Risk factors of cartilage regeneration in patients who underwent high tibial osteotomy combined with microfracture
One of the option for treating unicompartmental osteoarthritis (OA) is high tibial osteotomy (HTO). HTO which can shift the mechanical axis to the lateral compartment, can performed with microfracture which provides cells capable of producing cartilage. And this procedure is one of the common combinations that orthopaedic surgeons are in practice recently. The purpose of this study was to evaluate the degree of regeneration of cartilage after performing microfracture (MF) with high tibial
... h high tibial osteotomy (HTO) after 2-year follow up and identify the factors influencing the regeneration of cartilage after the procedure. We also evaluated whether the regenerated cartilage status affects clinical outcomes. Methods: A total of 81 cases that underwent second-look arthroscopy at the time of plate removal after MF and HTO with a minimum two-year follow-up were included. The patients were divided into two groups according to femoral cartilage regeneration. Multivariable logistic regression analyses were performend to identify independent factors that influence cartilage regeneration. We also compared differences in functional outcomes between the two groups. Results: On the femoral side, grade I cartilage regeneration was found in seven (8.6%), grade II in 19 (23.5%), grade III in 26 (32.1%), and grade IV in 29 cases (35.8%), resulting in 26 (32.1%) patients belonging to well regenerated group (group A) and 55 (67.9%) to the poorly regenerated group (group B). Among factors, the size of the cartilage lesion (P=.011) and the presence of kissing lesions (P=.027) significantly affected cartilage regeneration. There were no statistically significant differences between group A and group B in terms of KSS and WOMAC scores. Conclusions: A large cartilage defect and the presence of kissing lesions are associated with poor cartilage regeneration after combined MF and HTO surgery. However, the quality of regenerated cartilage does not affect functional outcomes in patients with MF and HTO.