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Effect of open wedge high tibial osteotomy on the lateral tibiofemoral compartment in sheep. Part III: analysis of the microstructure of the subchondral bone and correlations with the articular cartilage and meniscus

  • Experimental Study
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

First, to evaluate whether medial open wedge high tibial osteotomy (HTO) induces alterations of the microstructure of the lateral tibial subchondral bone plate of sheep. Second, to test the hypothesis that specific correlations exist between topographical structural alterations of the subchondral bone, the cartilage and the lateral meniscus.

Methods

Three experimental groups received biplanar osteotomies of the right proximal tibiae: (a) closing wedge HTO (4.5° of tibial varus), (b) opening wedge HTO (4.5° tibial valgus; standard correction) and (c) opening wedge HTO (9.5° of valgus; overcorrection), each of which was compared to the non-osteotomised contralateral proximal tibiae. After 6 months, subchondral bone structure indices were measured by computed tomography. Correlations between the subchondral bone, the articular cartilage and the lateral meniscus were determined.

Results

Increased loading by valgus overcorrection led to an enlarged specific bone surface (BS/BV) in the subarticular spongiosa compared with unloading by varisation. The subchondral bone plate was 3.9-fold thicker in the central region of the lateral tibial plateau than in the submeniscal periphery. Its thickness in the central region significantly correlated with the thickness of the articular cartilage. In the submeniscal region, such correlation did not exist. In general, a higher degree of osteoarthritis (OA) correlated with alterations of the subchondral bone plate microstructure. OA of the submeniscal articular cartilage also correlated with worse matrix staining of the lateral meniscus.

Conclusion

Osteoarthritis changes are associated with alterations of the subchondral bone plate microstructure. Specific topographical relationships exist in the central region between the articular cartilage and subchondral bone plate thickness, and in the submeniscal periphery between and the articular cartilage and lateral meniscus. From a clinical perspective, the combined follow-up data from this and the previous two investigations suggest that open wedge valgus HTO is a safe procedure for the lateral compartment to manage medial osteoarthritis of the knee with varus malalignment in the short term.

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Acknowledgments

We thank Dr. vet. Altmann and her team, Bad Langensalza, Thuringia, for their excellent support in the animal care. Supported in part by an AGA Research Grants to HM and DP, by a Grant of the Department of Orthopaedic Surgery, Saarland University, Homburg/Saar and by a grant of the Center of Experimental Orthopaedics, Saarland University, Homburg/Saar. HM, MC and DP are partners in the “Cartilage Net”, supported by the INTERREG IV Programme of the European Union.

Conflict of interest

None.

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Authors and Affiliations

  1. Center of Experimental Orthopaedics, Saarland University, Kirrbergerstr. 1, Building 37, 66421, Homburg, Saarland, Germany

    Raphaela Ziegler, Lars Goebel, Magali Cucchiarini & Henning Madry

  2. Department of Orthopaedic Surgery, Saarland University, 66421, Homburg, Germany

    Lars Goebel & Henning Madry

  3. Department of Diagnostic and Interventional Radiology, Saarland University Medical Center, Kirrberger Straße, Building 57, 66421, Homburg, Saarland, Germany

    Roland Seidel

  4. Department of Orthopaedic Surgery, Centre Hospitalier de Luxembourg, 1460, Luxembourg, Luxembourg

    Dietrich Pape

  5. Sports Medicine Research Laboratory, Public Research Centre for Health, Luxembourg, Centre Médical de la Fondation Norbert Metz, 76 Rue d’Eich, 1460, Luxembourg, Luxembourg

    Dietrich Pape

  6. Cartilage Net of the Greater Region, Homburg, Germany

    Magali Cucchiarini, Dietrich Pape & Henning Madry

Authors
  1. Raphaela Ziegler
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  2. Lars Goebel
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  4. Magali Cucchiarini
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  5. Dietrich Pape
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  6. Henning Madry
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Correspondence to Henning Madry.

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Ziegler, R., Goebel, L., Seidel, R. et al. Effect of open wedge high tibial osteotomy on the lateral tibiofemoral compartment in sheep. Part III: analysis of the microstructure of the subchondral bone and correlations with the articular cartilage and meniscus. Knee Surg Sports Traumatol Arthrosc 23, 2704–2714 (2015). https://doi.org/10.1007/s00167-014-3134-y

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  • DOI: https://doi.org/10.1007/s00167-014-3134-y

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