valgus alignment is necessary, and recent studies support slight valgus mechanical alignment of less than 3\u00b0 of mechanical femorotibial angle. Overcorrection and undercorrection is not recommended for achieving good surgical outcomes. To prevent undercorrection and overcorrection in MOWHTO, the method of placing the weight-bearing line in the target range must be precise. There are several ways to place a weight-bearing line within the target range. While the most important factor for a successful MOWHTO is achieving an ideal mechanical axis correction, there are a few other factors to consider, including joint line obliquity, posterior tibial slope, ligament balancing, and patellar height. Several factors exist that lead to undercorrection and overcorrection. Preoperative amount of varus deformity, lateral hinge fracture, and fixation failure can result in undercorrection, while medial soft tissue laxity and the amount of correction angle and target point beyond hypomochlion can result in overcorrection. This study aimed to review the literature on optimal alignment in MOWHTO and report on the factors to be considered to prevent correction errors and how to achieve an optimal alignment.<\/jats:p>","DOI":"10.1186\/s43019-021-00130-2","type":"journal-article","created":{"date-parts":[[2022,2,8]],"date-time":"2022-02-08T05:03:44Z","timestamp":1644296624000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":86,"title":["How to achieve an optimal alignment in medial opening wedge high tibial osteotomy?"],"prefix":"10.1186","volume":"34","author":[{"given":"Byoung Youl","family":"Kang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Do Kyung","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyeon Soo","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6530-795X","authenticated-orcid":false,"given":"Joon Ho","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,2,8]]},"reference":[{"key":"130_CR1","first-page":"87","volume":"41","author":"R Jakob","year":"1992","unstructured":"Jakob R, Murphy S (1992) Tibial osteotomy for varus gonarthrosis: indication, planning, and operative technique. Instr Course Lect 41:87","journal-title":"Instr Course Lect"},{"key":"130_CR2","first-page":"555","volume":"64","author":"CC Prodromos","year":"2015","unstructured":"Prodromos CC, Amendola A, Jakob RP (2015) High tibial osteotomy: indications, techniques. Instr Course Lect 64:555\u2013565","journal-title":"Instr Course Lect"},{"issue":"3","key":"130_CR3","doi-asserted-by":"crossref","first-page":"45","DOI":"10.3810\/psm.2011.09.1920","volume":"39","author":"AH Gomoll","year":"2011","unstructured":"Gomoll AH (2011) High tibial osteotomy for the treatment of unicompartmental knee osteoarthritis: a review of the literature, indications, and technique. Phys Sportsmed 39(3):45\u201354","journal-title":"Phys Sportsmed"},{"issue":"4","key":"130_CR4","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1007\/s12178-014-9234-y","volume":"7","author":"DE Bonasia","year":"2014","unstructured":"Bonasia DE, Governale G, Spolaore S, Rossi R, Amendola A (2014) High tibial osteotomy. Curr Rev Musculoskelet Med 7(4):292\u2013301","journal-title":"Curr Rev Musculoskelet Med"},{"issue":"8","key":"130_CR5","doi-asserted-by":"crossref","first-page":"852","DOI":"10.1016\/j.arthro.2007.05.018","volume":"23","author":"JD Agneskirchner","year":"2007","unstructured":"Agneskirchner JD, Hurschler C, Wrann CD, Lobenhoffer P (2007) The effects of valgus medial opening wedge high tibial osteotomy on articular cartilage pressure of the knee: a biomechanical study. Arthroscopy 23(8):852\u2013861","journal-title":"Arthroscopy"},{"issue":"5","key":"130_CR6","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1177\/0363546508315471","volume":"36","author":"C Mina","year":"2008","unstructured":"Mina C, Garrett WE Jr, Pietrobon R, Glisson R, Higgins L (2008) High tibial osteotomy for unloading osteochondral defects in the medial compartment of the knee. Am J Sports Med 36(5):949\u2013955","journal-title":"Am J Sports Med"},{"issue":"10","key":"130_CR7","doi-asserted-by":"crossref","first-page":"1328","DOI":"10.1007\/s00167-009-1020-9","volume":"18","author":"S Hankemeier","year":"2010","unstructured":"Hankemeier S, Mommsen P, Krettek