A 35-year-old presents with a 12-degree varus deformity of the knee, medial compartment osteoarthritis, and preserved articular cartilage in the lateral compartment. The deformity apex is at the medial tibial plateau. The most appropriate surgical procedure is:

• A Total knee replacement
• B Unicompartmental medial knee replacement
• C Arthroscopic debridement and washout
• D High tibial osteotomy (opening wedge or closing wedge) to shift the mechanical axis to the lateral compartment ✓

Explanation

High tibial osteotomy (HTO) is the preferred intervention in young, active patients with varus knee, unicompartmental medial OA, and preserved lateral compartment — especially when the deformity apex is proximal to the joint. HTO corrects alignment (shifting weight-bearing axis to the lateral compartment) and delays arthroplasty by reducing medial overload. Unicompartmental replacement is preferred for older, lower-demand patients; TKR is reserved for pan-compartmental disease or failed HTO.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.