Tibial Osteotomy
The practitioner might perform a valgus producing proximal tibial osteotomy in patients with symptomatic medial compartment osteoarthritis of the knee.

Rationale
Nine low-strength case series studies found nine out of 10 outcomes significantly improved from baseline. A cross-sectional time series regression analysis was used to predict the placebo effect on VAS pain for comparison to that of the treatment group. Compared to the predicted placebo effect on VAS pain, the proximal tibial osteotomy group reported decreased pain on the VAS.
 
Based on a lack of appropriate studies, distal femoral (varus producing) osteotomy was not evaluated.

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