Changes of degenerated articular cartilage of osteoarthritis of the knee after high tibial osteotomy, with special reference to regeneration

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High tibial osteotomy (HTO) was performed 127 osteoarthritic knees. Regeneration of the articular cartilage after HTO was observed and classified.Macroscopic findings at the time of plate removal were compared to those of the initial HTO.The averaged interval between these two operations was 25 months. The biopsy specimens were taken from the medial femoral condyle in 28 knees.At the time of the initial high tibial osteotomy the weight bearing portion of the articular surface was markedly degenerated in the medial femoral condyle. At the time of the plate removal, regeneration of the articular cartilage in the medial femoral condyle classified into the stages as Stage 0 (no regenerative change), Stage 1 (pink and yellowish fibrillation), Stage 2 (white fibrillation scattering), Stage 3 (partial coverage with white fibrillation), Stage 4 (overgrowth of white fibrocartilage), Stage 5 (even coverage with white fibrocartilage).The biopsy specimens showed different cell types and staining patterns between superficial zone with spindle shaped fibrocartilage-like cells and middle to deep zone with round shape distributed hyaline cartilage-like cells. Anti type collagen was observed in the cyteplasma and pericellar matrix of fibrocartilage-like cells while Safranin-0, anti-type collagen and S-100 protein was observed those area of hyaline cartilage-like cells. In the hybridization for mRNA of IGF-1 revealed that cells in the surface of regenerated cartilage were positive.