Table 1.

Advantages and Disadvantages of Osteotomies in the Treatment of Valgus Malalignment

MCWPTO	LOWPTO	MCWDFO	LOWDFO
Advantages	Advantages	Advantages	Advantages
•Effect joint contact in flexion and extension •No bone grafting required •Bone-to-bone healing •Early weight bearing	•Lateral approach— access for concomitant procedures •Able to “fine-tune” correction	•Bone-to-bone healing •Early weight bearing •Maintain joint line obliquity	•Familiar surgical approach •Access to lateral knee for concomitant procedures •Able to “fine-tune” correction

Disadvantages	Disadvantages	Disadvantages	Disadvantages
•Separate approach needed for lateral compartment •Iatrogenic excessive joint line obliquity (>10°) •Can be difficult to “fine-tune” correction	•Risk of iatrogenic peroneal nerve injury •Fibular osteotomy may be required for larger corrections •Hardware irritation	•Minimal effect on joint contact in flexion •Can be difficult to “fine-tune” correction	•Minimal effect on joint contact in flexion •Hardware irritation

LOWDFO, lateral opening-wedge distal femur osteotomy; LOWPTO, lateral opening-wedge proximal tibia osteotomy; MCWDFO, medial closing-wedge distal femur osteotomy; MCWPTO, medial closing-wedge proximal tibia osteotomy.