Medial opening-wedge high tibial osteotomy with microfracture in treatment of varus medial compartmental knee osteoarthritis: clinical outcomes and second-look arthroscopic results

Objective: This study aimed to investigate the clinical outcomes of medial opening high tibial osteotomy (MOWHTO) combined with arthroscopic microfracture in the treatment of varus medial compartmental knee osteoarthritis and to assess cartilage regeneration using second-look arthroscopy.Methods: Th...

Full description

Bibliographic Details
Main Authors: Yunpeng Bai, Binhui Lin, Miao Wang, Haoliang Ding, Weibing Sun, Jian Sun
Format: Article
Language:English
Published: Frontiers Media S.A. 2023-09-01
Series:Frontiers in Bioengineering and Biotechnology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fbioe.2023.1247165/full
_version_ 1797678770090409984
author Yunpeng Bai
Binhui Lin
Miao Wang
Haoliang Ding
Weibing Sun
Jian Sun
author_facet Yunpeng Bai
Binhui Lin
Miao Wang
Haoliang Ding
Weibing Sun
Jian Sun
author_sort Yunpeng Bai
collection DOAJ
description Objective: This study aimed to investigate the clinical outcomes of medial opening high tibial osteotomy (MOWHTO) combined with arthroscopic microfracture in the treatment of varus medial compartmental knee osteoarthritis and to assess cartilage regeneration using second-look arthroscopy.Methods: This study involved 86 patients (86 knees) who underwent MOWHTO and microfracture from August 2016 to August 2020, including 15 men and 71 women with an average age of 55.3 ± 7.6 years (range, 42–71 years). The patients underwent a second-look arthroscopy to evaluate the status of cartilage regeneration at the time of plate removal, an average of 2 years after the initial osteotomy. Clinical and radiological examinations were performed preoperatively and at the final follow-up visit. The radiologic evaluation included the weight-bearing line ratio (WBL ratio), mechanical femorotibial angle (FTA), medial proximal tibial angle (MPTA), posterior tibial slope angle (PTS) and Kellgren-Lawrence (KL) grade. Clinical outcomes were assessed using the Knee Society score (KSS) and International Knee Documentation Committee (IKDC) scores. Arthroscopic findings were assessed by macroscopic evaluation of cartilage repair according to the International Cartilage Repair Society (ICRS) grading system.Results: The mean KSS and IKDC scores significantly improved at the final follow-up compared to the scores obtained preoperatively (p < 0.05). At the time of plate removal, a second-look arthroscopic examination showed that the ICRS grade of the medial femoral condyle was as follows: grade I −11 cases, grade II -56, grade III-12, and grade IV-7, and cartilage regeneration was seen in 85% of knees (73/86). The ICRS grade of medial tibial plateau was grade I-12 cases, grade II-44, grade III-22, and grade IV-8, and cartilage regeneration was seen in 63% of knees (54/86). Significant differences were observed between cartilage regeneration and clinical outcomes (p < 0.05). Clinical results were better in the good cartilage regeneration group (grades I and II) than were in the poor cartilage regeneration group (grades III and IV).Conclusion: MOWHTO combined with arthroscopic microfracture can effectively improve clinical outcomes in the treatment of varus medial compartmental knee osteoarthritis. Cartilage regeneration can be promoted by correcting varus deformities, which affect clinical outcomes.
first_indexed 2024-03-11T23:04:59Z
format Article
id doaj.art-a2a1b6ecc4b44c8f9fb19dda1c787d4f
institution Directory Open Access Journal
issn 2296-4185
language English
last_indexed 2024-03-11T23:04:59Z
publishDate 2023-09-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Bioengineering and Biotechnology
spelling doaj.art-a2a1b6ecc4b44c8f9fb19dda1c787d4f2023-09-21T13:35:44ZengFrontiers Media S.A.Frontiers in Bioengineering and Biotechnology2296-41852023-09-011110.3389/fbioe.2023.12471651247165Medial opening-wedge high tibial osteotomy with microfracture in treatment of varus medial compartmental knee osteoarthritis: clinical outcomes and second-look arthroscopic resultsYunpeng BaiBinhui LinMiao WangHaoliang DingWeibing SunJian SunObjective: This study aimed to investigate the clinical outcomes of medial opening high tibial osteotomy (MOWHTO) combined with arthroscopic microfracture in the treatment of varus medial compartmental knee osteoarthritis and to assess cartilage regeneration using second-look arthroscopy.Methods: This study involved 86 patients (86 knees) who underwent MOWHTO and microfracture from August 2016 to August 2020, including 15 men and 71 women with an average age of 55.3 ± 7.6 years (range, 42–71 years). The patients underwent a second-look arthroscopy to evaluate the status of cartilage