# Treating Extensive Spontaneous Osteonecrosis of the Tibia by the Medial Opening Wedge High Tibial Osteotomy Procedure: A Case Report

## TL;DR

A case report shows that a specific surgical procedure can effectively treat extensive tibial osteonecrosis, offering symptom relief and functional improvement.

## Contribution

This case report introduces the use of medial opening wedge high tibial osteotomy for extensive spontaneous tibial osteonecrosis.

## Key findings

- The patient experienced significant symptomatic relief after the procedure.
- Functional improvement was observed following the OWHTO surgery.
- The case supports the role of mechanical stress in disease progression.

## Abstract

Osteonecrosis of the tibia is less common than that of the femoral condyle, with no consensus on surgical indications. In this study, a medial opening wedge high tibial osteotomy (OWHTO) was performed to treat the very extensive osteonecrosis of the tibia. This case demonstrates significant symptomatic relief and functional improvement following OWHTO for spontaneous tibial plateau osteonecrosis. The findings support the hypothesis that changes in mechanical stress contribute to disease progression. The promising results of this case study highlight the need for further studies to confirm its efficacy in a larger patient cohort, sparking interest in the future of this field. This case report is complemented by a literature review, which provides insights into management based on the patient's clinical course.