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The opening-wedge High Tibial Osteotomy is commonly used to relieve symptomatic medial knee compartment pain in the younger patient with a varus deformity. The opening wedge osteotomy avoids the issues associated with a closing wedge osteotomy but presents the challenge of filling the correction site with a suitable material. Allograft is now routinely used to fill the space created from correcting the mechanical axis.