C, Jagodzinski M, Brand J, Meyer C et\u00a0al (2010) Accuracy of high tibial osteotomy: comparison between open-and closed-wedge technique. Knee Surg Sports Traumatol Arthrosc 18(10):1328\u20131333","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"03","key":"130_CR8","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1055\/s-0030-1248216","volume":"17","author":"A Amendola","year":"2004","unstructured":"Amendola A, Fowler P, Litchfield R, Kirkley S, Clatworthy M (2004) Opening wedge high tibial osteotomy using a novel technique-early results and complications. J Knee Surg 17(03):164\u2013169","journal-title":"J Knee Surg"},{"issue":"1","key":"130_CR9","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1177\/230949900901700112","volume":"17","author":"W Lo","year":"2009","unstructured":"Lo W, Cheung K, Yung S, Chiu K (2009) Arthroscopy-assisted computer navigation in high tibial osteotomy for varus knee deformity. J Orthop Surg 17(1):51\u201355","journal-title":"J Orthop Surg"},{"issue":"12","key":"130_CR10","doi-asserted-by":"crossref","first-page":"3704","DOI":"10.1007\/s00167-015-3682-9","volume":"24","author":"D-H Lee","year":"2016","unstructured":"Lee D-H, Park S-C, Park H-J, Han S-B (2016) Effect of soft tissue laxity of the knee joint on limb alignment correction in open-wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 24(12):3704\u20133712","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"10","key":"130_CR11","doi-asserted-by":"crossref","first-page":"2368","DOI":"10.1177\/0363546513498062","volume":"41","author":"BS Kyung","year":"2013","unstructured":"Kyung BS, Kim JG, Jang K-M, Chang M, Moon Y-W, Ahn JH et\u00a0al (2013) Are navigation systems accurate enough to predict the correction angle during high tibial osteotomy? Comparison of navigation systems with 3-dimensional computed tomography and standing radiographs. Am J Sports Med 41(10):2368\u20132374","journal-title":"Am J Sports Med"},{"issue":"4","key":"130_CR12","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1016\/j.arthro.2004.01.024","volume":"20","author":"CB Marti","year":"2004","unstructured":"Marti CB, Gautier E, Wachtl SW, Jakob RP (2004) Accuracy of frontal and sagittal plane correction in open-wedge high tibial osteotomy. Arthroscopy 20(4):366\u2013372","journal-title":"Arthroscopy"},{"issue":"3","key":"130_CR13","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1007\/s00402-010-1145-9","volume":"131","author":"F Gebhard","year":"2011","unstructured":"Gebhard F, Krettek C, H\u00fcfner T, Gr\u00fctzner PA, St\u00f6ckle U, Imhoff AB et\u00a0al (2011) Reliability of computer-assisted surgery as an intraoperative ruler in navigated high tibial osteotomy. Arch Orthop Trauma Surg 131(3):297\u2013302","journal-title":"Arch Orthop Trauma Surg"},{"issue":"2","key":"130_CR14","doi-asserted-by":"crossref","first-page":"73","DOI":"10.3109\/10929080500228837","volume":"10","author":"G Wang","year":"2005","unstructured":"Wang G, Zheng G, Keppler P, Gebhard F, Staubli A, Mueller U et\u00a0al (2005) Implementation, accuracy evaluation, and preliminary clinical trial of a CT-free navigation system for high tibial opening wedge osteotomy. Comput Aided Surg 10(2):73\u201386","journal-title":"Comput Aided Surg"},{"issue":"1","key":"130_CR15","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1097\/JSA.0b013e3180303592","volume":"15","author":"DA Parker","year":"2007","unstructured":"Parker DA, Viskontas DG (2007) Osteotomy for the early varus arthritic knee. Sports Med Arthrosc Rev 15(1):3\u201314","journal-title":"Sports Med Arthrosc Rev"},{"issue":"3","key":"130_CR16","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1016\/S0030-5898(20)30753-7","volume":"10","author":"Y Fujisawa","year":"1979","unstructured":"Fujisawa Y, Masuhara K, Shiomi S (1979) The effect of high tibial osteotomy on osteoarthritis of the knee. An arthroscopic study of 54 knee joints. Orthop Clin North Am 10(3):585\u2013608","journal-title":"Orthop Clin North Am"},{"issue":"7","key":"130_CR17","doi-asserted-by":"crossref","first-page":"1136","DOI":"10.2106\/00004623-198567070-00025","volume":"67","author":"MB Coventry","year":"1985","unstructured":"Coventry MB (1985) Upper tibial osteotomy for osteoarthritis. J Bone Joint Surg Am 