ArticleBMC musculoskeletal disorders2026
Hybrid closed wedge high tibial osteotomy is associated with short-term arthroscopic changes in the patellofemoral joint.
Article in BMC musculoskeletal disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundHybrid closed wedge high tibial osteotomy (HCWHTO) has been reported to influence patellofemoral (PF) joint status; however, macroscopic cartilage changes remain insufficiently documented. This study aimed to evaluate 1-year arthroscopic changes in trochlear cartilage after HCWHTO and to examine their association with 2-year clinical outcomes.
methodsBetween July 2011 and May 2016, 77 patients (102 knees) underwent primary HCWHTO at our institution. Of these, 61 patients (81 knees) had complete second-look arthroscopy at approximately one year postoperatively and clinical and radiographic follow-up at a minimum of two years. These cases constituted the final analysis cohort. Preoperative radiographic severity was assessed using the Kellgren-Lawrence classification. All included knees were classified as grade 3 or 4. Cartilage status was assessed arthroscopically at approximately 1 year postoperatively using the International Cartilage Repair Society (ICRS) grading system. All analyses were performed on a per-knee basis.
resultsAll included knees were classified as Kellgren-Lawrence grade 3 or 4. At 1-year follow-up, 37.0% of knees demonstrated macroscopic cartilage surface improvement in the trochlear groove, whereas deterioration was observed in 6.2%. Although the median ICRS grade of the trochlea remained unchanged, the distribution shifted toward lower grades (p < 0.01). The medial patellar facet showed a slight improvement in median ICRS grade, while the lateral facet remained largely unchanged. All J-KOOS subscale scores improved significantly at 2 years postoperatively (p < 0.001). No significant correlation was observed between arthroscopic cartilage changes and improvements in clinical outcomes.
conclusionsIn knees with complete 2-year follow-up, HCWHTO was associated with macroscopic cartilage surface changes, including redistribution toward lower ICRS grades in the trochlea at 1 year after surgery. However, these changes were not significantly correlated with clinical outcomes at 2 years postoperatively.
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