Osteotomy for painful arthritis of the medial or lateral part of the knee is a well-defined and generally accepted procedure that usually results in relief of pain. The operation is based on sound biomechanical principles, the goal being to alter the forces about the knee by unloading the painful and mechanically overloaded compartment. This principle has gained widespread application due to the success of the proximal tibial osteotomy. Reports of varus-producing distal femoral osteotomy have appeared in the literature increasingly over the last 20 years. We describe our experience with this procedure utilizing the lateral opening-wedge technique.