Fig 10.

Left knee pin placement for the anterior closing wedge proximal tibial osteotomy with the patient in the supine position. Four pins (white arrows) are placed around the patellar tendon (black arrow) to delineate the cutting plane for the closing-wedge osteotomy. The superior and inferior pins should meet at the posterior aspect of the tibia to achieve a proper wedge. The cuts medially and laterally should be measured out and marked with a bovie. An anterior cruciate ligament saw blade is used to cut the cortical portion of the wedge and a combination of a rongeur, and curette are used to remove the deeper cancellous bone.