Tibial osteotomy in the management of osteoarthritis of the knee.

The historical development of operations for osteoarthritis of the knee is reviewed with emphasis on an upper tibial osteotomy, which was first described by the author and his colleague, Jackson, in 1961. Although the operation was used indiscriminately to correct both valgus and varus deformities in the early years, medial compartment osteoarthritis is now the main indication. The significance of angular deformity in relation to load-bearing across the joint is discussed. In the operative procedure, it is important to achieve a few degrees of overcorrection. Tibial osteotomy is a satisfactory procedure for the young patient with medial compartment osteoarthritis, particularly before the stage of bony collapse or subluxation.