Introduction: Open wedge high tibial osteotomy (HTO) with navigation provides accurate axial alignment correction in frontal plane. But it can cause unintentional increase of the proximal tibial slope. This study is to figure out how to prevent it during navigation assisted open wedge HTO. Materials and Methods: 40 open wedge HTO using Aescula open wedge plate (B. Braun Aesculap, Korea) was performed using the Orthopilot navigation system (HTO version 1.3, B. Braun Aesculap, Tuttligen, German). Preop 3D CT were reconstructed from the patient of medial unicompartmental OA with varus deformity. And virtual open wedge HTO were simulated and calculate the amount of opening wedge to maintain posterior slope of proximal tibia after open wedge HTO. Group A consist of 20 cases inserted equal sized plate anteriorly and posteriorly. Group B consist of 20 cases that anterior plate is 67% size of posterior plate. Preoperative and postoperative full weight bearing teleoroentgenogram and the posterior slop of proximal tibia in lateral radiograph were compared.
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