regeneration at the time of plate removal, an average of 2 years after the initial osteotomy. Clinical and radiological examinations were performed preoperatively and at the final follow-up visit. The radiologic evaluation included the weight-bearing line ratio (WBL ratio), mechanical femorotibial angle (FTA), medial proximal tibial angle (MPTA), posterior tibial slope angle (PTS) and Kellgren-Lawrence (KL) grade. Clinical outcomes were assessed using the Knee Society score (KSS) and International Knee Documentation Committee (IKDC) scores. Arthroscopic findings were assessed by macroscopic evaluation of cartilage repair according to the International Cartilage Repair Society (ICRS) grading system.Results: The mean KSS and IKDC scores significantly improved at the final follow-up compared to the scores obtained preoperatively (p < 0.05). At the time of plate removal, a second-look arthroscopic examination showed that the ICRS grade of the medial femoral condyle was as follows: grade I −11 cases, grade II -56, grade III-12, and grade IV-7, and cartilage regeneration was seen in 85% of knees (73/86). The ICRS grade of medial tibial plateau was grade I-12 cases, grade II-44, grade III-22, and grade IV-8, and cartilage regeneration was seen in 63% of knees (54/86). Significant differences were observed between cartilage regeneration and clinical outcomes (p < 0.05). Clinical results were better in the good cartilage regeneration group (grades I and II) than were in the poor cartilage regeneration group (grades III and IV).Conclusion: MOWHTO combined with arthroscopic microfracture can effectively improve clinical outcomes in the treatment of varus medial compartmental knee osteoarthritis. Cartilage regeneration can be promoted by correcting varus deformities, which affect clinical outcomes.https://www.frontiersin.org/articles/10.3389/fbioe.2023.1247165/fullhigh tibial osteotomyarthroscopymedial compartmental osteoarthritiscartilage regenerationmicrofracture
spellingShingle Yunpeng Bai
Binhui Lin
Miao Wang
Haoliang Ding
Weibing Sun
Jian Sun
Medial opening-wedge high tibial osteotomy with microfracture in treatment of varus medial compartmental knee osteoarthritis: clinical outcomes and second-look arthroscopic results
Frontiers in Bioengineering and Biotechnology
high tibial osteotomy
arthroscopy
medial compartmental osteoarthritis
cartilage regeneration
microfracture
title Medial opening-wedge high tibial osteotomy with microfracture in treatment of varus medial compartmental knee osteoarthritis: clinical outcomes and second-look arthroscopic results
title_full Medial opening-wedge high tibial osteotomy with microfracture in treatment of varus medial compartmental knee osteoarthritis: clinical outcomes and second-look arthroscopic results
title_fullStr Medial opening-wedge high tibial osteotomy with microfracture in treatment of varus medial compartmental knee osteoarthritis: clinical outcomes and second-look arthroscopic results
title_full_unstemmed Medial opening-wedge high tibial osteotomy with microfracture in treatment of varus medial compartmental knee osteoarthritis: clinical outcomes and second-look arthroscopic results
title_short Medial opening-wedge high tibial osteotomy with microfracture in treatment of varus medial compartmental knee osteoarthritis: clinical outcomes and second-look arthroscopic results
title_sort medial opening wedge high tibial osteotomy with microfracture in treatment of varus medial compartmental knee osteoarthritis clinical outcomes and second look arthroscopic results
topic high tibial osteotomy
arthroscopy
medial compartmental osteoarthritis
cartilage regeneration
microfracture
url https://www.frontiersin.org/articles/10.3389/fbioe.2023.1247165/full
work_keys_str_mv AT yunpengbai medialopeningwedgehightibialosteotomywithmicrofractureintreatmentofvarusmedialcompartmentalkneeosteoarthritisclinicaloutcomesandsecondlookarthroscopicresults
AT binhuilin medialopeningwedgehightibialosteotomywithmicrofractureintreatmentofvarusmedialcompartmentalkneeosteoarthritisclinicaloutcomesandsecondlookarthroscopicresults
AT miaowang medialopeningwedgehightibialosteotomywithmicrofractureintreatmentofvarusmedialcompartmentalkneeosteoarthritisclinicaloutcomesandsecondlookarthroscopicresults
AT haoliangding medialopeningwedgehightibialosteotomywithmicrofractureintreatmentofvarusmedialcompartmentalkneeosteoarthritisclinicaloutcomesandsecondlookarthroscopicresults
AT weibingsun medialopeningwedgehightibialosteotomywithmicrofractureintreatmentofvarusmedialcompartmentalkneeosteoarthritisclinicaloutcomesandsecondlookarthroscopicresults
AT jiansun medialopeningwedgehightibialosteotomywithmicrofractureintreatmentofvarusmedialcompartmentalkneeosteoarthritisclinicaloutcomesandsecondlookarthroscopicresults