Clinical and radiological evidence of knee instability was used as criteria for elevation of medial tibial condyle in severe tibia vara. Restoration of tension to the exposed medial collateral ligament was used as a guide for the required amount of elevation. A second-stage proximal tibial osteotomy was performed later for correction of the remaining varus deformity. External fixators were used in all instances. Elevation of the medial tibial condyle is indicated in severe tibia vara with arrest of the medial tibial physis, in which more than a 10° difference exists between valgus and varus stress radiographs with the knee in extension as compared with an opposite normal knee.