Medial knee articular cartilage composition improved by High
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The goals of this study were to:
(1) Test the hypothesis that HTO enhances articular cartilage composition in the medial compartment while having no negative effects on the lateral compartment or patella, and
(2) Investigate associations between knee alignment and cartilage composition after surgery.

3T MRI and standing radiographs were obtained from 34 patients before and 1-year after HTO. Articular cartilage was segmented from T2 maps. Mechanical axis angle (MAA), posterior tibial slope, and patellar height were measured from radiographs. Changes in T2 and radiographic measures were assessed using paired t tests, and associations were assessed using Pearson correlation coefficients.

Results:
--The mean (SD) MAA before and after HTO was - 6.5° and 0.6°, respectively.

--There was statistically significant shortening of T2 in the medial femur [- 2.8 ms] and medial tibia [- 2.2 ms], without changes in the lateral femur [- 0.5 ms], lateral tibia [0.2 ms], or patella 0.5 ms (- 1.0; 2.1).

--Associations between radiographic measures and T2 were low. 23% of the increase in lateral femur T2 was explained by postoperative posterior tibial slope.

To summarize, conducting medial opening wedge HTO without overcorrection strengthens articular cartilage composition in the medial compartment of the knee without jeopardizing the lateral compartment or the patella. These findings indicate that HTO may be a disease structure-modifying treatment for knee OA.

Source: https://link.springer.com/article/10.1007/s00167-021-06516-9
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