Comparison of Clinical, Radiologic, and Arthroscopic Outcomes Between the Microfracture and Microdrilling Techniques for Articular Cartilage Defects in Medial Opening-Wedge High Tibial Osteotomy
Bibliographic record
Abstract
Background: Microfracture is the most common procedure for cartilage lesions during medial opening-wedge high tibial osteotomy (MOWHTO), but microdrilling has recently been introduced as an alternative technique. Purpose: To compare the clinical, radiologic, and arthroscopic outcomes of microfracture and microdrilling during MOWHTO. Study Design: Cohort study; Level of evidence, 3. Methods: Included were 92 patients who underwent MOWHTO with either microfracture (n = 46) or microdrilling (n = 46), with a minimum follow-up of 24 months. Clinical outcomes included visual analog scale (VAS) for pain, Lysholm score, International Knee Document Committee (IKDC) subjective score, Western Ontario and McMaster Universities index (WOMAC), and objective IKDC grade. Medial femoral condyle (MFC) cartilage repair status was evaluated at 12 months postoperatively using the MOCART (magnetic resonance observation of cartilage repair tissue) 2.0 and the International Cartilage Regeneration & Joint Preservation Society (ICRS) Cartilage Repair Assessment (CRA) grade. Results: At 6 months postoperatively, the microdrilling group exhibited higher minimal clinically important difference achievement rates than the microfracture group for VAS pain (63.1% vs 41.3%; P = .04), Lysholm (61.2% vs 41.3%; P = .02), and IKDC subjective score (78.3% vs 45.7%; P = .001). At 12 months postoperatively, the microdrilling group exhibited significantly better VAS pain (33.7 ± 17.6 vs 25.7 ± 18.1; P = .03), Lysholm (57.8 ± 12.2 vs 67.9 ± 21.4; P = .007), and IKDC subjective score (52.9 ± 13.5 vs 61.9 ± 10.4; P = .001) compared with the microfracture group, but this difference was not observed at 24 months. WOMAC scores were superior in the microdrilling group at 6 months (32.1 ± 16.7 vs 48.4 ± 16.2; P = .004), 12 months (25.4 ± 15.4 vs 38.1 ± 17.0; P = .03), and 24 months (21.4 ± 13.9 vs 37.3 ± 14.6; P = .02). MFC cartilage repair status was superior in the microdrilling versus microfracture group (ICRS CRA grade, 8.2 ± 2.2 vs 6.7 ± 2.1 [ P = .005]; MOCART 2.0 score, 56.3 ± 12.8 vs 49.7 ± 8.9 [ P = .02]). At 24 months postoperatively, the microdrilling group had a higher proportion of IKDC A or B grades (84.8% vs 50.0%; P = .001). Conclusion: Combining MOWHTO with microdrilling for MFC defects resulted in earlier clinical recovery and superior functional outcomes over 24 months postoperatively compared with microfracture and demonstrated excellent cartilage repair on postoperative evaluation.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".