Increased kinematic changes in ascending compared with descending biplanar cut in open wedge high tibial osteotomy-a multibody simulation.

Background: The ascending or descending extended biplanar tibial cut in open wedge high tibial osteotomy (owHTO) not only changes the lower limb anatomy in the coronal plane but also leads to different three-dimensional (3D) changes in the patellofemoral joint. This study aimed to perform a comprehensive analysis of the dynamic biomechanical changes in the knee joint using a multibody simulation model.

Methods: Thirteen 3D computer models derived from lower limb computer tomography scans were used for owHTO.