Safety, Feasibility, and Radiographic Outcomes of the Anterior Meniscal Takedown Technique to Approach Chondral Defects on the Tibia and Posterior Femoral Condyle: A Matched Control Study

Objective Takedown of the anterior meniscus to facilitate exposure of the cartilage defects located on the tibial plateau and/or posterior femoral condyle with subsequent reattachment is being performed clinically; however, clinical evidence is lacking to support the safety of this technique. The aim of this study was therefore to investigate whether meniscal extrusion develops after patients undergo meniscus takedown and transosseous refixation during autologous chondrocyte implantation (ACI). Design We analyzed data from 124 patients with a mean follow-up of 6.8 ± 2.5 years. Sixty-two patients who underwent (ACI) with anterior meniscus takedown and refixation by the senior surgeon (TM), were compared with a matched control group of patients who underwent ACI without meniscus takedown. Meniscal extrusion was investigated by measuring the absolute value and the relative percentage of extrusion (RPE) on 1.5-T magnetic resonance images (MRI) at final follow-up. The number of menisci with radial displacement greater or lesser than 3 mm was determined. In cases where a preoperative MRI was available, both pre- and postoperative meniscal extrusion was evaluated ( n = 30) in those patients undergoing meniscal takedown. Results There was no significant difference in either absolute meniscus extrusion, RPE, or extrusion rate in patients with and without meniscus takedown. Among patients with meniscal takedown and both pre- and postoperative MRI scans, absolute meniscus extrusion, RPE, and extrusion rate showed no significant differences. Conclusion Meniscal takedown and subsequent transosseous refixation is a safe and effective technique for exposure of the tibial plateau and posterior femoral condyle.

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An imaging measurement study of normal knee parameters in southeast China

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/1573405617666210827131228 ◽

2021 ◽

Vol 17 ◽

Author(s):

Huitong Liu ◽

Bingqiang Xu ◽

Eryou Feng ◽

Shizhang Liu ◽

Wei Zhang ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Knee Arthroplasty ◽

Tibial Plateau ◽

Femoral Condyle ◽

Age Groups ◽

Young Group ◽

Normal Female ◽

Valgus Angle ◽

Significant Difference ◽

Total Knee

Background: Imaging measurement of distal femur and proximal tibia has been the hot point in the research of total knee arthroplasty and prosthesis development, which is an important treatment for patients with advanced knee joint disease. This study retrospectively investigated the digital imaging measurement of normal knee parameters in southeast China and evaluated their clinical value. Methods: From February 2010 to May 2014, and in accordance with the inclusion criteria, a total of 677 knees (334 female knees and 343 male knees) were categorized into 3 age groups. Clinical and digital imaging data, including the distal femoral condyle diameter (FCD), tibial plateau diameter (TPD), the distance between the medial tibial plateau and fibular head (DPF), tibiofemoral valgus angle, distal femoral valgus angle, proximal tibia (PT) varus angle and the angle from femoral condyle to tibial perpendicular (FT), were measured by using AutoCAD 10.0 software. All measured variables were statistically analyzed by SPSS statistical software (version 18.0). Results: Data are presented as the mean ± standard deviation. The normal female and male femoral condyle diameter was (7.69 ± 0.46) cm and (8.68 ± 0.55) cm, while the normal female and male tibial plateau diameter was (7.66 ± 0.46) cm and (8.60 ± 0.55) cm, respectively. The normal female and male DPF was (0.76 ± 0.36) cm and (0.79 ± 0.36) cm. For females and males, the tibiofemoral valgus angle and distal femoral valgus angle were (3.89 ± 2.20) ° and (3.29 ± 2.12) °, (9.03 ± 2.18) ° and (8.25 ± 2.20) °. As the two methods to measure tibial plateau varus angle, PT angle of normal female and male was (4.29 ± 1.86) ° and (4.84 ± 2.23) °, while the normal female and male FT angle was (5.34 ± 1.95) ° and (5.52 ± 2.07) °. Based on the data obtained, we found significant differences between the two genders in terms of the femoral condyle diameter and tibial plateau diameter in all age groups (P < 0.01). The DPF parameter showed an obvious difference between the young group and the middle-aged group (P < 0.05), and no significant difference was observed between the sides and genders (P > 0.05). The distal femoral valgus angle showed statistical differences between genders in the left side of the young group and middle-aged group (P < 0.05), while angle PT and FT showed no significant difference (P > 0.05). Conclusion: A large number of knee measurements was obtained, and a local knee database was developed in this study. Imaging measurement prior to total knee arthroplasty is clinically important for increasing the accuracy and long-term efficacy of total knee arthroplasty. These data can also provide useful information for knee surgery and sports medicine as well as prosthesis development.

