High tibial osteotomy (HTO) has been used for many years to correct angular deformity about the knee, however, it’s use in the treatment of knee arthritis was not described in the English language literature until 1958 (Jackson 1958). This report presented at the Sheffield Regional Orthopaedic Club detailed Jackson’s experience of fourteen osteotomies ‘to correct a lateral deformity of the knee accompanied by osteoarthritis’. Six were supracondylar femoral osteotomies and eight were high tibial osteotomies, he concluded that range of motion was better after HTO and overall there was a ‘reasonable chance of relieving pain’. HTOs had however, been in use in France for many years before this (Hernigou 1987).