Osteochondral Allograft and High Tibial Osteotomy With Patient-Specific Instrumentation.

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Abstract

Conflict of interest statement: One or more of the authors has declared the following potential conflict of interest or source of funding: R.S. received support for education from Medwest Associates, Arthrex, and Smith & Nephew; hospitality payments from Stryker Corporation; and a grant from Arthrex. A.S.R. has stocks, stock options, or other ownership interest in Enhatch, Conformis (A.S.R.; sibling of A.S.R.), and Strathspey (sibling of A.S.R.); is a consultant for Stryker, Enhatch, Smith & Nephew, Anika, Bodycad, Xiros, NewClip, Ranfac, Marrow Cellution, Arthrex (sibling of A.S.R.), CeramTec (sibling of A.S.R.), and Cervos; received consulting fees from Heron Therapeutics; received education support from Gotham Surgical Solutions; serves on the speakers’ bureau for Pfizer; and receives royalties from intellectual property from Stryker (sibling of A.S.R.) and DePuy (parents or other ancestors of A.S.R.). AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto. 20. SICOT J. 2021;7:44. doi: 10.1051/sicotj/2021044. Epub 2021 Aug 25. Focal cartilage defects of the lateral compartment do influence the outcome after high tibial valgus osteotomy. Heinz T(1), Reppenhagen S(1), Wagenbrenner M(1), Horas K(1), Ohlmeier M(2), Schäfer T(1), Rudert M(1), Barthel T(1), Weißenberger M(1). Author information: (1)Department of Orthopaedic Surgery, University of Wuerzburg, Koenig-Ludwig-Haus, Brettreichstr. 11, 97074 Wuerzburg, Germany. (2)Department of Orthopaedic Surgery, HELIOS ENDO-Klinik Hamburg, 22767 Hamburg, Germany. INTRODUCTION: High tibial medial open-wedge valgus osteotomy (HTO) is a well-established procedure for unicompartimental medial osteoarthritis of the young and active patient. However, the influence of cartilage defects of the lateral compartment on the total outcome remains obscure. METHODS: From 2005 to 2012, a total of 63 patients underwent HTO for medial osteoarthritis of the knee at a single university orthopaedic center. Baseline data as well as intraoperative findings, including the grade and location of cartilage lesions, were evaluated retrospectively. Two groups were formed regarding the integrity of the lateral tibiofemoral compartment as measured by the Outerbridge score (group A: no lateral cartilage defects, group B: mild to moderate lateral cartilage defects). Functional outcome was assessed using the Knee and Osteoarthritis Outcome Score (KOOS), including its five subscores. RESULTS: Comparing pre- and postoperative data, we identified an overall benefit of the HTO procedure as measured by the KOOS. Group A (no lateral cartilage defects) showed an increase in all five KOOS subscores (p = 0.00-0.01), whereas for group B (mild to moderate lateral cartilage defects), only two KOOS subscores revealed a significant increase (p = 0.03-0.04). There was also a statistically significant difference in the total KOOS score with higher values for group A at the postoperative visit. Cartilage defects with a higher Outerbridge score were associated with lower postoperative KOOS subscores. DISCUSSION: Mild to moderate cartilage defects of the lateral compartment humble the total outcome after HTO procedure. Thus, indication for HTO should be made very carefully if any degree of lateral cartilage degeneration is present. © The Authors, published by EDP Sciences, 2021. DOI: 10.1051/sicotj/2021044 PMCID: PMC8386396