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Comparison of outcomes of ORIF versus bidirectional tractor and arthroscopically assisted CRIF in the treatment of lateral tibial plateau fractures: a retrospective cohort study

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02447-w ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Xiangtian Deng ◽

Hongzhi Hu ◽

Yiran Zhang ◽

Weijian Liu ◽

Qingcheng Song ◽

...

Keyword(s):

Cohort Study ◽

Internal Fixation ◽

Clinical Outcomes ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Tibial Plateau ◽

Clinical Score ◽

Lateral Tibial Plateau ◽

Significant Difference

Abstract Background Lateral tibial plateau fractures (TPFs) are often treated with conventional open reduction and internal fixation (ORIF) through standard anterolateral sub-meniscal arthrotomy. There has been increasing support for “bidirectional rapid redactor” device-assisted closed reduction and internal fixation (CRIF) for treating TPFs. The aim of the present study is to compare the clinical and radiological outcomes between CRIF and ORIF procedures. Methods We performed a retrospective cohort study of 55 lateral TPF patients (Schatzker types I–III) who accepted surgical treatment at our trauma level 1 center between January 2016 and January 2018. They were divided into the CRIF group (32 patients) and the ORIF group (23 patients) based upon the different surgical protocols. The patients’ clinical outcome analysis was evaluated by using the Knee Society Score (KSS) and Rasmussen’s clinical score. For radiological assessment, changes in tibial plateau width (TPW), articular depression depth (ADD), medial proximal tibial angle (MPTA), and posterior tibial slope angle (PTSA) were evaluated using radiographs and computed tomography (CT) scan. Results The CRIF group had a mean follow-up of 28.9 months, and the ORIF group had a mean follow-up of 30.7 months (p>0.05). Furthermore, there was no statistically significant difference in terms of age, gender, injury mechanism, follow-up time, time interval from injury to surgery, and Schatzker classification in the two groups. With respect to the clinical outcomes including the KSS score and Rasmussen’s clinical score, there was also no significant difference (p>0.05). Nevertheless, the CRIF group had lower intra-operative blood loss, shorter hospitalization days, and better range of movement of the knee joint than the ORIF group (p<0.05). Furthermore, CRIF had better radiological results when compared to the ORIF group using Rasmussen’s radiological score (p<0.05), although no significant difference was observed in TPW, ADD, MPTA, and PTSA between the two groups (p>0.05). Conclusion The present study showed that CRIF could achieve comparable clinical outcomes and better radiological results for treating lateral TPFs as compared with conventional ORIF.

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A comparative study of surgical outcomes of ossiculoplasty using biomaterials and autologous implants

Bangladesh Journal of Otorhinolaryngology ◽

10.3329/bjo.v19i1.12619 ◽

2013 ◽

Vol 19 (1) ◽

pp. 29-35 ◽

Cited By ~ 3

Author(s):

Rahul Kawatra ◽

Puneet Maheshwari

Keyword(s):

