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  • Author: Jae-Sung An x
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Ahmed Mabrouk Mid Yorkshire Teaching Hospitals, Yorkshire, United Kingdom
Institut du mouvement et de l’appareil locomoteur, Marseille, France

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Jae-Sung An Institut du mouvement et de l’appareil locomoteur, Marseille, France

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Kristian Kley Orthoprofis Hannover, Hannover, Germany

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Komal Tapasvi The Orthopaedic Speciality Clinic, Pune, India

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Sachin Tapasvi The Orthopaedic Speciality Clinic, Pune, India

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Matthieu Ollivier Institut du mouvement et de l’appareil locomoteur, Marseille, France

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  • Varus knees with associated cartilage pathologies are not uncommon scenarios that present to orthopaedic surgeons.

  • There is no agreement on the ideal management of varus knees with concomitant cartilage pathology.

  • Through a literature review, the authors tried to answer three main questions:

  • On October 2022, OVID MEDLINE, EMBASE, and COCHRANE databases were searched. Clinical studies reporting on clinical, radiologic, or macroscopic cartilage regeneration following either isolated knee osteotomy or concomitant osteotomy and a cartilage procedure were reviewed.

  • Despite controversies, the literature demonstrated favourable outcomes of combined knee osteotomy and a cartilage procedure in patients with substantial deformity and cartilage defects.

  • Isolated high tibial osteotomy may induce cartilage regeneration in several scenarios and severities of concomitant malalignment and cartilage defects.

  • There are recommendations that knee osteotomy should be added to a cartilage procedure when an extra-articular deformity of > 5° is detected.

  • Some studies report good outcomes for combining a knee osteotomy with cartilage grafting, but they lack a control group of isolated osteotomy.

  • There is still scarce of evidence on the influence of osteotomies on cartilage regeneration and the outcomes of concomitant osteotomy and different cartilage procedures vs isolated osteotomies.

  • With advanced statistical evaluation (artificial intelligence, machine learning) of big datasets, more answers and better results will be delivered.

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