Combination of bone marrow derived cells transplantation and high tibial osteotomy in early osteoarthritis of knee: A preliminary study

Purpose: high tibial osteotomy (HTO) is a recommended treatment for medial compartment knee osteoarthritis. Newer cartilage regenerative procedures may add benefits to the result of HTO. In this prospective study we investigate safety and also results of HTO associated with bone marrow derived cells (BMDC) transplantation in relatively young and middle aged active individuals with early osteoarthritis of the knee and our hypothesis is combination of these procedures is safe and leads to better outcome. Methods: 24 patients (with 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 transplantation of bone marrow derived cells into the chondral lesions. Clinical outcome was assessed by IKDC score, KOOS score, VAS and Tegner scores and radiographic study was performed preoperatively and at follow-ups. Results: there were no major complications during operation and postoperative follow-ups.all the clinical scores significantly were improved for the IKDC score (from 32.7 +/-15 to 64+/- 21), KOOS score (from30 +/- 11 to 68 +/- 19), VAS (from7.5 to 3), and Tegner score (from 1.2 to 2.1). Conclusions: HTO in conjunction with BMDC transplantation is a safe and feasible treatment for early medial compartment osteoarthritis in varus knees and associated with good results in short term follow up.

Keywords:

High tibial osteotomy , Osteoarthritis , bone marrow derived cells transplantation , Stem cells , cartilage repair