Ackermann J, Merkely G, Arango D, et al. - The present study was performed to test graft survivorship in patients that underwent autologous chondrocyte implantation (ACI) or osteochondral allograft transplantation (OCA) for the treatment of focal full-thickness cartilage lesions on the medial femoral condyle (MFC) with and without concomitant high tibial osteotomy (HTO), depending on the pre-operative lower extremity alignment. Researchers retrospectively evaluated correlated factors for ACI and OCA graft failures. This study enrolled a sum of 168 patients who had undergone cartilage repair with ACI or OCA with or without HTO for focal chondral defects on the MFC by a single surgeon between March 2007 and February 2018. For each patient, clinical notes, operative reports and radiographic imaging were examined. They conducted Detailed Kaplan-Meier analyses based on patient’s mechanical axis alignment. They comparatively examined, failures and non-failures in patients treated with ACI or OCA. The outcomes of this research imply that neutral mechanical axis alignment, regardless whether physiologic or through HTO, enhances survivorship in patients undergoing medial compartment ACI. As per the results, neutral alignment also exhibited a trend towards enhanced survivorship in individuals after OCA, but this did not reach statistical significance.