Material and Methods: This is a prospective study of patients who attended the Orthopaedics outpatient clinic in tertiary care hospital. The patients were evaluated by clinical examination and weight bearing radiographs. The patients who were found to have unicompartmental osteoarthritis with knee pain not relieved by conservative management and who satisfy the inclusion criteria were selected. During this period 21 patients were selected and were included in study.

Results: Major group of patients in our study belong to age group 46-50 years (62%). The mean age of patients in our study is 48.38 years, the mean time of union is 4.04 months. As far as complications are concerned there were 3 complications we encountered 1 among them was superficial infection 1 had lateral tibial condyle involvement due to higher correction angle 1 patient had under correction noted on post operative HKA axis scanogram. The average JOA Knee score preoperatively was 52.6 which improved postoperatively with average score of 82.9.average. Functional knee society score was 70.80 preoperatively which improved postoperatively to 90.57. VAS score preoperatively was 6.95 which reduced considerably to an average score of 2.09 postoperatively. We got excellent results in 18 patients (86%), good results in 2 patients (9.5%) and fair results in 1 patient (4.5%).

Conclusion: In our study medial opening wedge high tibial osteotomy with osteosynthesis is a physiologically better surgery in medial compartmental primary osteoarthritis knee in early stages. Early results are gratifying for Indian patients, who cannot afford the costlier surgery and implant and also are reluctant to change squatting habits & job profile. Though complications are there but they are avoidable & treatable.