2015 ISAKOS Biennial Congress ePoster #1701

Factors Affecting Cartilage Repair After Opening Wedge High Tibial Osteotomy for Patients With Osteoarthritis of the Knee

Ken Kumagai, MD, Yokohama JAPAN
Yasushi Akamatsu, MD, PhD, Yokohama JAPAN
Hideo Kobayashi, Yokohama JAPAN
Yoshihiro Kusayama, MD, Yokohama JAPAN
Tomihisa Koshino, MD, PhD, Yokohama JAPAN
Tomoyuki Saito, MD, PhD, Yokohama, Kanagawa JAPAN

Department of Orthopaedic Surgery, Yokohama City University, Yokohama, Kanagawa, JAPAN

FDA Status Not Applicable

Summary: Factors affecting cartilage repair after opening wedge high tibial osteotomy were preoperative ICRS grade, BMI and postoperative lower limb alignment.




This study documented the healing potential of degenerated articular cartilage after opening-wedge high tibial osteotomy (HTO) in patients with osteoarthritis (OA) of the knee. Methods: Medial opening-wedge HTO was performed in 100 patients with OA of the knee (mean age 66+/-7.7 years, 131 knees). Preoperative status of articular cartilage was assessed by arthroscopy according to the ICRS grade and a second look arthroscopy was performed at the time of plate removal. Cartilage repair was classified into three stages: no reparative change (Stage 1), partial coverage with white cartilaginous tissue (Stage 2), even coverage with white cartilaginous tissue (Stage 3). Results: Cartilage repair in femoral surface resulted in 38 (29%) of Stage 1, 72 (55%) of Stage 2, and 21 (16%) of Stage 3. Cartilage repair in tibial surface resulted in 64 (49%) of Stage 1, 57 (43%) of Stage 2, and 10 (8%) of Stage 3. Thus, cartilage repair was significantly better in femoral surface than in tibial surface. Incidence of cartilage repair (Stage 2 or 3) was significantly higher in advanced ICRS grade, lower BMI cases or overcorrected knees. Age, gender and clinical outcomes did not affect the stage classification. Conclusion: Cartilage repair with partial or even coverage was achieved in 71% of the femoral surface and 51% of the tibial surface. The factors influencing stage of cartilage repair were preoperative ICRS grade, BMI and postoperative lower limb alignment.