Introduction
High tibial osteotomy (HTO) is reported to be an effective treatment for varus knee osteoarthritis (OA) by redistributing the load line within the knee jointThis report showed clinical and radiological results of a new HTO technique incorporating the tibial tubercle into osteotomy line (TT-OWHTO). The cell-based tissue engineering approach using autologous adipose mesenchymal stem cells (AASCs) has addressed the issue of articular cartilage repair in knee OA. In this prospective study we have investigated the safety and also results of TT-OWHTO associated with AASC application.
Methods
74 treated with patient treated with TT-OWHTO for varus knee OA from September 2018 to April 2020, patients treated with TT-OWHTO alone (conventional group; n = 37) were pair-matched with those who underwent TT-OWHTO with an AASCs injection (injection group; n = 37) based on sex, age, and lesion size. Clinical outcomes were evaluated using the International Knee Documentation Committee (IKDC) score and Lysholm score.
Results
Clinical outcomes at final follow-up (mean, 20.2. months [conventional group] and 19.8 months [injection group]) improved for conventional group from 38.2 to 62.3 ± 9.1 (IKDC) and from 56.3 ± 11.2 (Lysholm); on the other hand for injection group IKDC improved from 38.4 ± 9.2 to 64.8 ± 13.4 and Lysholm from 56.7 ± 12.2 to 84.7 ± 16.. ( P < .001 and P = .034, respectively). At final follow-up, there was a significant difference in the mean IKDC and Lysholm scores between groups ( P = .049 and P = .041, respectively). Overall Radiological outcomes at final follow-up showed improved knee joint alignment relative to patients' preoperative conditions.
Conclusion
The group that received an AASCs injection showed better IKDC and Lysholm scores at final follow-up than the group that did not. TT-OWHTO in conjunction with AASCs injection is a safe and feasible treatment and should be considered as an additional procedure for better cartilage regeneration with improved clinical outcomes in patients undergoing TT-OWHTO for varus knee OA.