Abstract: Objective: Non-union is a well-known complication after high tibial osteotomy. Non-union may result in a loss of correction or failed implants. Methods: revision surgery of failed dome-shaped HTO with a re-corrective open wedge HTO has not been described to date. Here, the case of a 74-year-old woman with a varus angulated non-union (mechanical tibiofemoral angle of −28°C) after a dome-shaped osteotomy is presented. Results: revision surgery was performed with the tomoFix^TM plate. Conclusions: Even in elderly patients, the clinical result that is achieved without a total knee arthroplasty can be satisfactory.

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