Well, that was a valiant attempt in a failed effort. I'm going to argue just do the osteotomy. And I'd like to thank Mayesika's friends for teaching us Americans the power of osteotomy. And Eric, this ship is going down. And MacGyver, with his little sutures and his little anchor, are not going to change that natural history. A post-op protocol of weight loss, unloader bracing, and prayer is not going to get the job done. Let's just look at the case history. This patient is young. They're active. This is subacute. This ship has already sailed. They are debilitated. They have marginal gains and will benefit greatly from osteotomy. They have asymmetry, a varus, and a thrust. I mean, this is like 101 osteotomy, osteotomy, osteotomy. So where are we going here? They already have extrusion. And we have measurements that give us obvious targets for correction. And if that's not enough, the person who made this case told us he did an osteotomy. So I could stop there, but I won't. I have a little time left. Pre-op varus, greater than 5 degrees, and post-op meniscus extrusion are bad actors, predictive of clinical failure after your root repair. Extrusion itself is an independent predictor of chondrosis and subchondral change. You pointed out that extrusion is not improved after root repair, so the incidence of root failure is much higher in those patients. Aaron, who's here, who I love and has taught me a lot about this, his outcomes for centralization might be good. But if you actually read the paper, you'll see that he excluded patients like this with greater than 5 degrees of malalignment. Our friends around the world have taught us that isolated HTO reduces extrusion. This is the Brazilian experience. This is the South Korean experience. This is the Japanese experience. They've even taught us that we may not need to do the root repair with our HTO. High rates of healing, HTO alone. And if the root healed or didn't heal, it does not even correlate with our clinical outcome. And again, this has been corroborated across the world. So we need to think more globally here. So just to finalize, varus greater than 5 is clearly a major risk factor for root repair failure. Repair alone does not fix the extrusion. We have no idea in patients greater than 5 degrees if centralization is gonna do anything to affect the natural history. Osteotomy gets it done. Reduce extrusion, improves outcomes with or without meniscus healing. So Eric, I love you, but you're definitely on the wrong side of history on this one. And actually, he emailed Mike and I and said, I would love to switch, he said. And Eric, Instagrams, I don't know why you need 10 people to do an HTO, we do it on Mondays. But at any rate, you like osteotomy. It's an international solution, and HTO is a go. And I apologize, Eric. I love you. Woo-hoo. Great.

osteotomy

varus

thrust

extrusion

treatment failure