title: Cartilage repair procedures associated with high tibial osteotomy in varus knees: clinical results at 11 years' follow-up.
abstract: OBJECTIVE
  In this study, the authors retrospectively compared the clinical outcome of middle-aged active patients affected by a varus knee with medial unicompartmental osteoarthritis: the treatment was isolated high tibial osteotomy (HTO) for one group or HTO associated with a cartilage repair procedure, that was autologous chondrocyte implantation (ACI) for one group (HTO+ACI) and microfracture (MFX) for the other group (HTO+MFX). The purpose of this study was to analyse the clinical outcomes at long-term follow-up. The hypothesis was that a cartilage repair procedure may add some benefit to isolated axial correction.
  
  
  METHODS
  56 patients affected by medial osteoarthcritis in a varus knee were retrospectively investigated: 20 patients were treated by HTO, 18 by HTO+ACI and 18 by HTO+MFX. All patients underwent clinical assessment following HSS and WOMAC rating scores and a radiographic study was performed preoperatively and at follow-up. The statistical analysis confirmed that the three groups of patients were homogeneous regarding clinical, radiographical and anatomopathological patterns; differences have been reported in body mass index (BMI).
  
  
  RESULTS
  At final follow-up, improvements in clinical and radiographical results were obtained in all patients. HTO and HTO+ACI series showed significantly higher scores compared to the HTO+MFX series.
  
  
  CONCLUSIONS
  At more than 11 years of follow-up, isolated HTO and HTO+ACI treatments showed satisfactory results similar to those reported in the literature with no evidence of superiority of the addition of ACI to isolated HTO. MFX associated with HTO provided the worst results in the series.
authors: Ist Clinic of Orthopaedics and Traumatology, Istituto Ortopedico Rizzoli, via G.C. Pupilli 1, 40136 Bologna, Italy.
authors: A
authors: A
authors: Ferruzzi
authors: Ist Clinic of Orthopaedics and Traumatology, Istituto Ortopedico Rizzoli, via G.C. Pupilli 1, 40136 Bologna, Italy.
authors: R
authors: R
authors: Buda
authors: Ist Clinic of Orthopaedics and Traumatology, Istituto Ortopedico Rizzoli, via G.C. Pupilli 1, 40136 Bologna, Italy. Electronic address: marco.cavallo@ior.it.
authors: M
authors: M
authors: Cavallo
authors: Ist Clinic of Orthopaedics and Traumatology, Istituto Ortopedico Rizzoli, via G.C. Pupilli 1, 40136 Bologna, Italy.
authors: A
authors: A
authors: Timoncini
authors: Ist Clinic of Orthopaedics and Traumatology, Istituto Ortopedico Rizzoli, via G.C. Pupilli 1, 40136 Bologna, Italy.
authors: S
authors: S
authors: Natali
authors: Ist Clinic of Orthopaedics and Traumatology, Istituto Ortopedico Rizzoli, via G.C. Pupilli 1, 40136 Bologna, Italy.
authors: S
authors: S
authors: Giannini
mesh_terms: D054544:Arthroplasty, Subchondral; D001182:Arthroscopy; D015992:Body Mass Index; D002358:Cartilage, Articular / Q000503:physiopathology / Q000601:surgery*; D019902:Chondrocytes / Q000637:transplantation; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016916:Joint Deformities, Acquired / Q000503:physiopathology / Q000601:surgery*; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D010027:Osteotomy / Q000379:methods*; D063868:Patient Outcome Assessment; D011859:Radiography; D012189:Retrospective Studies; D013977:Tibia / Q000601:surgery*
keywords: Arthritis; Cartilage; Knee; Osteotomy; Surgery; Varus