<p>Objective: To analyze the application value of open wedge high tibial osteotomy. Methods: From January 2022 to January 2023, 60 patients with varus knee osteoarthritis with medial meniscus protrusion were selected and randomly divided into observation group (30 cases) and control group (30 cases). The control group received total knee arthroplasty, and the observation group received open wedge high tibial osteotomy. The difference in surgical outcome between the two groups was compared, and the changes of VAS score and HSS score before and after surgery were compared between the two groups. Results: ①The intraoperative blood loss and postoperative complication rate in the observation group were lower than those in the control group (P<0.05), and the operation time and hospital stay were shorter than those in the control group (P<0.05). ②The change range of VAS score and HSS score in the observation group before and after operation was higher than that in the control group (P<0.05). Conclusion: Both open wedge high tibial osteotomy and total knee arthroplasty have good therapeutic effect. However, open wedge-shaped high tibial osteotomy has less blood loss, faster recovery, and can improve the pain and joint function of patients, so it can be widely used.</p>