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High tibial osteotomy and distal femoral osteotomy are 2 popular techniques for the treatment of monocompartmental osteoarthritis of the knee joint in young patients. Injury to the popliteal neurovascular bundle is still considered to be the most severe complication during an osteotomy procedure even if the rate of occurrence is very low. Loss of correction and hardware failures are more frequent, but not as devastating. Patella baja and modification of tibial slope are associated with high tibial osteotomy. In contrast, complications most commonly associated with distal femoral osteotomy include nonunion and failure of the internal fixation. In general with evolution of techniques and fixation devices, complication rates seem to be reduced. A summary and literature review of complications associated with knee osteotomies will be discussed in this paper.