Meniscal root tears significantly impact knee biomechanics, producing effects similar to a total meniscectomy. The loss of hoop stress distribution leads to a reduction in tibiofemoral contact area and an increase in contact pressure, accelerating cartilage degeneration and the onset of early arthritis. Individuals with varus-aligned lower limbs experience even more pronounced biomechanical alterations, which elevate the risk of arthritis progression. This results in joint pain, functional impairment, and a heightened likelihood of requiring early joint replacement surgery. Surgical intervention, including meniscal repair combined with corrective osteotomy to restore anatomical alignment, has been documented to enhance functional and clinical outcomes while delaying the need for joint replacement. This study aimed to assess the functional outcomes of concurrent Medial Meniscus Posterior Horn Root (MMPR) repair performed alongside open medial wedge high tibial osteotomy (HTO) in patients with medial osteoarthritis. Methods: Between 2016 and 2021, a total of nine patients underwent posterior horn root repair in conjunction with open medial wedge high tibial osteotomy. The average follow-up duration was 2 years. Significant improvements were observed in the mean Lysholm Knee Score and International Knee Documentation Committee (IKDC) scores, with seven patients achieving excellent outcomes and two attaining satisfactory results. Additionally, all patients were able to resume their routine daily activities as expected. Conclusion: Performing MMPR repair concurrently with medial open wedge HTO for medial compartment osteoarthritis in patients with varus alignment has demonstrated favorable clinical and radiological outcomes in the short term. This approach offers promising results in terms of pain relief, functional recovery, and joint preservation.