Three-dimensional surgical planning and clinical evaluation of the efficacy of distal tibial tuberosity high tibial osteotomy in obese patients with varus knee osteoarthritis

•Distal tibial tuberosity high tibial osteotomy (DTT-HTO) can effectively correct varus deformity, and relieve symptoms.•DTT-HTO has a significant curative effect in obese patients with varus knee osteoarthritis.•A new patented π-shaped plate using DTT-HTO in obese patients with varus knee osteoarthritis is proposed.•The π-shaped plate can effectively prevent angle loss and internal fixation fractures due to its high levels of strength and stability.•Three-dimensional surgical planning using DTT-HTO helps us to accurate preoperative evaluation, optimize osteotomy and improve the successful rate.