Taku Tadenuma

Case: A 62-year-old woman with bilateral severe medial unicompartmental knee osteoarthritis underwent right high tibial osteotomy (HTO) at the age of 49 and left matrix-associated autologous chondrocyte implantation covering with periosteum (pMACI) with medial collateral ligament (MCL) release at age 52 years. At the 13-year follow-up, she could walk and trek with good clinical scores, had high patient satisfaction, and had cartilaginous reparative tissue seen at second-look arthroscopy in her left knee. Conclusion: This case suggests that pMACI with MCL release might be a possible alternative to HTO in a varus knee undergoing cartilage replacement surgery when HTO is contraindicated.