Lower extremity malalignment problem, associated focal cartilage problem in medial and lateral tibiofemoral joint and finally osteoarthritis is a common pathology. High tibial osteotomy (HTO) and Distal femoral varus osteotomy (DFVO) are more biological and physiological alternatives than unicompartmental or total knee arthroplasty and more popular methods with their high survival rates and successful clinical results especially in young patient group. Proximal femoral osteotomy is a new and promising method in the treatment of lower extremity malalignment since it is a minimal invasive method with regard to HTO and DFVO and lock of implant need in the surgery. But the results of this methods should be supported by the studies with bigger patient volume and longer follow up. As a consequence of the improvement in the regenerative medicine that has been used in the cartilage and meniscus problem, the correction of lower extremity alignment became more important entity since tissue saving surgeries more popular.