Axial But Not Sagittal Hinge Axis Affects Posterior Tibial Slope in Medial Open‐Wedge High Tibial Osteotomy: A 3‐Dimensional Surgical Simulation Study

Hinge axis in the axial plane significantly affects PTS, but hinge axis in the sagittal plane has no effect on PTS. To maintain PTS, surgeons should make hinge axis at the true lateral position of the tibia in the axial plane. To intentionally alter PTS, an anterolateral axial hinge axis could be used to decrease PTS or a posterolateral axial hinge axis could be used to increase PTS. Opening wedge angle or gap ratio is also useful for intentional modification of PTS.