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The treatment of combined knee pathology is a challenging problem that requires careful attention to all aspects of the underlying disease. This is true of the interplay among malalignment and meniscal or articular cartilage restoration in the knee. Optimal outcomes are contingent on a comprehensive preoperative evaluation of patient-specific factors (patient expectations, patient age, and activity level), as well as disease-specific factors of the knee. Surgical intervention for meniscal or chondral deficiencies without attention to malalignment will lead to inferior outcomes. The focus of this review is to highlight the importance of malalignment correction when treating meniscal and articular cartilage pathology. This objective will be accomplished by outlining the approach to the preoperative evaluation, discussing the indications for surgical intervention, reviewing the preferred surgical techniques for correcting coronal malalignment of the knee, and providing a discussion of clinical outcomes.