The influence of high tibial osteotomy on the patello-femoral joint: an arthroscopic study

In the presented prospective study, high tibial osteotomy for medial gonarthrosis was performed in 95 patients (105 knees) using four different operative techniques with different rehabilitation programs. All patients underwent arthroscopic examination at the time of the osteotomy. Advanced cartilage damage was seen in the central patcllar area and on the lateral facet. Cartilage damage on the trochlea was distributed similar to the degenerative changes seen on the patella. Follow-up arthroscopy was performed in 85 knees, 10 months later, together with internal fixateur removal. This demonstrated cartilage regeneration on the lateral facet and the lateral central area, while on the medial facet degenerative changes progressed. On the trochlea there was cartilage regeneration without significant side distribution in 23.5% of the knees, while 62.4% remained unchanged. There was no evidence of a change in patella position on the trochlea secondary to valgus osteotomy. There was no difference in the clinical improvement of joint symptoms and no statistical difference in cartilage regeneration after 1 year between all groups.