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Opening wedge osteotomy. (A) A guide wire is placed from 3.5-4 cm below the medial joint line to about 1 cm below the lateral articular margin of the tibia. (B) Cortical osteotomy is performed with an oscillating saw inferior to the guide wire and an osteotome. (C) When the osteotomy is completed, the medial tibia is opened with a wedge.
