Cartilage repair examined by second-look arthroscopy following double-level osteotomy performed for osteoarthritic knees with severe varus deformity |
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| Institution: | 1. Department of Orthopaedic Surgery, Hyogo College of Medicine, Japan;2. Department of Orthopaedic Surgery, Nishinomiya Kaisei Hospital, Japan;3. Diakonie Klinikum Jung-Stilling, Siegen, Germany;1. Department of Clinical Medicine, Aarhus University, Aarhus, Denmark;2. AutoRSA Research Group, Orthopaedic Research Unit, Aarhus University Hospital, Aarhus, Denmark;3. Department of Orthopeadics, University Clinic for Hand, Hip and Knee Surgery, Hospital Unit West, Holstebro, Denmark;4. Department of Orthopedics, Aarhus University Hospital, Aarhus, Denmark;1. Department of Orthopaedic Surgery, Centre of Head and Orthopaedics, Rigshospitalet, 2100 Copenhagen Ø, Denmark;2. Department of Orthopaedic Surgery, Clinic of Hip, Knee and Foot Surgery, Gentofte and Herlev Hospital, 2900 Hellerup, Denmark;3. Clinical Sciences, Lund University, Department of Orthopaedics, Skåne University Hospital, 221 85 Lund, Sweden;4. Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark;1. Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan;2. Department of Orthopaedic Biomaterial Science, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka 565-0871, Japan;3. Department of Information Systems, Faculty of Engineering, Saitama Institute of Technology, 1690 Fusaiji, Fukaya, Saitama 369-0293, Japan;1. Department of Orthopaedics, Vanderbilt University Medical Center, 1215 21st Avenue South, 4200 Medical Center East, Nashville, TN 37232-8774, United States;2. Attending Orthopaedic Surgeon, Kerlan Jobe Institute, 6801 Park Terrace, Los Angeles, CA 90045, United States;3. Department of Orthopaedics, Rush University Medical Center, 1611 W Harrison, Suite 300, Chicago, IL 60612, United States;4. Attending Orthopaedic Surgeon, Kerlan Jobe Institute, 6801 Park Terrace, Los Angeles, CA 90045, United States |
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| Abstract: | BackgroundThe purpose of this study was to examine the status of cartilage repair by second-look arthroscopy following double-level osteotomy (DLO) performed for osteoarthritic knees with severe varus deformity.MethodsForty-seven consecutive knees in 33 patients who underwent DLO were included in the study. The surgical technique used was a minimally invasive DLO procedure combining lateral closed-wedge distal femoral and medial open-wedge high tibial osteotomies. In the second-look arthroscopic evaluation, the following grading system proposed by Koshino was adopted: Stage A, no repair; stage B, pink fibrous tissue with or without partial coverage with white fibrocartilage; and stage C, total coverage with cartilage. The findings corresponding to stage B or C were considered as repaired. Arthroscopic assessment was performed for each compartment. Clinical outcomes were evaluated using the validated outcome measures.ResultsThe mean age at surgery was 62.8 ± 6.2 years (range: 45–75 years), and the mean time period from DLO to second-look arthroscopy was 17.1 ± 5.0 months (range: 12–33 months). Cartilage repair to some extent was identified in over 90% of the medial femoral and tibial condyles, and 12.8% of the patellar facet. As for clinical scores, both Knee Injury and Osteoarthritis Outcome Score (KOOS) and the International Knee Documentation Committee Subjective Knee Form (IKDC) subjective scores significantly improved after surgery (P < 0.01).ConclusionsEvaluation of the present study subjects showed that DLO could induce cartilage repair in the majority of the affected femoral and tibial articular surfaces with significant clinical improvement. In the patellar facet, however, cartilage repair could be identified in only 12.8% of cases. |
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| Keywords: | Double-level osteotomy Cartilage repair Osteoarthritis Knee Osteotomy Repair |
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