The effect of osteotomy depth and hinge axis orientation on biplanar surgical accuracy in medial opening-wedge high tibial osteotomy-a deeper understanding by 3D simulations.

The study showed that the medio-lateral osteotomy length is the main parameter for obtaining bony accuracy in the coronal plane and maintaining a strict perpendicular axial hinge axis position is crucial in preserving the native tibial slope. Correct axial alignment of the hinge axis can be obtained by creating an equal osteotomy depth of the anterior and posterior tibial cortices in the lateral metaphyseal area.