Cost Effectiveness ◽

Success Rate ◽

Pure Tone ◽

Suppurative Otitis Media ◽

Extrusion Rate ◽

Hearing Sensitivity ◽

Pure Tone Audiogram ◽

Significant Difference ◽

And Cartilage

Objective: To determine amongst biomaterials (Teflon and Silicon) and autologous materials (autologous incus and cartilage), the one which give the best results of ossiculoplasty, in terms of increase in hearing sensitivity including cost effectiveness. Methods: Study was conducted in Eras Lucknow Medical College & Hospital, Lucknow, India. Randomized prospective crossover study with eighteen months follow up. 80 patients of Chronic Suppurative Otitis Media (CSOM) were randomly assigned for ossiculoplasty using biomaterials (Teflon and silicon) and autologous materials (bone and cartilage ). Surgical outcome was compared for all the four types of implant material used, in terms of increase in hearing sensitivity, extrusion rate, cost effectiveness. Pre-operatively all patients had a pure tone audiogram with a four frequency average (0.5/1/2/4 kHz) calculated for both air conduction and bone conduction. Post-operatively a pure tone audiogram using (0.5/1/2/4 kHz) was performed at 18 months follow-up. Results: Mean hearing gain (change in A-B gap) was 20.80±7.08 dB in autologous group and 19.93±7.27 dB in biomaterials. Hearing Success Rate-It indicates, total no. of patients, whose postoperative AB Gap (calculated at 500Hz,1,2,3 KHz) is equal to or less than 20 dB. In the present study the overall hearing success rate at follow up period of 4 months is 78.8%. For autologous implants it is 80% and for biomaterials it is 77.5%. Conclusion: The study concluded that there is no significant difference in improvement in AB gap, extrusion rate of implant and overall success rate between biomaterials (Teflon, silicon) and autologous implants (autologous incus, cartilage). The only significant difference between the two groups was the cost effectiveness. Hence, it is concluded in our study that the biomaterials and autologous implants used in the study have equal overall efficacy. The autologous material requires no extra cost so it can be considered as a preferred choice of implant, in comparison to biomaterial in SAARC countries, where the majority is of poor patients. DOI: http://dx.doi.org/10.3329/bjo.v19i1.12619 Bangladesh J Otorhinolaryngol 2013; 19(1): 29-35

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Preoperative Meniscal Extrusion Predicts Unsatisfactory Clinical Outcomes and Progression of Osteoarthritis after Isolated Partial Medial Meniscectomy: A 5-Year Follow-Up Study

The Journal of Knee Surgery ◽

10.1055/s-0040-1715109 ◽

2020 ◽

Author(s):

João V. Novaretti ◽

Diego C. Astur ◽

Elton L.B. Cavalcante ◽

Camila C. Kaleka ◽

Joicemar T. Amaro ◽

...

Keyword(s):

Clinical Outcomes ◽

Medial Meniscus ◽

International Knee Documentation Committee ◽

Meniscal Extrusion ◽

Optimal Cutoff ◽

Medial Meniscectomy ◽

The Mean ◽

Medial Meniscus Extrusion ◽

Meniscus Extrusion

AbstractThe objective of this study was to examine the association between preoperative meniscal extrusion of patients undergoing partial medial meniscectomy with clinical outcomes and progression of osteoarthritis and to determine the extent of meniscal extrusion associated with unsatisfactory clinical outcomes and progression of osteoarthritis. Ninety-five patients who underwent partial medial meniscectomy with a minimum follow-up of 5 years were retrospectively reviewed. Preoperative meniscal extrusion was evaluated with magnetic resonance imaging. Patients were assessed preoperatively and postoperatively with Lysholm and International Knee Documentation Committee (IKDC) subjective scores for clinical outcomes and with IKDC radiographic scale for osteoarthritis. An ANOVA (Analysis of Variance) was used to analyze the variations in meniscal extrusion and the clinical and radiological outcomes. A regression analysis was performed to identify factors that affect preoperative medial meniscus extrusion and that influence results after partial meniscectomy. An optimal cutoff value for meniscal extrusion associated with unsatisfactory clinical outcomes and progression of osteoarthritis was established. Significance was set at p < 0.05. The mean ± SD preoperative and postoperative Lysholm scores were 59.6 ± 15.5 versus 83.8 ± 13.1 (p < 0.001) and the mean preoperative and postoperative IKDC subjective scores were 59.4 ± 16.8 versus 82.0 ± 15.8 (p < 0.001). Meniscal extrusion greater than 2.2 mm (sensitivity, 84%; specificity, 81%) and 2.8 mm (sensitivity, 73%; specificity, 85%) was associated with unsatisfactory (poor/fair) Lysholm and IKDC subjective scores, respectively. The progression of osteoarthritis, characterized as a change of at least one category on the IKDC radiographic scale, occurred when meniscal extrusion was greater than 2.2 mm (sensitivity, 63%; specificity, 75%). Patients with higher body mass index (BMI) had significantly greater meniscal extrusion that patients with normal BMI (p < 0.001). The medial meniscus was more extruded in patients with horizontal and root tears. In conclusion, patients with preoperative meniscal extrusion of 2.2 mm or greater had unsatisfactory clinical outcomes and progression of osteoarthritis after partial medial meniscectomy at a minimum of 5 years follow-up. Higher BMI and horizontal and root tears were associated with greater preoperative meniscal extrusion.

