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Year : 2020  |  Volume : 4  |  Issue : 2  |  Page : 97-105

Arthroscopic treatment of chondral lesions in varus knee in adults combined with corrective high tibial osteotomy

Department of Orthopedic Surgery, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt

Correspondence Address:
Dr. Wael Shaban
MD, Assistant Professor of Orthopedic Surgery, 15, Mohamed Refat St, Abassia, Cairo
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/sjamf.sjamf_1_20

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Objectives To document whether cartilage regeneration occurs in the degenerated medial compartment of arthritic knees in patients with varus malalignment after medial opening wedge high tibial osteotomy (MOWHTO) with concomitant cartilage procedures and to assess which predictive factors influence the clinical outcome. Patients and methods A total of 28 patients underwent MOWHTO between December 2016 and December 2018 in Al-Zahraa University Hospital for varus malalignment and medial osteoarthritis. Preoperative and postoperative assessments were done using American Knee Society’s Knee and Functional Scoring System. All patients were evaluated by arthroscopy before and ∼12 months after HTO. The International Cartilage Repair Society grading system was used for arthroscopic grading. Results At initial arthroscopy, two (7.1%) knees had grade II medial femoral condyle articular cartilage finding, seven (25%) knees had grade III findings, and 19 (67.9%) knees had grade IV findings. Only 20 cases had second-look arthroscopy, no regenerative change was found in 40% of knees, white scattering fibrocartilage was found in 55% of knees, and deterioration of the cartilage was observed in one (5%) case. Conclusion The degenerated cartilage could be partially or entirely covered by newly regenerated cartilage at 1 years after adequate correction of varus deformity by MOWHTO.

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