High Tibial Osteotomy for Medial Compartment Knee Osteoarthritis : A Randomized Trial With Parallel Preference Arm.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: Disclosures: Disclosure forms are available with the article online. 14. Osteoporos Int. 2025 Dec;36(12):2483-2495. doi: 10.1007/s00198-025-07652-5. Epub 2025 Aug 27. More severe microdamage and micromechanical alterations: altered subchondral bone remodeling in varus knee osteoarthritis with osteoporosis. Zeng ZJ(1), PengPeng(1)(2), Huang CL(1), Yao FM(1), Wu JW(1), Gu BN(1), ShunLu(1), KunLin(1), Han LF(1), Yang XH(1), Yang JQ(1), He MC(3)(4), Wei QS(5)(6), He W(7)(8). Author information: (1)Guangzhou University of Chinese Medicine, Guangzhou, China. (2)Guangdong Provincial Second Hospital of Traditional Chinese Medicine, Guangzhou, China. (3)The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China. min-cong.he@hotmail.com. (4)State Key Laboratory of Traditional Chinese Medicine Syndrome, Guangzhou, China. min-cong.he@hotmail.com. (5)The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China. weiqshi@126.com. (6)State Key Laboratory of Traditional Chinese Medicine Syndrome, Guangzhou, China. weiqshi@126.com. (7)The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China. hw13802516062@163.com. (8)State Key Laboratory of Traditional Chinese Medicine Syndrome, Guangzhou, China. hw13802516062@163.com. Previous studies show osteoporosis causes tibial varus in knee osteoarthritis patients. Our analysis of tibial plateau specimens from osteoarthritic patients reveals that osteoporosis accelerates the deterioration of the subchondral microstructure of the tibial plateau, exacerbating tibial varus. INTRODUCTION: The relationship between osteoporosis (OP) and knee osteoarthritis (OA) has garnered significant clinical interest, particularly regarding the prevalence of tibial varus in patients suffering from both conditions. This study aimed to elucidate the association between OP and knee OA by examining bone remodeling and microstructural parameters of cartilage and subchondral bone. METHODS: We analyzed tibial plateau specimens from 50 patients, with 25 in the OA group and 25 in the OP-OA group. These specimens were further categorized into four subgroups: OA medial plateau, OA lateral plateau, OP-OA medial plateau, and OP-OA lateral plateau. Comprehensive analyses, including cartilage histology, micro-CT, immunohistochemical techniques, basic fuchsin histological analysis, and micro-finite elements, revealed significant microstructural differences and aberrant bone remodeling processes between the groups. RESULTS: The OARSI cartilage score of the medial tibial plateau was 13.71% higher in the OP-OA group compared to the OA group (P