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Article analysis:

The article provides a systematic review of multiple medical databases to determine the survival and clinical outcomes of high tibial osteotomy (HTO) with or without articular cartilage surgery and/or meniscal allograft transplantation in patients with medial compartment chondral pathology, varus malalignment, and/or meniscal deficiency. The study quality was assessed via modified Coleman Methodology Scores (MCMS), which were overall poor due to the lack of detailed information on the methodology used in the studies included in the review. The mean follow-up period was 7.1 years and mean subject age was 53 years old; survival of isolated HTO was 92.4%, 84.5%, 77.3%, and 72.3% at 5, 10, 15, and 20 years of follow-up respectively; at 5 years of follow-up, HTO with articular cartilage surgery had significantly greater survival than either isolated HTO or HTO with MAT; Isolated HTO, HTO with articular cartilage surgery, and HTO with MAT all significantly improved subjective and objective clinical outcome scores; at two years of follow-up, survival was significantly greater following OWHTO versus CWHTO; however there was no significant difference between the techniques at other time points with or without combined procedures such as articular cartilage surgery or MATs.

The article does not provide any information on potential biases that may have affected the results obtained from the studies included in this review such as selection bias due to nonrandomized studies or publication bias due to only including published studies in the review rather than unpublished ones as well which could have provided more reliable results if included in this review as well as possible conflicts of interest that may have been present among authors involved in these studies which could have led to one sided reporting or unsupported claims being made by them regarding their findings from these studies which could have affected the reliability of this review’s results if not taken into consideration when conducting it . Additionally , there is also a lack of exploration into counterarguments regarding these findings which could have provided more insight into their validity if explored further . Furthermore , there is also a lack of discussion regarding potential risks associated with undergoing these treatments such as infection , nerve damage , etc . which should be noted when discussing their efficacy . Lastly , there is also a lack of presentation regarding both sides equally when discussing these treatments ; while it does discuss their efficacy , it does not provide any information on potential drawbacks associated with them which should be discussed when providing an overview on them .