Superficial Medial Collateral Ligament Reattachment During High Tibial Osteotomy: Regulate Tension, Preserve Stability!

High tibial osteotomy (HTO) is a commonly performed surgical procedure. Although it is well-known that the superficial medial collateral ligament (sMCL) should be released during HTO, there is still no agreement on performing its reattachment. Considering the function of the sMCL, after its release during HTO, increased medial joint instability may be expected. We present a technique for sMCL reattachment that prevents medial gapping development and maintains nearly native pressure on the medial compartment of the knee joint by matching the tension on the sMCL to the size of the osteotomy gap. This technique is suitable for any correction angle.