Combination of High Tibial Osteotomy and Autologous Bone Marrow Derived Cell Implantation in Early Osteoarthritis of Knee: A Preliminary Study

Background: High tibial osteotomy (HTO) is a recommended treatment for medial compartment knee osteoarthritis. Newer cartilage regenerative procedures may add benefits to the results of HTO. In this prospective study we have investigated the safety and also results of HTO associated with autologous bone marrow derived cells (BMDC) implantation in relatively young and middle aged active individuals with early osteoarthritis of the knee. Methods: A total of 24 patients (mean age of 47.9 years) with varus knee and symptomatic medial compartment osteoarthritis were treated with medial opening-wedge high tibial osteotomy in conjunction with implantation of bone marrow derived cells into the chondral lesions. The clinical outcomes were assessed by IKDC, KOOS, VAS, and Tegner scores. The radiographic studies were performed preoperatively and at follow-ups. Results: No major complications were seen during the operations and postoperative follow-ups. All clinical scores were significantly improved for the IKDC score (from 32.7±15 to 64±21) (P<0.005), KOOS score (from30±11 to 68±19) (P<0.005), VAS (from 7.5 to 3) and Tegner score (from 1.2 to 2.1) (P<0.004). Conclusion: HTO in conjunction with BMDC implantation is a safe and feasible treatment and is associated with good results in short term follow up for early medial compartment osteoarthritis in varus knees. Level of evidence: IV