Review ArticlesThe Role of the High Tibial Osteotomy in the Unstable KneeRobert Giffin, J. MD, FRCS(C); Shannon, Fintan J. FRCS(Tr&Orth)Author Information Department of Surgery, London Health Science Centre, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada Reprints: J. Robert Giffin, MD FRCS(C), Fowler Kennedy Sport Medicine Clinic, 3M Centre, University of Western Ontario, London, Ontario, Canada N6A 3K7 (e-mail: firstname.lastname@example.org). Sports Medicine and Arthroscopy Review: March 2007 - Volume 15 - Issue 1 - p 23-31 doi: 10.1097/JSA.0b013e3180310a89 Buy Metrics Abstract High tibial osteotomy is an accepted treatment option for knee arthrosis in association with coronal malalignment. However, the effect of this procedure on the sagittal balance of the knee has until recently been largely ignored. Basic science research over the past several years and some small clinical series have introduced a “novel” concept whereby the sagittal balance of a ligament deficient knee can be restored to some degree by altering the posterior tibial slope. This review summarizes the available evidence supporting the role of selective high tibial osteotomy in the treatment of both the acute and chronic ligament deficient knee. © 2007 Lippincott Williams & Wilkins, Inc.