67(7):1136\u20131140","journal-title":"J Bone Joint Surg Am"},{"issue":"2","key":"130_CR18","doi-asserted-by":"crossref","first-page":"196","DOI":"10.2106\/00004623-199302000-00006","volume":"75","author":"MB Coventry","year":"1993","unstructured":"Coventry MB, Ilstrup DM, Wallrichs SL (1993) Proximal tibial osteotomy. A critical long-term study of eighty-seven cases. J Bone Joint Surg Am 75(2):196\u2013201","journal-title":"J Bone Joint Surg Am"},{"issue":"3","key":"130_CR19","doi-asserted-by":"crossref","first-page":"332","DOI":"10.2106\/00004623-198769030-00005","volume":"69","author":"P Hernigou","year":"1987","unstructured":"Hernigou P, Medevielle D, Debeyre J, Goutallier D (1987) Proximal tibial osteotomy for osteoarthritis with varus deformity. A ten to thirteen-year follow-up study. J Bone Joint Surg Am 69(3):332\u2013354","journal-title":"J Bone Joint Surg Am"},{"issue":"2","key":"130_CR20","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1016\/j.knee.2017.12.006","volume":"25","author":"JLB Martay","year":"2018","unstructured":"Martay JLB, Palmer AJR, Bangerter NK, Clare S, Monk AP, Brown CP et\u00a0al (2018) A preliminary modeling investigation into the safe correction zone for high tibial osteotomy. Knee 25(2):286\u2013295","journal-title":"Knee"},{"key":"130_CR21","doi-asserted-by":"crossref","first-page":"105190","DOI":"10.1016\/j.clinbiomech.2020.105190","volume":"80","author":"S Kuriyama","year":"2020","unstructured":"Kuriyama S, Watanabe M, Nakamura S, Nishitani K, Tanaka Y, Sekiguchi K et\u00a0al (2020) Large medial proximal tibial angles cause excessively medial tibiofemoral contact forces and abnormal knee kinematics following open-wedge high tibial osteotomy. Clin Biomech 80:105190","journal-title":"Clin Biomech"},{"key":"130_CR22","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-021-06516-9","author":"HF Atkinson","year":"2021","unstructured":"Atkinson HF, Birmingham TB, Schulz JM, Primeau CA, Leitch KM, Pritchett SL et\u00a0al (2021) High tibial osteotomy to neutral alignment improves medial knee articular cartilage composition. Knee Surg Sports Traumatol Arthrosc. https:\/\/doi.org\/10.1007\/s00167-021-06516-9","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"2","key":"130_CR23","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1007\/s00132-003-0600-5","volume":"33","author":"RP Jakob","year":"2004","unstructured":"Jakob RP, Jacobi M (2004) Closing wedge osteotomy of the tibial head in treatment of single compartment arthrosis. Orthopade 33(2):143\u2013152","journal-title":"Orthopade"},{"issue":"1","key":"130_CR24","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1186\/s13018-019-1333-4","volume":"14","author":"MK Kim","year":"2019","unstructured":"Kim MK, Ko BS, Park JH (2019) The proper correction of the mechanical axis in high tibial osteotomy with concomitant cartilage procedures-a retrospective comparative study. J Orthop Surg Res 14(1):281","journal-title":"J Orthop Surg Res"},{"issue":"2","key":"130_CR25","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1007\/BF00393883","volume":"110","author":"S Odenbring","year":"1991","unstructured":"Odenbring S, Egund N, Hagstedt B, Larsson J, Lindstrand A, Toksvig-Larsen S (1991) Ten-year results of tibial osteotomy for medial gonarthrosis. Arch Orthop Trauma Surg 110(2):103\u2013108","journal-title":"Arch Orthop Trauma Surg"},{"issue":"10","key":"130_CR26","first-page":"e622","volume":"34","author":"HM El-Azab","year":"2011","unstructured":"El-Azab HM, Morgenstern M, Ahrens P, Schuster T, Imhoff AB, Lorenz SG (2011) Limb alignment after open-wedge high tibial osteotomy and its effect on the clinical outcome. Orthopedics 34(10):e622\u2013e628","journal-title":"Orthopedics"},{"issue":"7","key":"130_CR27","doi-asserted-by":"crossref","first-page":"874","DOI":"10.1007\/s00167-009-1000-0","volume":"18","author":"JA Sim","year":"2010","unstructured":"Sim JA, Kwak JH, Yang SH, Choi ES, Lee BK (2010) Effect of weight-bearing on the alignment after open wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 18(7):874\u2013878","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"2","key":"130_CR28","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.knee.2005.08.002","volume":"13","author":"GS