Combined Biplanar High Tibial Osteotomy, Anterior Cruciate Ligament Reconstruction, and Abrasion/Microfracture in Severe Medial Osteoarthritis of Unstable Varus Knees

Schuster, Philipp; Schulz, Martin; Richter, Joerg

doi:10.1016/j.arthro.2015.07.008

Cited by 21 publications

(17 citation statements)

References 49 publications

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“…Recently Schuster et al 6 published 5-year results of 23 knees with a mean age of 47 years, treated with HTO combined with ACL reconstruction and MF/abrasion in patients having osteoarthritis Kellgren-Lawrence grades 3 and 4. These cases were evaluated clinicoradiologically and arthroscopically between 1 and 2 years, and with outcome scores for 5 years.…”

Section: Discussionmentioning

confidence: 99%

“…Jung et al 3 claimed that the degenerated cartilage of the medial femoral condyle and medial tibial plateau could be partially or entirely covered by the newly regenerated cartilage at 2 years after HTO, without cartilage regeneration strategies. However, Schuster et al 6 claimed that HTO in combination with a chondral resurfacing procedure is effective in the treatment of severe medial osteoarthritis and varus malalignment.…”

Section: Discussionmentioning

confidence: 99%

“…However, there are multiple reports of good long-term results of MF used for the treatment of the degenerative lesions in the elderly, more so if combined with HTO. 6,7 Encouraged by these good results of cartilage repair treatment and because of a higher chance of patients' dissatisfaction and failure after replacement surgeries in the middle age, cartilage surgeons are increasingly shifting their focus to the arthritic cases. 1,4,5 A detailed step-by-step surgical technique is thus important to lay down the standardized procedure.…”

Section: Discussionmentioning

confidence: 99%

“…5 However, the role of additional cartilage surgeries in better survival and higher clinical scores cannot be ruled out. 6,7 For any joint preservation surgery to be successful, a cartilage surgeon must select the "best of two worlds" and perform both the procedures as a single-stage procedure.…”

Section: Discussionmentioning

confidence: 99%

“…3 However, combining the principles of biomechanical correction along with the cartilage repairs has also given encouraging results with a longer duration of follow-up and better clinical scores. [4][5][6][7] Somewhere, it is the synergistic role of both the principles that leads to a better outcome with the combined procedure.…”

mentioning

confidence: 99%

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Joint Preservation Surgery for Medial Compartment Osteoarthritis

Goyal¹,

Goyal

Adachi

2017

Arthroscopy Techniques

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Single compartment osteoarthritis is a commonly encountered condition in the middle-aged population, with the medial compartment being the most commonly involved compartment. Medial compartment osteoarthritis becomes seriously disabling for these active patients, with a very few definitive solutions. These patients quickly stop responding to the conservative methods such as lifestyle modification, drugs, physiotherapy, and rehab programs. Less invasive procedures such as intra-articular injections or joint debridement also do not give a long-lasting relief. On the other hand, this population is too young to undergo a knee replacement surgery because the failure rate of a knee replacement surgery is too high in the middle-aged patients as compared with the elderly population. A combination of biological stimulation of the damaged single compartment cartilage and biomechanical correction surgery can give a long-lasting relief in the middle-aged population. Because the medial compartment osteoarthritis is increasingly being treated with joint preservation surgeries, it is important to lay out the step-by-step surgical technique of a joint preservation surgery. This Technical Note presents the detailed technique, patient selection flow chart, tips, pearls, and surgical decision making, along with a surgical video of a joint preservation surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Joint Preservation Surgery for Medial Compartment Osteoarthritis

Goyal¹,

Goyal

Adachi

2017

Arthroscopy Techniques

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Recent strategies in cartilage repair: A systemic review of the scaffold development and tissue engineering

Rai

Dilisio

Dietz

et al. 2017

J Biomedical Materials Res

124

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Osteoarthritis results in irreparable loss of articular cartilage. Due to its avascular nature and low mitotic activity, cartilage has little intrinsic capacity for repair. Cartilage loss leads to pain, physical disability, movement restriction, and morbidity. Various treatment strategies have been proposed for cartilage regeneration, but the optimum treatment is yet to be defined. Tissue engineering with engineered constructs aimed towards developing a suitable substrate may help in cartilage regeneration by providing the mechanical, biological and chemical support to the cells. The use of scaffold as a substrate to support the progenitor cells or autologous chondrocytes has given promising results. Leakage of cells, poor cell survival, poor cell differentiation, inadequate integration into the host tissue, incorrect distribution of cells, and dedifferentiation of the normal cartilage are the common problems in tissue engineering. Current research is focused on improving mechanical and biochemical properties of scaffold to make it more efficient. The aim of this review is to provide a critical discussion on existing challenges, scaffold type and properties, and an update on ongoing recent developments in the architecture and composition of scaffold to enhance the proliferation and viability of mesenchymal stem cells. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 2343-2354, 2017.

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