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Based on current evidence, we do not recommend that POEs be incorporated into the clinical guidelines or advice for such carriers.PURPOSE High tibial osteotomy (HTO) is an effective treatment option in early osteoarthritis. However, preoperative planning and surgical execution can be challenging. Computer assisted three-dimensional (3D) planning and patient-specific instruments (PSI) might be helpful tools in achieving successful outcomes. Goal of this study was to assess the accuracy of HTO using PSI. METHODS All medial open wedge PSI-