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This course, with help from members of the European Society of Sports Traumatology, Knee Surgery & Arthroscopy (ESSKA), will review knee malalignment with special focus on coronal plane and sagittal plane alignment. Indications for proximal tibia osteotomies and distal femur osteotomies will be discussed. The advantages and disadvantages of closing-wedge and opening-wedge osteotomies, will be examined in a case-based discussion with special attention to the tibial slope. Surgical technique for osteotomies will be presented in a case-based format.