Objective To compare the plantar pressure distribution in patients with medial compartment knee osteoarthritis(KOA) who underwent medial opening wedge tibial high osteotomy(OWHTO) or unicoondylar replacement(UKA).Methods From January 2020 to March 2021，17 patients with medial compartment KOA who underwent OWHTO treatment(HTO group) and 19 patients with UKA treatment (UKA group) were selected from the knee joint ward of Xi’an Honghui Hospital as the experimental group，while 22 healthy individuals of the same age were included as control groups using the Pedomedic 40 plantar pressure detection system was tested.The change in plantar pressure was assessed in the medial compartment KOA patients after OWHTO and UKA by comparing max-pressure (Max-P)，force-time integral(FTI) and valgus-varus index(VVI) during walking.Results Compared with the control group，Max-P in the first metatarsal region (MH1)was smaller (P＜0.05)，FTI in the second metatarsal region (MH2)was smaller (P＜0.05)，Max-P in the fifth metatarsal region (MH5) was larger (P＜0.05)，MaxP in the lateral midfoot region (MFL)was larger (P＜0.05)，and FTI in the lateral hindfoot region (RFL)was larger (P＜0.05) in the UKA group.Compared with the control group，the FTI of HTO group in MH1 was larger (P＜0.05)，Max-P in MH5 was smaller (P＜0.05)，and FTI and Max-P in medial midfoot region (MFM)were larger (P＜0.05).The hip knee ankle angle(HKA) of HTO group and UKA group were significantly improved after operation (P＜0.05)，but there was significant difference between the two groups (P＜0.05).In terms of the Knee Society score(KSS)，both groups were significantly improved compared with those before operation(P＜0.05)，and there was no significant difference between HTO group and UKA group after operation (P＞0.05).Conclusion The plantar pressure distribution of patients with medial compartment KOA after UKA is closer to that of normal people than after OWHTO.Prospective，multi center，large sample clinical observation and study are still needed to evaluate in the next step.