What question did this study set out to answer?

This research evaluates the arthroscopic changes in cartilage after hybrid closed wedge high tibial osteotomy and their clinical associations over two years.

April 16, 2026BMC Musculoskeletal Disorders0 citationsOpen Access

Hybrid closed wedge high tibial osteotomy is associated with short-term arthroscopic changes in the patellofemoral joint

MSMikio ShiodaInstitute of Sports Medicine and Science RTRyohei TakeuchiToyo Seikan (Japan)WJWoon-Hwa JungMasan National Tuberculosis Hospital

Key Points

This research evaluates the arthroscopic changes in cartilage after hybrid closed wedge high tibial osteotomy and their clinical associations over two years.
Conducted a retrospective analysis of 77 patients who underwent primary HCWHTO.
Performed second-look arthroscopy approximately one year post-surgery on 61 patients.
Assessed cartilage status using the International Cartilage Repair Society grading system.
Evaluated clinical outcomes using J-KOOS subscale scores at a minimum of two years postoperatively.
At one-year follow-up, 37.0% of knees showed improvement in trochlear cartilage, while 6.2% showed deterioration.
The median ICRS grade of trochlea remained unchanged, but distribution shifted toward lower grades (p < 0.01).
Significant improvements in clinical outcomes were seen at two years postoperatively (p < 0.001).
No significant correlation was found between arthroscopic changes and improvements in clinical outcomes.

Abstract

Hybrid closed wedge high tibial osteotomy (HCWHTO) has been reported to influence patellofemoral (PF) joint status; however, macroscopic cartilage changes remain insufficiently documented. This study aimed to evaluate 1-year arthroscopic changes in trochlear cartilage after HCWHTO and to examine their association with 2-year clinical outcomes. Between July 2011 and May 2016, 77 patients (102 knees) underwent primary HCWHTO at our institution. Of these, 61 patients (81 knees) had complete second-look arthroscopy at approximately one year postoperatively and clinical and radiographic follow-up at a minimum of two years. These cases constituted the final analysis cohort. Preoperative radiographic severity was assessed using the Kellgren–Lawrence classification. All included knees were classified as grade 3 or 4. Cartilage status was assessed arthroscopically at approximately 1 year postoperatively using the International Cartilage Repair Society (ICRS) grading system. All analyses were performed on a per-knee basis. All included knees were classified as Kellgren–Lawrence grade 3 or 4. At 1-year follow-up, 37.0% of knees demonstrated macroscopic cartilage surface improvement in the trochlear groove, whereas deterioration was observed in 6.2%. Although the median ICRS grade of the trochlea remained unchanged, the distribution shifted toward lower grades (p < 0.01). The medial patellar facet showed a slight improvement in median ICRS grade, while the lateral facet remained largely unchanged. All J-KOOS subscale scores improved significantly at 2 years postoperatively (p < 0.001). No significant correlation was observed between arthroscopic cartilage changes and improvements in clinical outcomes. In knees with complete 2-year follow-up, HCWHTO was associated with macroscopic cartilage surface changes, including redistribution toward lower ICRS grades in the trochlea at 1 year after surgery. However, these changes were not significantly correlated with clinical outcomes at 2 years postoperatively.

AIに質問

Bookmark

View Full Paper