Surgical procedures
patellar
In the pre-operative phase, the desired correction angle and wedge size were measured and calculated from standing radiographs. Under endotracheal tube intubation general anaesthesia, the participant was placed in the supine position on a radiolucent operating table with a tourniquet applied. A medial longitudinal skin incision was made just distal to the joint line. After the pes anserinus was detached from the tibia, the superficial medial collateral ligament was exposed. The patellar tendon was protected by anterior retraction. Medial opening wedge osteotomy was carried out with a custom-made cutting jig. After temporary fixation of the cutting jig with multiple Kirschner-pins, the sawing was performed. The open wedge was subsequently filled with bone allograft, and a proximal medial tibia locking plate (APlus™) was used to fix the osteotomy.