title: Analysis of Outcomes for High Tibial Osteotomies Performed With Cartilage Restoration Techniques.
abstract: OBJECTIVE
  To evaluate reported medium- to long-term outcomes after high tibial osteotomy (HTO) with associated cartilage restoration procedures.
  
  
  METHODS
  A review of the MEDLINE database was performed. The inclusion criteria were English language, clinical outcome study with HTO as the primary procedure, use of a form of cartilage repair included, and the mean follow-up period of at least 2 years. Each identified study was reviewed for study design, patient demographics, type of procedures performed, clinical outcomes, progression to total knee arthroplasty, and complications.
  
  
  RESULTS
  Eight hundred and twenty-seven patients (839 knees) were included. The most common cartilage preservation technique used in conjunction with HTO was microfracture (4 studies; 22.2%). The mean Lyscholm scores, reported in 50% of the studies, ranged from 40 to 65.7 preoperatively and improved to a range of 67 to 94.6 postoperatively. Four studies (22.2%) used a visual analog scale for evaluation of pain and all had a mean visual analog scale of less than 3 postoperatively. Among studies evaluating conversion to arthroplasty, the rate of conversion was 6.8% and the range of mean number of years from HTO to conversion was 4.9 to 13.0. The overall reported complication rate was 10.3%.
  
  
  CONCLUSIONS
  HTO with cartilage restoration procedures provides reliable improvement in functional status in the medium- to long-term period after surgery and has potential to delay or avoid the need for knee arthroplasty surgery.
  
  
  METHODS
  Level IV, systematic review of Level I to IV studies.
authors: Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, U.S.A.. Electronic address: kahlenbergc@hss.edu.
authors: Cynthia A
authors: CA
authors: Kahlenberg
authors: Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, U.S.A.
authors: Benedict U
authors: BU
authors: Nwachukwu
authors: Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois, U.S.A.
authors: Kamran S
authors: KS
authors: Hamid
authors: Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, U.S.A.
authors: Michael E
authors: ME
authors: Steinhaus
authors: Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, U.S.A.
authors: Riley J
authors: RJ
authors: Williams
mesh_terms: D019645:Arthroplasty, Replacement, Knee / Q000706:statistics & numerical data; D054544:Arthroplasty, Subchondral; D002358:Cartilage, Articular / Q000601:surgery; D006801:Humans; D065466:Lysholm Knee Score; D020370:Osteoarthritis, Knee / Q000601:surgery*; D010027:Osteotomy / Q000379:methods*; D013977:Tibia / Q000601:surgery*; D064232:Visual Analog Scale