The in vivo kinematics of the knee in 7 patients with moderate medial gonarthrosis was analyzed before and 6 months after high tibial osteotomy using roentgen stereophotogrammetric analysis. The inclination of the femorotibial helical axis of rotation did not change with knee flexion or after surgery. The femorotibial rotation increased after surgery. No consistent change in patellar position after surgery was found. Patella translated laterally as the knee was flexed with a maximum patellar translation of about 15 mm and rotated internally with a maximum patellar internal rotation of about 15 degrees. There was no significant change in patellar translation or rotation after surgery. There was a good concordance regarding the size of the tibial wedge removed during surgery, calculated from the Hip-Knee-Ankle radiographs and from the roentgen stereophotogrammetric measurements.
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