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Background. Arthrosis of the knee joint is one of the most common diseases in elderly patients with the varus deformity. One of the treatment methods is corrective osteotomy. Aims: optimization of the diagnosis of deformities in patients with gonarthrosis, improvement of the technique of operation and postoperative control of the main reference lines and angles, assessment of the correction results, analysis of complications. Methods. A retrospective clinical study was conducted. 39 patients were observed, in whom 78 operations were performed on both legs simultaneously. In all the cases, tibia osteotomies and osteosynthesis with the Ilizarov apparatus were used. All the patients underwent an X-ray study of the legs along the entire length with the identification of the main reference lines and angles. Results. In all the cases, it was possible to normalize the position of the mechanical axis and the angle of orientation of the knee joint. After the surgery, the wounds were not sutured to prevent compartment syndrome. The correction was performed in a single-stage manner in elderly patients, gradually in young patients. The period of fixation with the Ilizarov apparatus was 16.6 ± 3.1 weeks. Conclusions. The Ilizarov method has significant advantages: low invasiveness, stable fixation, absence of foreign bodies to the end of treatment. This allows us to recommend it for a wider use in patients with gonarthrosis and varus deformity.