A study assessing Periarticular Knee Osteotomy Surgery Outcomes with or without Autologous Chrondrocyte Implantation (MACI technique).

The study is a prospective investigation analyzing the outcomes of patients with unicompartmental osteoarthritis undergoing osteotomy (HTO). We will compare the outcomes of patients undergoing HTO alone, to those undergoing the combined procedure of HTO and MACI resurfacing of the arthritic femoral and tibial surfaces of the involved compartment. It has been shown previously that some articular surface regeneration can occur with HTO alone, although the amount and quality of this regenerate is not well defined. The next stage in evolution of regeneration would seem to be to directly promote this by chondrocyte transplantation. Techniques such as MACI have successfully improved patient outcomes in the treatment of isolated chondral defects. The next step would be to show these improvements are possible in patients with more advanced osteoarthritis. Before advocating this however, it is important to show objective advantages of this technique over HTO alone. The outcomes will be assessed radiologically and clinically, and if the combined procedure is shown to have superior results, this would provide greater evidence for increased application of this technology. In addition, this would demonstrate a clear advantage of the MACI technique over periosteal patch techniques due to the difficulty of application of periosteal patches to diffuse arthritic defects.