Editorial Commentary: Anterolateral Hinge Position Decreases the Slope in Opening-Wedge High Tibial Osteotomy: A Key Point in Treating an Anterior Cruciate Ligament–Deficient, Varus Knee

The orthopaedic surgeon who performs opening-wedge high tibial osteotomy (HTO) has to be aware of the behavior slope depending on variations in location hinge and inclination osteotomy. most important point is that changing both rotation axis cut affects slope. There a natural trend unintentionally increase when performing an HTO. However, increased been established as risk factor for primary recurrent anterior cruciate ligament (ACL) injuries, whereas slope-reducing osteotomies decrease translation protect ACL graft. To reduce HTO, it seems more practical internally rotate osteotomy, establishing anterolateral hinge, than change cut, given predictable technically easier perform internal during surgery. Trying achieve extension increases complexity Not every needs have hinge; fact, decreasing would disadvantage posterior ligament–deficient knee. ACL-deficient knee with varus malalignment, aiming using could considered preoperative planning.