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HTO associated with knee cartilage regeneration in patients with OA
Medial opening-wedge high tibial osteotomy has been shown to cause significant regeneration of articular knee cartilage in patients with osteoarthritis and varus deformity, according to results of this study.
“The degenerated cartilage of the medial femoral condyle and medial tibial plateau could be partially or entirely covered by newly regenerated cartilage at 2 years after adequate correction of varus deformity by medial opening-wedge high tibial osteotomy without cartilage regeneration strategies,” Woon-Hwa Jung, MD, and colleagues wrote in the study.
The retrospective study they conducted included 159 patients who underwent high tibial osteotomy (HTO) for medial-compartment osteoarthritis and they used the International Cartilage Repair Society grading system to evaluate the cartilage on initial arthroscopy during HTO procedures, as well as at about 2 years after HTO when they removed the plate.
The researchers found Grade 2 regeneration of cartilage of the medial femoral condyle cartilage in 92% of knees and of the medial tibial plateau in 69% of knees. Jung and colleagues observed maturation of the regenerated cartilage in the medial femoral condyle in 4% of knees and in the medial tibial plateau in 1% of knees.
At 2 years follow-up, no significant differences were seen between clinical outcomes and the initial amount of cartilage degeneration or cartilage regeneration the patients had, based on the results. Regeneration of the medial femoral condyle articular cartilage occurred in at least 75% of knees with mechanical tibiofemoral angles of 0° or less.
The mean knee and function Knee Society Scores improved significantly from the time of surgery to the 2-year follow-up. – by Christian Ingram
Disclosure: The authors have no relevant financial disclosures.
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Jung W-H. Arthroscopy. 2014;doi: 10.1016/j.arthro.2013.10.008