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Abstract We tried our best to conduct a recent useful study to help other surgeons and to become a corner stone of making well-informed decisions. ▪ In conclusions, our meta-analysis showed no difference in most of the clinical outcomes except the operation time. OWO increased the posterior slope angle and limb length, decreased the patellar height, and provided higher accuracy of correction. CWO led to higher incidence of opposite cortical fracture. ▪ OWO and CWO have their own advantages and disadvantages. The patellar height, posterior tibial slope, and potential complications should be considered before choosing between the two. Partial results with long-term follow-up were different from previous studies with medium-short-term follow-up. Studies comparing the outcomes of OWO and CWO with long-term follow-up are required. ▪ Finally it should be noticed that the orthopaedic surgeon should be qualified to utilize either techniques & the choice depends on the preoperative planning & method of fixation available which leads us to an important result is that the best approach is that the surgeon best knows. |