History: 41-yr-old man was suffering from immense pain in his left knee and standing scanogram showed a varus malalignment whereas MRI showed a medial meniscus tear.
Case: A plain arthroscopic meniscectomy would not have relieved his symptoms. Normal mechanical axis is the line from the center of head passing through the lateral tibial spine in the knee and comes to lie in the center of the ankle. Look at the preoperation scanogram, the line is way outside the ankle. An open wedge osteotomy was done along with arthroscopic meniscectomy and the alignment of the limb was restored. Look at the mechanical axis from center of femoral head to center of knee and center of ankle. Open Wedge High Tibial Osteotomy is a forgotten art but it is reviving again now with better implants so that patient can bear weight early. Knee movements have started for this patient and weight-bearing will commence in 3 weeks.