Dowd","year":"2006","unstructured":"Dowd GS, Somayaji HS, Uthukuri M (2006) High tibial osteotomy for medial compartment osteoarthritis. Knee 13(2):87\u201392","journal-title":"Knee"},{"issue":"1","key":"130_CR29","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1016\/j.knee.2019.10.018","volume":"27","author":"Y Yin","year":"2020","unstructured":"Yin Y, Li S, Zhang R, Guo J, Hou Z, Zhang Y (2020) What is the relationship between the \u201cFujisawa point\u201d and postoperative knee valgus angle? A theoretical, computer-based study. Knee 27(1):183\u2013191","journal-title":"Knee"},{"issue":"11","key":"130_CR30","doi-asserted-by":"crossref","first-page":"2393","DOI":"10.1016\/j.arthro.2016.06.012","volume":"32","author":"S-I Bin","year":"2016","unstructured":"Bin S-I, Kim H-J, Ahn H-S, Rim DS, Lee D-H (2016) Changes in patellar height after opening wedge and closing wedge high tibial osteotomy: a meta-analysis. Arthroscopy 32(11):2393\u20132400","journal-title":"Arthroscopy"},{"issue":"6","key":"130_CR31","doi-asserted-by":"crossref","first-page":"1703","DOI":"10.1016\/j.arthro.2019.01.032","volume":"35","author":"S-S Lee","year":"2019","unstructured":"Lee S-S, So S-Y, Jung E-Y, Kim H-J, Lee BH, Wang JH (2019) Predictive factors for patellofemoral degenerative progression after opening-wedge high tibial osteotomy. Arthroscopy 35(6):1703\u20131710","journal-title":"Arthroscopy"},{"issue":"2","key":"130_CR32","doi-asserted-by":"crossref","first-page":"89","DOI":"10.5792\/ksrr.2016.28.2.89","volume":"28","author":"SJ Song","year":"2016","unstructured":"Song SJ, Bae DK, Kim KI, Lee CH (2016) Conversion total knee arthroplasty after failed high tibial osteotomy. Knee Surg Relat Res 28(2):89","journal-title":"Knee Surg Relat Res"},{"key":"130_CR33","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1097\/00003086-198909000-00035","volume":"246","author":"A Miniaci","year":"1989","unstructured":"Miniaci A, Ballmer F, Ballmer P, Jakob R (1989) Proximal tibial osteotomy. A new fixation device. Clin Orthop Relat Res 246:250\u2013259","journal-title":"Clin Orthop Relat Res"},{"issue":"3","key":"130_CR34","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1007\/s00167-013-2700-z","volume":"23","author":"YS Lee","year":"2015","unstructured":"Lee YS, Kim MG, Byun HW, Kim SB, Kim JG (2015) Reliability of the imaging software in the preoperative planning of the open-wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 23(3):846\u2013851","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"7","key":"130_CR35","doi-asserted-by":"crossref","first-page":"2041","DOI":"10.1007\/s00167-014-2920-x","volume":"23","author":"D Elson","year":"2015","unstructured":"Elson D, Petheram T, Dawson M (2015) High reliability in digital planning of medial opening wedge high tibial osteotomy, using Miniaci\u2019s method. Knee Surg Sports Traumatol Arthrosc 23(7):2041\u20132048","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"130_CR36","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1097\/00003086-199201000-00025","volume":"274","author":"TW Dugdale","year":"1992","unstructured":"Dugdale TW, Noyes FR, Styer D (1992) Preoperative planning for high tibial osteotomy. The effect of lateral tibiofemoral separation and tibiofemoral length. Clin Orthop Relat Res 274:248\u2013264","journal-title":"Clin Orthop Relat Res"},{"issue":"11","key":"130_CR37","doi-asserted-by":"crossref","first-page":"3410","DOI":"10.1007\/s00167-016-3983-7","volume":"24","author":"S Schr\u00f6ter","year":"2016","unstructured":"Schr\u00f6ter S, Ihle C, Elson D, D\u00f6bele S, St\u00f6ckle U, Ateschrang A (2016) Surgical accuracy in high tibial osteotomy: coronal equivalence of computer navigation and gap measurement. Knee Surg Sports Traumatol Arthrosc 24(11):3410\u20133417","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"1","key":"130_CR38","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1016\/j.knee.2017.11.007","volume":"25","author":"J Blackburn","year":"2018","unstructured":"Blackburn J, Ansari A, Porteous A, Murray J (2018) Reliability of two techniques and training level of the observer in measuring the correction angle when planning a high tibial osteotomy. Knee 