Editorial Commentary: Long-Term Outcomes After High Tibial Osteotomy May Depend More on Lateral Compartment Preservation Than on Medial Cartilage Regeneration.

The long-term clinical benefit of cartilage regeneration after high tibial osteotomy remains controversial. Although such regeneration is often observed during second-look arthroscopy, long-term studies suggest that it does not ensure durable improvements in function or radiographic outcomes. Rather, preservation of lateral compartment integrity through precise alignment correction appears more critical to long-term success than medial regeneration alone. Therefore, surgical strategies should prioritize accurate correction and maintenance of optimal load distribution, with biological augmentation of cartilage repair considered a complementary direction for future investigations.