Arthroscopic evidence of improvement in cartilage lesions after medial opening-wedge high-tibial osteotomy with valgus correction and its positive impact on clinical outcomes, a prospective study
- 02.06.2025
- Research
Erschienen in:
- Verfasst von
- Ayman F. AbdelKawi
- Maher A. El-Assal
- Mohamed M. Abdelhamid
- Ahmed M. Sayed
- Erschienen in
- International Orthopaedics | Ausgabe 8/2025
Abstract
Purpose
This study documented changes in cartilage lesions in the arthritic medial knee compartment after medial opening wedge high tibial osteotomy (MOWHTO), their impact on clinical outcomes and possible factors influencing this improvement.
Methods
Forty-nine patients indicated for MOWHTO (per ISAKOS criteria) underwent arthroscopy at osteotomy and implant removal (mean interval: 22.2 months). Cartilage lesions (medial femoral condyle [MFC], medial tibial plateau [MTP]) and clinical scores (Lysholm score and KOOS) were documented. No cartilage restoration procedures were performed.
Results
The mean age was 47.5 years and most were females (n = 32). Arthroscopically, cartilage improvement occurred in 32 (65.3%) MFC and 25 (51%) MTP lesions. MOWHTO significantly improved the mechanical tibiofemoral angle (TFA) (7.88 ± 3.66 vs. − 2.71 ± 1.98 (°); P < 0.001). Lysholm knee score (77 ± 16.2 vs. 48.4 ± 16.3, p < 0.001) and KOOS (64.1 ± 13.6 vs. 43.8 ± 12.5, p < 0.001) significantly improved after osteotomy. On the femoral side, cartilage repair was documented in patients who achieved relatively more valgus correction, with a mean final TFA of 3.32 ± 1.7, compared with 1.57 ± 2 in the no improvement group (P = 0.001). For the MTP, no factor of statistical significance could be detected.
Conclusions
MOWHTO can improve articular cartilage lesions as a standalone procedure. A greater incidence of cartilage repair is expected with more valgus correction of the mechanical axis of the limb. This cartilage infill is associated with slightly better clinical outcomes.
Trial registration
ClinicalTrials.gov (ID NCT04541342) registered on 9.9.2020, https://clinicaltrials.gov/study/NCT04541342.
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- Titel
- Arthroscopic evidence of improvement in cartilage lesions after medial opening-wedge high-tibial osteotomy with valgus correction and its positive impact on clinical outcomes, a prospective study
- Verfasst von
-
Ayman F. AbdelKawi
Maher A. El-Assal
Mohamed M. Abdelhamid
Ahmed M. Sayed
- Publikationsdatum
- 02.06.2025
- Verlag
- Springer Berlin Heidelberg
- Erschienen in
-
International Orthopaedics / Ausgabe 8/2025
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195 - DOI
- https://doi.org/10.1007/s00264-025-06552-x
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