Changes in sagittal and axial plane alignment in medial opening wedge high tibial osteotomy: a prospective observational study

Three-Dimensional Hinge Axis Orientation Contributes to Simultaneous Alignment Correction in All Three Anatomical Planes in Opening-Wedge High Tibial Osteotomy

“…However, the accuracy of osteotomy procedures based on the 2D framework is poor, and osteotomy procedures based on 2D imaging introduce unintended corrections in anatomical reference planes other than the one targeted. 12 , 13 , 14 , 15 , 16 , 17 The reasons for this latter-side effect already have been addressed in previous studies. 18 , 19 , 20 , 21 , 22 , 23 It was demonstrated that when performing an osteotomy, the HA direction must be truly perpendicular to one of the anatomical reference planes in order to leave the alignment parameters in the other 2 anatomical reference planes unaltered.…”