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Arthroscopic-Guided Balloon Tibioplasty in Schatzker III Tibial Plateau Fracture

Joints ◽

10.1055/s-0039-1697607 ◽

2018 ◽

Vol 06 (04) ◽

pp. 220-227 ◽

Cited By ~ 1

Author(s):

Fabrizio Cuzzocrea ◽

Eugenio Jannelli ◽

Alessandro Ivone ◽

Simone Perelli ◽

Alberto Fioruzzi ◽

...

Keyword(s):

Ct Scan ◽

Tibial Plateau ◽

Case Series ◽

Clinical Score ◽

Joint Surface ◽

X Rays ◽

Level Of Evidence ◽

Significant Difference ◽

The Mean

Abstract Purpose The study aims to present the results at a mean 28-months follow-up of arthroscopic-guided balloon tibioplasty and to spot some technical tricks and some practice using tools and materials. Methods The study relates to six patients with tibial plateau fractures type Schatzker III with tibial plateau depression more than 4 mm at preoperative computed tomography scan (CT-scan). The follow-up period ranged from 22 to 33 months, with a mean of 28 months. No patients were lost to follow-up. The patients were evaluated clinically using the Rasmussen score system and Lysholm score systems at 6 to 12 and 24 months, postoperatively. Radiographic evaluations (standard X-rays) were done preoperatively at 1, 3, and 12 months postoperatively while a CT-scan with 3D reconstruction was performed preoperatively, at the first day and 6 months, postoperatively. Results The mean Rasmussen clinical score at 6 months postoperatively was 26.3 while at 1-year postoperatively the mean Rasmussen clinical score was 28.33. At 2-year postoperatively the mean Rasmussen clinical score was 28.83. Statistically significant difference was found in 6-months and 2-years results (p < 0.05). CT-scan achieved the first postoperative day showed the recovery of approximately 70% of the area of the interested tibial plateau, restoring of the joint surface without articular bone free fragments. Conclusion The described surgical procedure, if correctly performed with proper indications (Schatzker III), respect the principles mentioned above and the clinical and radiological results confirm our purpose. Level of Evidence This is a therapeutic case series, level IV study.

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Clinical effects of staged joint replacement in patients with septic arthritic knee

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-020-02062-1 ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Ming Ni ◽

Jun Fu ◽

Tao Deng ◽

Erlong Niu ◽

Chi Xu ◽

...

Keyword(s):

Joint Replacement ◽

Tibial Plateau ◽

Recurrent Infection ◽

Clinical Effects ◽

Antibiotic Cement ◽

Post Surgery ◽

Significant Difference ◽

Thorough Debridement ◽

Arthritic Knee

Abstract Objective To assess the clinical effect of staged joint replacement for the treatment of septic arthritic knee and the therapeutic differences between antibiotic cement beads and the tibial plateau spacer. Methods Twenty-three patients (24 knee joints) treated with a staged joint replacement for septic arthritis knee were retrospectively reviewed between March 2014 and April 2018. At the first stage, thorough debridement and irrigation with self-made antibiotic cement beads or tibial plateau spacer were performed. After that, systemic antibiotic treatment was followed; when the infection was surely eliminated, the second-stage TKA was performed. Knee mobility (range of motion, abbreviated to ROM) and function (HSS scores system) were evaluated before surgery, in the interval period, and after joint replacement. Results All patients finished follow-up, and the mean follow-up time was 27.3 months (12–54 months). Each group has one patient replaced with a homotypic spacer, and all patients eventually cleared the infection. None of the patients had a recurrent infection. The mobility and HSS scores of the two groups were significantly improved postoperation (p < 0.05). And there was no significant difference in the post-surgery ROM (p = 0.153) and the HSS score (p = 0.054) between the two groups. Conclusion Staged joint replacement is an efficacious way for septic arthritic knees, whether tibial plateau spacer or antibiotic cement beads were used, which can effectively control infection and improve knee function.

