Osteoarthritis (OA) is a degenerative disease of articular cartilage that affects millions of people [1]. Local biomechanical factors may severely affect the initiation and progression of OA due to changes in loading conditions at the knee cartilage. Body weight and the frontal plane tibiofemoral alignment are two biomechanical factors that could increase the overall loading at the knee. A normal knee will have a tibiofemoral angle approximately 7° valgus [2]. Deviation from this angle leads to a knee joint with a varus or valgus condition. The tibiofemoral angle is measured by the intersection made between the mechanical axis of the femur and the tibia in the frontal plane and affects the magnitude of the varus knee moment, Fig. 1A. Biomechanical studies have shown the varus moment is a key determinant in the load distribution at the knee [3, 4], Fig. 1A, and has been linked to OA progression [5, 6].

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