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Radiographs were taken preoperatively, postoperatively, at 1, 3, 6, 12, 18, and 24\u00a0months after surgery. Radiographic examinations included a weight bearing long\u2010standing anteroposterior (AP) view of the whole lower extremity, as well as, the AP, lateral, and both oblique views of the knee. Bone healing was measured on the medial oblique view of the knee. The postoperative alignment correction and its maintenance were assessed using the three radiologic parameters of the weight\u2010bearing line (WBL) ratio, the hip\u2013knee\u2013ankle angle (HKAA), and the medial proximal tibial angle (MPTA) on the weight\u2010bearing long\u2010standing AP view of the lower extremity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty\u2010two consecutive patients underwent MOWHTO, but three patients failed to follow\u2010up for more than 24\u00a0months. A total of 49 patients were assessed in this study. The median opening gap height was 10.0\u00a0mm (IQR, 8.0\u201312.0; range, 7\u201320). On immediate post\u2010operative radiographs, the mean gap filling was 31.4\u2009\u00b1\u20093.6%. After 1, 3, 6, 12, 18, and 24\u00a0months, the mean gap filling rates increased to 38.7\u2009\u00b1\u20094.4%, 51.4\u2009\u00b1\u20096.6%, 66.5\u2009\u00b1\u20095.1%, 84.8\u2009\u00b1\u20097.0%, 92.4\u2009\u00b1\u20095.6%, and 97.8\u2009\u00b1\u20092.3%, respectively. Statistical differences were observed between all the follow\u2010up evaluations (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Statistical differences in the WBL ratio, HKAA, and MPTA were observed between preoperatively and 1\u00a0month after surgery (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). The mean PTSA increased significantly from preoperatively to postoperatively (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). However, no statistical differences were found between the post\u2010operative follow\u2010up radiographs performed for these four values.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>MOWHTO using a locking plate without bone graft achieved at least 90% bone healing and had no loss in correction at 2 years postoperatively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>III.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-021-06506-x","type":"journal-article","created":{"date-parts":[[2021,3,1]],"date-time":"2021-03-01T05:03:58Z","timestamp":1614575038000},"page":"993-1000","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Bone healing on serial plain radiographs occurs slowly but adequately after medial opening wedge high tibial osteotomy without bone graft"],"prefix":"10.1002","volume":"30","author":[{"given":"Sung Jae","family":"Kim","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Dongtan Sacred Heart Hospital, Hallym University College of Medicine 7 Keunjaebong\u2010gil 18450 Hwaseong Gyeonggi\u2010do Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lich Thi","family":"Nguyen","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Dongtan Sacred Heart Hospital, Hallym University College of Medicine 7 Keunjaebong\u2010gil 18450 Hwaseong Gyeonggi\u2010do Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young\u2010Jin","family":"Seo","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Dongtan Sacred Heart Hospital, Hallym University College of Medicine 7 Keunjaebong\u2010gil 18450 Hwaseong Gyeonggi\u2010do Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dawoon","family":"Jung","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Dongtan Sacred Heart Hospital, Hallym University College of Medicine 7 Keunjaebong\u2010gil 18450 Hwaseong Gyeonggi\u2010do Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young\u2010Soo","family":"Shin","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Department of Orthopaedic Surgery Chuncheon Sacred Heart Hospital Chuncheon Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeehyoung","family":"Kim","sequence":"additional","affiliation":[{"name":"<!--<label>3<\/label>--> Department of Orthopaedic Surgery Seoul Sacred Heart General Hospital Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae\u2010Young","family":"Choi","sequence":"additional","affiliation":[{"name":"<!--<label>4<\/label>--> School of Advanced Materials Science &amp; 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