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Clinical effects of two-stage joint replacement on septic arthritic knee

10.21203/rs.3.rs-18004/v2 ◽

2020 ◽

Author(s):

Ming Ni ◽

Jun Fu ◽

Tao Deng ◽

Erlong Niu ◽

Chi Xu ◽

...

Keyword(s):

Joint Replacement ◽

Tibial Plateau ◽

Recurrent Infection ◽

Clinical Effects ◽

Antibiotic Cement ◽

Post Surgery ◽

Significant Difference ◽

Post Operation ◽

Arthritic Knee

Abstract Objective: To assess the clinical effect of staged joint replacement for the treatment of septic arthritic knee and the therapeutic differences between antibiotic cement beads and the tibial plateau spacer. Methods: 23 patients (24 knee joints) treated with staged joint replacement for septic arthritis knee were retrospectively reviewed between March 2014 and April 2018. At the first-stage, thoroughly debridement and irrigation with self-made antibiotic cement beads or tibial plateau spacer was performed; After that, systemic antibiotic treatment was followed; when the infection was surely eliminated, second-stage TKA was performed. Knee mobility (range of motion, abbreviated to ROM) and function (HSS scores system) were evaluated before surgery, in the interval period, and after joint replacement. Results: All patients finished follow-up and the mean follow-up time was 27.3 months (12-54 months). Each group has one patient replaced with a homotypic spacer, and all patients eventually cleared the infection. None of the patients had a recurrent infection. The mobility and HSS scores of the two groups were significantly improved post-operation (p<0.05). And there was no significant difference in post-surgery ROM (P=0.153) and the HSS score (P = 0.054) between the two groups. Conclusion: Staged joint replacement is an efficacious way for septic arthritic knees, whether tibial plateau spacer or antibiotic cement beads were used, which can effectively control infection and improve knee function.

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Estimation of the posterior tibial slope on magnetic resonance images in Serbian population

Vojnosanitetski pregled ◽

10.2298/vsp160301203j ◽

2018 ◽

Vol 75 (2) ◽

pp. 154-158

Author(s):

Natasa Janjusevic ◽

Maja Vulovic ◽

Aleksandar Radunovic ◽

Milan Jovanovic ◽

Jasenka Vasic-Vilic ◽

...

Keyword(s):

Magnetic Resonance ◽

Tibial Plateau ◽

Statistical Tests ◽

Tibial Slope ◽

Magnetic Resonance Images ◽

Posterior Tibial Slope ◽

Mean Values ◽

Posterior Tibial ◽

Significant Difference ◽

Medial Tibial Slope

Background/Aim. Preservation of an adequate posterior tibial slope (PTS) during total knee arthroplasty is crucial for the biomechanical stability and function of the knee joint. Studies that investigated anatomical features of the tibial plateau found significant gender and inter-population differences in all components of the PTS. The aim of this study was to establish reference values of PTS in Serbian population and to explore if there is any difference in the tibial plateau inclination between genders. Methods. We retrospectively reviewed 161 magnetic resonance images (MRIs) of the knee of adult patients examined in Medical Military Academy in Belgrade, Serbia, in a period from November 2011 to September 2014. Measurements of PTS components: medial tibial slope (MTS), lateral tibial slope (LTS), and coronal tibial slope (CTS) were performed through several steps, according to the suggestions in the recent literature. Obtained values for each tibial slope were compared between gender subgroups using appropriate statistical tests. Results. Mean values of each component of the posterior tibial slope for male vs. female subgroups were as follows: MTS 3.7? ? 2.8? vs. 5.1? ? 2.9?, LTS 4.2? ? 2.8? vs. 4.3? ? 2.7?, and CTS 3.9? ? 2.4? vs. 3.3? ? 1.9? respectively. The medial tibial slope was significantly higher in females than in males (p = 0.005). The mean value of the coronal tibial slope was greater in males without statistically significant difference (p = 0.105). Conclusion. This study demonstrated significant difference in MTS of the tibial plateau between males and females, being higher in the female subgroup.

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Clinical effects of two-stage joint replacement on septic arthritic knee

10.21203/rs.3.rs-18004/v1 ◽

2020 ◽

Author(s):

Ming Ni ◽

Jun Fu ◽

Tao Deng ◽

Erlong Niu ◽

Chi Xu ◽

...

