Open wedge high tibial osteotomy (OWHTO) is an established treatment option for treating medial compartmental knee osteoarthritis with varus deformity. Among several factors associated with postoperative outcomes, patient age is immensely decisive in reconstructive knee joint surgeries, including OWHTO and total knee arthroplasty. Surprisingly, the direct effect of age on OWHTO outcomes is poorly defined in current clinical practice. Recent research comparing clinical and radiologic outcomes according to age was introduced, and the influential predictor determining OWHTO outcomes was cartilage status rather than age. In the future, when deciding its suitability, OWHTO should absolutely be considered as an attractive treatment even in elderly patients without highly advanced cartilage degeneration; advanced age should not be identified as a risk factor but rather a potential indication for OWHTO. However, a large-scale long-term follow-up study is necessary to elucidate these findings.
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