25(1):130\u2013134","journal-title":"Knee"},{"issue":"2","key":"130_CR39","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1016\/j.knee.2012.09.003","volume":"21","author":"DH Lee","year":"2014","unstructured":"Lee DH, Han SB, Oh KJ, Lee JS, Kwon JH, Kim JI et\u00a0al (2014) The weight-bearing scanogram technique provides better coronal limb alignment than the navigation technique in open high tibial osteotomy. Knee 21(2):451\u2013455","journal-title":"Knee"},{"key":"130_CR40","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/9246529","author":"JC-S Yang","year":"2018","unstructured":"Yang JC-S, Chen C-F, Luo C-A, Chang M-C, Lee OK, Huang Y et\u00a0al (2018) Clinical experience using a 3D-printed patient-specific instrument for medial opening wedge high tibial osteotomy. BioMed Res Int. https:\/\/doi.org\/10.1155\/2018\/9246529","journal-title":"BioMed Res Int"},{"issue":"8","key":"130_CR41","doi-asserted-by":"crossref","first-page":"S231","DOI":"10.1016\/j.otsr.2020.08.009","volume":"106","author":"N Tardy","year":"2020","unstructured":"Tardy N, Steltzlen C, Bouguennec N, Cartier J-L, Mertl P, Batailler C et\u00a0al (2020) Is patient-specific instrumentation more precise than conventional techniques and navigation in achieving planned correction in high tibial osteotomy? Orthop Traumatol Surg Res 106(8):S231\u2013S236","journal-title":"Orthop Traumatol Surg Res"},{"issue":"4","key":"130_CR42","doi-asserted-by":"crossref","first-page":"283","DOI":"10.5792\/ksrr.16.052","volume":"28","author":"S-D Yoon","year":"2016","unstructured":"Yoon S-D, Zhang G, Kim H-J, Lee B-J, Kyung H-S (2016) Comparison of cable method and miniaci method using picture archiving and communication system in preoperative planning for open wedge high tibial osteotomy. Knee Surg Relat Res 28(4):283","journal-title":"Knee Surg Relat Res"},{"issue":"3","key":"130_CR43","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1007\/s00167-015-3954-4","volume":"25","author":"J Moore","year":"2017","unstructured":"Moore J, Mychaltchouk L, Lavoie F (2017) Applicability of a modified angular correction measurement method for open-wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 25(3):846\u2013852","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"8","key":"130_CR44","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1007\/s00402-017-2729-4","volume":"137","author":"MS Kim","year":"2017","unstructured":"Kim MS, Son JM, Koh IJ, Bahk JH, In Y (2017) Intraoperative adjustment of alignment under valgus stress reduces outliers in patients undergoing medial opening-wedge high tibial osteotomy. Arch Orthop Trauma Surg 137(8):1035\u20131045","journal-title":"Arch Orthop Trauma Surg"},{"issue":"1","key":"130_CR45","doi-asserted-by":"crossref","first-page":"16","DOI":"10.5792\/ksrr.2016.28.1.16","volume":"28","author":"HJ Kim","year":"2016","unstructured":"Kim HJ, Yoon JR, Choi GW, Yang JH (2016) Imageless navigation versus conventional open wedge high tibial osteotomy: a meta-analysis of comparative studies. Knee Surg Relat Res 28(1):16\u201326","journal-title":"Knee Surg Relat Res"},{"issue":"11","key":"130_CR46","doi-asserted-by":"crossref","first-page":"3529","DOI":"10.1007\/s00167-016-4327-3","volume":"24","author":"J Yan","year":"2016","unstructured":"Yan J, Musahl V, Kay J, Khan M, Simunovic N, Ayeni OR (2016) Outcome reporting following navigated high tibial osteotomy of the knee: a systematic review. Knee Surg Sports Traumatol Arthrosc 24(11):3529\u20133555","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"2","key":"130_CR47","doi-asserted-by":"crossref","first-page":"81","DOI":"10.5792\/ksrr.17.090","volume":"31","author":"KW Nha","year":"2019","unstructured":"Nha KW, Shin YS, Kwon HM, Sim JA, Na YG (2019) Navigated versus conventional technique in high tibial osteotomy: a meta-analysis focusing on weight bearing effect. Knee Surg Relat Res 31(2):81\u2013102","journal-title":"Knee Surg Relat Res"},{"issue":"2","key":"130_CR48","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1097\/JSA.0b013e318172b547","volume":"16","author":"E-K Song","year":"2008","unstructured":"Song E-K, Seon J-K, Park S-J, Seo H-Y (2008) Navigated open wedge high tibial osteotomy. Sports Med Arthrosc Rev 16(2):84\u201390","journal-title":"Sports Med Arthrosc Rev"},{"issue":"8","key":"130_CR49","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1007\/s00132-009-1458-y","volume":"38","author":"S Hofmann","year":"2009","unstructured":"Hofmann S, Lobenhoffer P, Staubli A, Van RH (2009) Osteotomies of the knee joint in patients with monocompartmental arthritis. Der Orthopade. 