Keyword(s):

Joint Replacement ◽

Tibial Plateau ◽

Recurrent Infection ◽

Knee Joints ◽

Clinical Effects ◽

Two Stage ◽

Antibiotic Cement ◽

Significant Difference ◽

Arthritic Knee

Abstract Objective: To assess the clinical effect of two staged joint replacement for the treatment of septic arthritic knee and the therapeutic differences between antibiotic cement beads and the tibial plateau spacer.Methods: 26 patients (27 knee joints) treated with spacer (antibiotic cement beads or the tibial plateau spacer) for septic arthritis knee were retrospectively reviewed between 2014 and 2018. At the first stage, thoroughly debridement and irrigation with self-made antibiotic cement beads or tibial plateau spacer was performed; After that, systemic antibiotic treatment was followed; when the infection was surely eliminated, Two-stage TKA was performed. Knee mobility (range of motion, abbreviated to ROM) and function (HSS scores system) were evaluated before surgery, in the interval period, and after joint replacement.Results: All patients finished follow-up and the follow-up time was 27.3 months (12-54 months). 23 patients (24 knee joints) completed the staged surgery as expected, 3 patients in the beads group gave up the second-stage operation after infection elimination. Each group has one patient replaced with a homotypic spacer, and all patients eventually cleared the infection. None of the patients had a recurrent infection. The mobility and HSS scores of the two groups were significantly improved post-operation (p<0.05). There was no significant difference in mobility between the two groups (p=0.153). The HSS score of the tibial plateau spacer group had a better trend of improvement after TKA (p= 0.054).Conclusion: Two-stage TKA is an efficacious way for septic arthritic knees, which can effectively control infection and improve knee function.

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Meniscal and Cartilage Changes on Serial MRI After Medial Opening-Wedge High Tibial Osteotomy

Orthopaedic Journal of Sports Medicine ◽

10.1177/23259671211047904 ◽

2021 ◽

Vol 9 (12) ◽

pp. 232596712110479

Author(s):

Han Gyeol Choi ◽

Yu Suhn Kang ◽

Joo Sung Kim ◽

Han Sang Lee ◽

Yong Seuk Lee

Keyword(s):

Tibial Plateau ◽

Femoral Condyle ◽

Relaxation Times ◽

Lateral Compartment ◽

Tibial Osteotomy ◽

T2 Relaxation ◽

Opening Wedge ◽

Wedge High Tibial Osteotomy ◽

Serial Mri

Background: Assessments of the effects of realignment using opening-wedge high tibial osteotomy (OWHTO) on the medial, lateral, and patellofemoral compartments have been limited to cartilage evaluations. Purpose/Hypothesis: The purpose was to evaluate the effects of OWHTO on the meniscus and cartilage of each compartment as a cooperative unit (meniscochondral unit) using serial magnetic resonance imaging (MRI). It was hypothesized that (1) favorable changes in the meniscochondral unit would occur in the medial compartment and (2) that changes in the patellofemoral and lateral compartments would be negligible. Study Design: Case series; Level of evidence, 4. Methods: Included were 36 knees that underwent OWHTO from March 2014 to February 2016 and had postoperative serial MRI. The MRI was performed at 19.9 ± 7.4 and 52.3 ± 8.3 months postoperatively, and the cartilage and meniscal changes were evaluated by highlighting the regions of interest. We evaluated the T2 relaxation times of each cartilage and meniscal area, the cross-sectional area of the menisci, and the extrusion of the medial meniscus (MM). The meniscochondral unit was assessed using subgroup analyses according to the status of the MM. Results: Significant decreases were seen in T2 relaxation times in the medial femoral condyle (MFC) ( P < .001) and medial tibial plateau (MTP) ( P = .050), and significant increases were seen in the lateral femoral condyle (LFC) ( P = .036). The change was more prominent in the MFC compared with the MTP and LFC ( P = .003). No significant changes were observed in the lateral tibial plateau, patella, or trochlear groove. The area of the lateral meniscus (body and posterior horn) was decreased compared with preoperative MRI ( P < .001 for both). The extent of MM extrusion decreased between the preoperative, first follow-up, and second follow-up MRIs ( P < .001). Conclusion: OWHTO affected the medial compartment positively, the lateral compartment negatively, and the patellofemoral compartment negligibly. The effects were more prominent and consistent in the medial than in the lateral compartment.

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