Kim JS, Lee JI, Choi HG, et al. - This study was sought to distinguish if retro-tubercle opening-wedge high tibial osteotomy (RT-OWHTO) produces more favorable radiographic outcomes on patellofemoral joint alignment and clinical outcomes than supra-tubercle opening-wedge high tibial osteotomy (ST-OWHTO). Individuals who had undergone biplanar OWHTO were allocated to 1 of 2 groups (ST-OWHTO and RT-OWHTO) between January 2017 and July 2018. Researchers applied plain radiographs and computed tomography to examine patellofemoral alignment and other radiologic parameters representing osteotomy configurations. American Knee Society Score and Western Ontario and McMaster Universities Osteoarthritis Index were used to evaluate clinical outcomes. Researchers included a total of 50 knees that had undergone ST-OWHTO and 44 knees that had undergone RT-OWHTO. No difference was found in clinical outcome, although the RT-OWHTO technique maintains patellofemoral joint alignment. As per the findings, the RT-OWHTO has an elevated risk of tuberosity fracture, delayed union, and prominent tibial tuberosity. The data suggest that surgeons should consider these negative aspects of the technique and consider adjusting additional stabilization.