For patients with concomitant genu varum deformity and anterior cruciate ligament deficiency, there is constant adduction moment at knee joint during weight bearing leading to increased load over medial compartment. In this prospective cohort study we treated these patients by anatomical single bundle ACL reconstruction and medial open wedge high tibial osteotomy and evaluated their clinical and radiological outcomes. The mean follow up period was 25 months. The mean International Knee

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... tion Committee score improved from pre-oprerative 45 to post-operative 77. Range of motion was near normal in all cases. Lachman test and Pivot-shift test showed significant improvement post-operatively. The femorotibial mechanical axis was significantly corrected from 7.0° varus to 1.2° valgus and tibial posterior slope was not significantly changed. Thus to conclude although the procedure requires long learning curve, it decreases load on medial compartment, preserving articular cartilage and reduces adduction moment thereby lessening tension on the graft, both of which are important for future of these knees.