Open-wedge high tibial osteotomy: a technical trick to avoid loss of reduction of the opposite cortex

High tibial osteotomies for the treatment of gonarthrosis in young and active patients are well-accepted and frequently performed procedures. Several techniques are described to achieve good axial alignment with enough stability for early motion, but they come along with a considerable number of complications, such as insufficient or excessive axial correction, loss of reduction, delayed union, and pseudoarthrosis. We present a case of early loss of reduction in a medial opening-wedge high tibial osteotomy and a simple technical trick to avoid and treat this potential complication.