title: Effect of open wedge high tibial osteotomy on the lateral tibiofemoral compartment in sheep. Part III: analysis of the microstructure of the subchondral bone and correlations with the articular cartilage and meniscus.
abstract: OBJECTIVE
  First, to evaluate whether medial open wedge high tibial osteotomy (HTO) induces alterations of the microstructure of the lateral tibial subchondral bone plate of sheep. Second, to test the hypothesis that specific correlations exist between topographical structural alterations of the subchondral bone, the cartilage and the lateral meniscus.
  
  
  METHODS
  Three experimental groups received biplanar osteotomies of the right proximal tibiae: (a) closing wedge HTO (4.5° of tibial varus), (b) opening wedge HTO (4.5° tibial valgus; standard correction) and (c) opening wedge HTO (9.5° of valgus; overcorrection), each of which was compared to the non-osteotomised contralateral proximal tibiae. After 6 months, subchondral bone structure indices were measured by computed tomography. Correlations between the subchondral bone, the articular cartilage and the lateral meniscus were determined.
  
  
  RESULTS
  Increased loading by valgus overcorrection led to an enlarged specific bone surface (BS/BV) in the subarticular spongiosa compared with unloading by varisation. The subchondral bone plate was 3.9-fold thicker in the central region of the lateral tibial plateau than in the submeniscal periphery. Its thickness in the central region significantly correlated with the thickness of the articular cartilage. In the submeniscal region, such correlation did not exist. In general, a higher degree of osteoarthritis (OA) correlated with alterations of the subchondral bone plate microstructure. OA of the submeniscal articular cartilage also correlated with worse matrix staining of the lateral meniscus.
  
  
  CONCLUSIONS
  Osteoarthritis changes are associated with alterations of the subchondral bone plate microstructure. Specific topographical relationships exist in the central region between the articular cartilage and subchondral bone plate thickness, and in the submeniscal periphery between and the articular cartilage and lateral meniscus. From a clinical perspective, the combined follow-up data from this and the previous two investigations suggest that open wedge valgus HTO is a safe procedure for the lateral compartment to manage medial osteoarthritis of the knee with varus malalignment in the short term.
authors.affiliation: Center of Experimental Orthopaedics, Saarland University, Kirrbergerstr. 1, Building 37, 66421, Homburg, Saarland, Germany.
authors.forename: Raphaela
authors.initials: R
authors.lastname: Ziegler
authors.forename: Lars
authors.initials: L
authors.lastname: Goebel
authors.forename: Roland
authors.initials: R
authors.lastname: Seidel
authors.forename: Magali
authors.initials: M
authors.lastname: Cucchiarini
authors.forename: Dietrich
authors.initials: D
authors.lastname: Pape
authors.forename: Henning
authors.initials: H
authors.lastname: Madry
mesh_terms: D000820:Animal Diseases; D000818:Animals; D002358:Cartilage, Articular / Q000000981:diagnostic imaging / Q000473:pathology*; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D008592:Menisci, Tibial / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology*; D010027:Osteotomy; D034561:Sheep, Domestic; D013977:Tibia / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D014057:Tomography, X-Ray Computed