38(8):755\u2013769","journal-title":"Der Orthopade."},{"issue":"1","key":"130_CR50","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.arthro.2008.08.015","volume":"25","author":"R Takeuchi","year":"2009","unstructured":"Takeuchi R, Ishikawa H, Aratake M, Bito H, Saito I, Kumagai K et\u00a0al (2009) Medial opening wedge high tibial osteotomy with early full weight bearing. Arthroscopy 25(1):46\u201353","journal-title":"Arthroscopy"},{"issue":"6","key":"130_CR51","doi-asserted-by":"crossref","first-page":"1873","DOI":"10.1007\/s00167-017-4680-x","volume":"26","author":"H Nakayama","year":"2018","unstructured":"Nakayama H, Schr\u00f6ter S, Yamamoto C, Iseki T, Kanto R, Kurosaka K et\u00a0al (2018) Large correction in opening wedge high tibial osteotomy with resultant joint-line obliquity induces excessive shear stress on the articular cartilage. Knee Surg Sports Traumatol Arthrosc 26(6):1873\u20131878","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"12","key":"130_CR52","doi-asserted-by":"crossref","first-page":"3028","DOI":"10.1177\/0363546520949552","volume":"48","author":"J-H Song","year":"2020","unstructured":"Song J-H, Bin S-I, Kim J-M, Lee B-S (2020) What is an acceptable limit of joint-line obliquity after medial open wedge high tibial osteotomy? Analysis based on midterm results. Am J Sports Med 48(12):3028\u20133035","journal-title":"Am J Sports Med"},{"issue":"08","key":"130_CR53","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1055\/s-0036-1571430","volume":"29","author":"K-J Oh","year":"2016","unstructured":"Oh K-J, Ko YB, Bae JH, Yoon ST, Kim JG (2016) Analysis of knee joint line obliquity after high tibial osteotomy. J Knee Surg 29(08):649\u2013657","journal-title":"J Knee Surg"},{"issue":"2","key":"130_CR54","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1177\/0363546509348050","volume":"38","author":"H El-Azab","year":"2010","unstructured":"El-Azab H, Glabgly P, Paul J, Imhoff AB, Hinterwimmer S (2010) Patellar height and posterior tibial slope after open-and closed-wedge high tibial osteotomy: a radiological study on 100 patients. Am J Sports Med 38(2):323\u2013329","journal-title":"Am J Sports Med"},{"issue":"11","key":"130_CR55","doi-asserted-by":"crossref","first-page":"3006","DOI":"10.1177\/0363546515626172","volume":"44","author":"K-W Nha","year":"2016","unstructured":"Nha K-W, Kim H-J, Ahn H-S, Lee D-H (2016) Change in posterior tibial slope after open-wedge and closed-wedge high tibial osteotomy: a meta-analysis. Am J Sports Med 44(11):3006\u20133013","journal-title":"Am J Sports Med"},{"issue":"2","key":"130_CR56","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1177\/0363546503258880","volume":"32","author":"JR Giffin","year":"2004","unstructured":"Giffin JR, Vogrin TM, Zantop T, Woo SL, Harner CD (2004) Effects of increasing tibial slope on the biomechanics of the knee. Am J Sports Med 32(2):376\u2013382","journal-title":"Am J Sports Med"},{"issue":"10","key":"130_CR57","first-page":"S127","volume":"30","author":"E-K Song","year":"2007","unstructured":"Song E-K, Seon J-K, Park S-J (2007) How to avoid unintended increase of posterior slope in navigation-assisted open-wedge high tibial osteotomy. Orthopedics 30(10):S127","journal-title":"Orthopedics"},{"issue":"12","key":"130_CR58","doi-asserted-by":"crossref","first-page":"2411","DOI":"10.1177\/0363546509341174","volume":"37","author":"JH Wang","year":"2009","unstructured":"Wang JH, Bae JH, Lim HC, Shon WY, Kim CW, Cho JW (2009) Medial open wedge high tibial osteotomy: the effect of the cortical hinge on posterior tibial slope. Am J Sports Med 37(12):2411\u20132418","journal-title":"Am J Sports Med"},{"issue":"8","key":"130_CR59","doi-asserted-by":"crossref","first-page":"978","DOI":"10.1007\/s00167-007-0305-0","volume":"15","author":"R Gaasbeek","year":"2007","unstructured":"Gaasbeek R, Welsing R, Barink M, Verdonschot N, van Kampen A (2007) The influence of open and closed high tibial osteotomy on dynamic patellar tracking: a biomechanical study. Knee Surg Sports Traumatol Arthrosc 15(8):978\u2013984","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"9","key":"130_CR60","doi-asserted-by":"crossref","first-page":"1094","DOI":"10.1007\/s00167-007-0297-9","volume":"15","author":"K Stoffel","year":"2007","unstructured":"Stoffel K, Willers C, Korshid O, Kuster M (2007) Patellofemoral contact pressure following high tibial osteotomy: a cadaveric study. Knee Surg Sports Traumatol Arthrosc 15(9):1094\u20131100","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"4","key":"130_CR61","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1016\/j.arthro.2016.09.034","volume":"33","author":"K-I Kim","year":"2017","unstructured":"Kim K-I, Kim D-K, Song S-J, Lee S-H, Bae D-K (2017) Medial open-wedge high tibial osteotomy may adversely affect the patellofemoral joint. Arthroscopy 33(4):811\u2013816","journal-title":"Arthroscopy"},{"issue":"6","key":"130_CR62","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1016\/j.knee.2004.02.002","volume":"11","author":"R Gaasbeek","year":"2004","unstructured":"Gaasbeek R, Sonneveld H, Van Heerwaarden R, Jacobs W, Wymenga A (2004) Distal tuberosity osteotomy in open wedge high tibial osteotomy can prevent patella infera: a new technique. Knee 11(6):457\u2013461","journal-title":"Knee"},{"issue":"6","key":"130_CR63","doi-asserted-by":"crossref","first-page":"1750","DOI":"10.1007\/s00167-019-05596-y","volume":"28","author":"T Horikawa","year":"2020","unstructured":"Horikawa T, Kubota K, Hara S, Akasaki Y (2020) Distal tuberosity osteotomy in open-wedge high tibial osteotomy does not exacerbate patellofemoral osteoarthritis on arthroscopic evaluation. Knee Surg Sports Traumatol Arthrosc 28(6):1750\u20131756","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"2","key":"130_CR64","doi-asserted-by":"crossref","first-page":"230949901984666","DOI":"10.1177\/2309499019846660","volume":"27","author":"S Kamada","year":"2019","unstructured":"Kamada S, Shiota E, Saeki K, Kiyama T, Maeyama A, Yamamoto T (2019) Severe varus knees result in a high rate of undercorrection of lower limb alignment after opening wedge high tibial osteotomy. J Orthop Surg (Hong Kong) 27(2):2309499019846660","journal-title":"J Orthop Surg (Hong Kong)"},{"issue":"12","key":"130_CR65","doi-asserted-by":"crossref","first-page":"2377","DOI":"10.1007\/s00264-013-2066-3","volume":"37","author":"P Hernigou","year":"2013","unstructured":"Hernigou P, Queinnec S, Picard L, Guissou I, Naanaa T, Duffiet P et\u00a0al (2013) Safety of a novel high tibial osteotomy locked plate fixation for immediate full weight-bearing: a case-control study. Int Orthop 37(12):2377\u20132384","journal-title":"Int Orthop"},{"issue":"6","key":"130_CR66","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1016\/j.arthro.2008.12.020","volume":"25","author":"BS Miller","year":"2009","unstructured":"Miller BS, Downie B, McDonough EB, Wojtys EM (2009) Complications after medial opening wedge high tibial osteotomy. Arthroscopy 25(6):639\u2013646","journal-title":"Arthroscopy"},{"issue":"4","key":"130_CR67","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1016\/j.knee.2008.04.004","volume":"15","author":"C Kaz\u0131mo\u011flu","year":"2008","unstructured":"Kaz\u0131mo\u011flu C, Akdo\u011fan Y, \u015eener M, Kurtulmu\u015f A, Karap\u0131nar H, Uzun B (2008) Which is the best fixation method for lateral cortex disruption in the medial open wedge high tibial osteotomy? A biomechanical study. Knee 15(4):305\u2013308","journal-title":"Knee"},{"issue":"11","key":"130_CR68","doi-asserted-by":"crossref","first-page":"3073","DOI":"10.1016\/j.arthro.2018.06.041","volume":"34","author":"S-S Lee","year":"2018","unstructured":"Lee S-S, Celik H, Lee D-H (2018) Predictive factors for and detection of lateral hinge fractures following open wedge high tibial osteotomy: plain radiography versus computed tomography. Arthroscopy 34(11):3073\u20133079","journal-title":"Arthroscopy"},{"issue":"10","key":"130_CR69","doi-asserted-by":"crossref","first-page":"1313","DOI":"10.1302\/0301-620X.99B10.BJJ-2017-0103.R1","volume":"99","author":"R Nakamura","year":"2017","unstructured":"Nakamura R, Komatsu N, Fujita K, Kuroda K, Takahashi M, Omi R et\u00a0al (2017) Appropriate hinge