New developments in osteotomy techniques and methods of fixation have caused a renewed interest in closing wedge osteotomies of the tibia and femur in the treatment of gonarthrosis. The rationale, definition and techniques of closing wedge tibial and femoral osteotomies in the treatment of gonarthrosis are discussed. The principal indications include unicompartmental medial and much less so, varus knee gonarthrosis and unicompartmental lateral or valgus knee gonarthrosis with a well-maintained range of motion in patients who are physiologically young. Newer techniques have provided more rigid fixation and improved accuracy of correction.

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