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In patients with osteoarthritis of the knees, quadriceps muscle dysfunction is an early and common clinical feature and an important determinant of disability. In the current study, changes in quadriceps muscle strength and voluntary quadriceps muscle activation after high tibial osteotomies for primary osteoarthritis of the knee in 19 patients were investigated. Quadriceps muscle function was assessed during different degrees of isometric maximum voluntary contraction using a specially built chair. One year after surgery all patients had reexamination of their surgically treated and contralateral knees. Voluntary activation and maximum voluntary contraction values of the followup assessment were significantly lower in the surgically treated knees compared with the preoperative assessment. In the contralateral knees, there were no differences between preoperative and followup measurements. High tibial osteotomy is an extraarticular operative therapeutic approach to treatment of osteoarthritis of the knee that does not lead to improvement of quadriceps muscle function. Because there is evidence that quadriceps sensorimotor dysfunction is important not only for the disability in osteoarthritis of the knee, but also for progression of the disease, knee function may be worsened by high tibial osteotomy in some patients.