Is There a Role for High Tibial Osteotomies in the Athlete

Context:The use of high tibial osteotomies (HTOs) in elite and professional athletes has been slow to gain acceptance by both the athlete and the surgeon because it is generally thought that return to competitive sports will be unlikely. Conversely, HTOs have been used extensively and effectively in managing degenerative knee arthrosis in the less active recreational patient with varus deformity who wishes to maintain activity and delay the need for knee arthroplasty. Unfortunately, situations arise where elite athletes develop debilitating pain secondary to malalignment that prevents them from participation, at which time corrective osteotomy may be indicated. Return to sport is not necessarily the goal of osteotomy surgery, but success with correction may allow the athlete to return to high-level activity. Return to elite competition is not the singular goal of HTO in the athlete; however, if the surgery is successful, then consideration can be given to return to play.Evidence Acquisition:Despite an ext...