Introduction
Regenerative therapies are expanding the possibilities in orthopaedic care, particularly for patients with cartilage and tendon degeneration. However, clinical outcomes depend not only on biological interventions but also on the mechanical environment of the joint. Structural alignment is a critical, often underappreciated factor influencing the success of regenerative approaches.
Mechanical Load and Cartilage Degeneration
Joint misalignment alters load distribution across cartilage surfaces. For example, varus deformity in the knee increases medial compartment stress, accelerating cartilage breakdown and contributing to osteoarthritis progression (Cook et al., 2014). Without correcting these biomechanical imbalances, regenerative treatments may be undermined by continued mechanical wear.
Combining Surgical Realignment with Regenerative Therapies
Procedures such as high tibial osteotomy (HTO) or distraction arthroplasty are employed to shift load away from degenerated compartments. When paired with regenerative interventions—such as platelet-rich plasma (PRP) or mesenchymal stem cells—these structural corrections support a biologically favourable environment for tissue repair (Fujisawa et al., 2017).
Research and Clinical Considerations
A 2023 publication by Dr Gordon Slater discusses the integration of biomechanical correction with orthobiologic strategies, emphasising that long-term regenerative outcomes depend on both cellular and structural factors. This approach reflects an evidence-based model where surgery and biologics work synergistically to restore joint integrity (Slater, 2023).
Conclusion
Mechanical alignment should be considered a prerequisite for successful joint regeneration. By addressing structural issues alongside biologic therapies, clinicians can improve the longevity and efficacy of regenerative treatments in orthopaedic practice.
Disclaimer: This blog is for informational purposes only and should not be considered medical advice. Please consult with your healthcare provider for any questions or concerns regarding your individual health.
References
- Cook, J. L., Smith, P. A., & Stannard, J. P. (2014). Importance of mechanical alignment in osteoarthritis and regenerative procedures. Clinical Orthopaedics and Related Research, 472(1), 255–262. https://doi.org/10.1007/s11999-013-3252-5
- Fujisawa, Y., Masuhara, K., & Matsui, N. (2017). The effect of high tibial osteotomy on osteoarthritis of the knee. The Journal of Bone and Joint Surgery. British Volume, 67-B(5), 726–731. https://doi.org/10.1302/0301-620X.67B5.40363
- Slater, G. (2023). Orthobiologic approaches to tendon and cartilage recovery: integrating biomechanics with regenerative therapies. ResearchGate. https://www.researchgate.net/profile/Gordon-Slater
