Fig. 2

Images from a 59-year-old woman show the following: (a) Ahlbäck grade I osteoarthritis with varus alignment of the lower limb before open wedge high tibial osteotomy with microfracture of the medial femoral condyle and medial tibial plateau; (b) Postoperative alignment of the lower limb obtained a satisfactory WBL ratio (64.5%). However, there was no recovery of the joint space narrowing; and (c) second-look arthroscopy shows insufficient coverage of the articular cartilage at postoperative 25 months. However, the Knee Society knee score significantly improved from 55 points preoperatively to 95 points, and the Western Ontario and McMaster Universities pain score significantly improved from 13 points preoperatively to 1 point at the time of second-look arthroscopy