High tibial osteotomy for unilateral medial knee osteoarthritis unloads the osteoarthritic area, gives pain relief, and may prevent later osteoarthritis if performed for the ideal indications. The risk of conversion of high tibial osteotomy to total knee arthroplasty is higher if osteoarthritis has advanced too far and for overweight persons, cigarette smokers, older patients, female patients, patients with a high level of comorbidity, and patients with under-correction of the varus malalignment.
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