After determining the angle of correction preoperatively, the medial exposure of the tibia is established and the anterior, medial, and posterior soft tissues are safely elevated. The tibial osteotomy then begins by placing the Arthrex® HTO Cutting Guide on the medial tibia and drilling two 2.4 mm guide pins to within approximately 1 cm of the lateral cortex under fluoroscopy control. The surgeon may also choose to use the Arthrex Biplanar Alignment Guide to set the height and align the osteotomy with the patient's native tibial slope. Once the desired Arthrex Cutting Guide and retractors are in place, the osteotomy is completed utilizing an osteotome or specific saw blade. The osteotomy is then opened to the desired amount of correction via the Arthrex iBalance® HTO Opening Jack, Osteotome Jack or Osteotomy Wedge.

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