position for prevention of unstable lateral hinge fracture in open wedge high tibial osteotomy. Bone Joint J 99(10):1313\u20131318","journal-title":"Bone Joint J"},{"issue":"1","key":"130_CR70","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1007\/s00167-011-1706-7","volume":"21","author":"SB Han","year":"2013","unstructured":"Han SB, Lee DH, Shetty GM, Chae DJ, Song JG, Nha KW (2013) A \u201csafe zone\u201d in medial open-wedge high tibia osteotomy to prevent lateral cortex fracture. Knee Surg Sports Traumatol Arthrosc 21(1):90\u201395","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"130_CR71","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-019-05555-7","author":"S-Y So","year":"2019","unstructured":"So S-Y, Lee S-S, Jung EY, Kim JH, Wang JH (2019) Difference in joint line convergence angle between the supine and standing positions is the most important predictive factor of coronal correction error after medial opening wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc. https:\/\/doi.org\/10.1007\/s00167-019-05555-7","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"10","key":"130_CR72","doi-asserted-by":"crossref","first-page":"1337","DOI":"10.1007\/s00402-016-2521-x","volume":"136","author":"H Ogawa","year":"2016","unstructured":"Ogawa H, Matsumoto K, Ogawa T, Takeuchi K, Akiyama H (2016) Preoperative varus laxity correlates with overcorrection in medial opening wedge high tibial osteotomy. Arch Orthop Trauma Surg 136(10):1337\u20131342","journal-title":"Arch Orthop Trauma Surg"},{"issue":"2","key":"130_CR73","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1007\/s00167-005-0649-2","volume":"14","author":"D Pape","year":"2006","unstructured":"Pape D, Duchow J, Rupp S, Seil R, Kohn D (2006) Partial release of the superficial medial collateral ligament for open-wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 14(2):141\u2013148","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"5","key":"130_CR74","doi-asserted-by":"crossref","first-page":"1411","DOI":"10.1007\/s00167-019-05502-6","volume":"28","author":"DK Lee","year":"2020","unstructured":"Lee DK, Wang JH, Won Y, Min YK, Jaiswal S, Lee BH et\u00a0al (2020) Preoperative latent medial laxity and correction angle are crucial factors for overcorrection in medial open-wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 28(5):1411\u20131418","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"10","key":"130_CR75","first-page":"232596712110341","volume":"9","author":"DJ Ryu","year":"2021","unstructured":"Ryu DJ, Lee S-S, Jung EY, Kim JH, Shin TS, Wang JH (2021) Reliability of preoperative planning method that considers latent medial joint laxity in medial open-wedge proximal tibial osteotomy. Orthop J Sports Med 9(10):232596712110341","journal-title":"Orthop J Sports Med"},{"key":"130_CR76","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.98B5.33394","author":"E Heijens","year":"2016","unstructured":"Heijens E, Kornherr P, Meister C (2016) The coronal hypomochlion: a tipping point of clinical relevance when planning valgus producing high tibial osteotomies. Bone Joint J. https:\/\/doi.org\/10.1302\/0301-620X.98B5.33394","journal-title":"Bone Joint J."}],"container-title":["Knee Surgery &amp; Related Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s43019-021-00130-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s43019-021-00130-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s43019-021-00130-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,26]],"date-time":"2023-01-26T02:21:27Z","timestamp":1674699687000},"score":1,"resource":{"primary":{"URL":"https:\/\/kneesurgrelatres.biomedcentral.com\/articles\/10.1186\/s43019-021-00130-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,8]]},"references-count":76,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,12]]}},"alternative-id":["130"],"URL":"https:\/\/doi.org\/10.1186\/s43019-021-00130-2","relation":{},"ISSN":["2234-2451"],"issn-type":[{"value":"2234-2451","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,8]]},"assertion":[{"value":"15 June 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 December 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 February 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"3"}}