Open-Wedge High Tibial Osteotomy Associated With Lipogems® Intra-Articular Injection For The Treatment Of Varus Knee Osteoarthritis – Retrospective Study

Main Article Content

Stefano Magnanelli
Daniele Screpis
Paolo Di Benedetto
Simone Natali
Araldo Causero
Claudio Zorzi

Keywords

high tibial osteotomy, varus knee osteoarthritis, adipose derived stem cells, Lipogems

Abstract

Background and aim: Open-wedge high tibial osteotomy (HTO) is a good choice in the treatment of varus knee medial osteoarthritis, with the restore of the correct mechanical axis of the lower limb. Autologous adipose derived stem cells (aASCs) are used in cartilage regeneration and in the treatment of early osteoarthritis. Aim of this study is to retrospectively analyze clinical (and radiological) results in two populations of patients with initial varus medial knee osteoarthritis, treated with HTO, with or without associated intra-articular injection of aASCs.


Methods: In this study we analyze 85 patients treated with HTO for varus knee osteoarthritis with or without Lipogems® intra-articular injection. It was used of a single model of HTO plate. No associated procedure was performed.


Results: Significant improvement in the daily life activity assessment (KOOS score) was observed in the group treated also with aASCs compared with group treated with isolated HTO.


Conclusions: We suggest, in these patients, the surgical indication of an open-wedge high tibial osteotomy (HTO) and simultaneous injection with aASCs associated procedure to improve cartilage regeneration, with clinical improvement

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References

1. Prodromos CC, Amendola A, Jakob RP. “High tibial osteotomy: indications, techniques, and postoperative management”. Instr Course Lect 2015; 64:555-65.
2. Coventry MB. “Oteotomy about the knee for degenerative and rheumatoid arthritis”. J Bone Joint Surg Am 1973; 55(1):23-48.
3. Niemeyer P, Stöhr A, Köhne M, Hochrein A. “Medial opening wedge high tibial osteotomy”. Oper Orthop Traumatol 2017; Aug;29(4):294-305.
4. Matsunaga D, Akizuki S, Takizawa T, Yamazaki I, Kuraishi J. “Repair of articular cartilage and clinical outcome after osteotomy with microfracture or abrasion arthroplasty for medial gonarthrosis”. Knee 2007; 14:465-471.
5. Hurley ET, Yasui Y, Gianakos AL, Seow D, Shimozono Y, Kerkhoffs GMMJ, Kennedy JG. “Limited evidence for adipose-derived stem cell therapy on the treatment of osteoarthritis”. Knee Surg Sports Traumatol Arthrosc. 2018 Nov;26(11):3499-3507.
6. Hudetz D, Borić I, Rod E, Jeleč Ž, Radić A, Vrdoljak T, Skelin A, Lauc G, Trbojević-Akmačić I, Plečko M, Polašek O, Primorac D. “The effect of intra-articular injection of autologous microfragmented fat tissue on proteoglycan synthesis in patients with knee osteoarthritis”. Genes (Basel) 2017; 13;8(10):270.
7. Roos EM, Roos HP, Lohmander LS, Ekdahl C, Beynnon BD. “Knee injury and Osteoarthritis Outcome Score (KOOS) e development of a self-administered outcome measure”. J Orthop Sports Phys Ther 1998;28:88e96.
8. Monticone M, Ferrante S, Salvaderi S, Rocca B, Totti V, Foti C, Roi GS. “Development of the Italian version of the knee injury and osteoarthritis outcome score for patients with knee injuries: cross-cultural adaptation, dimensionality, reliability, and validity”. Osteoarthritis Cartilage. 2012 Apr;20(4):330-5. doi: 10.1016/j.joca.2012.01.001. Epub 2012 Jan 10.
9. Échelle de Lysholm-Tegner, www.orthopaedicscore.com/scorepages/ tegner lysholm knee.html
10. Tegner Y, Lysholm J. “Rating systems in the evaluation of knee ligament injuries”. Clin Orthop 1985;198:43–9.
11. Girgis FG, Marshall JL, Monajem A, “The cruciate ligaments of the knee joint. Anatomical, functional and experimental analysis,” Clin. Orthop., no. 106, pp. 216–231, Feb. 1975.
12. Amis AA, Dawkins GP, “Functional anatomy of the anterior cruciate ligament. Fibre bundle actions related to ligament replacements and injuries,” J. Bone Joint Surg. Br., vol. 73, no. 2, pp. 260–267, Mar. 1991.
13. Hollis JM, Takai S, Adams DJ, Horibe S, Woo SL, “The effects of knee motion and external loading on the length of the anterior cruciate ligament (ACL): a kinematic study,” J. Biomech. Eng., vol. 113, no. 2, pp. 208–214, May 1991
14. Duthon VB, Barea C, Abrassart S, Fasel JH, Fritschy D, Ménétrey J, “Anatomy of the anterior cruciate ligament,” Knee Surg. Sports Traumatol. Arthrosc. Off. J. ESSKA, vol. 14, no. 3, pp. 204–213, Mar. 2006.
15. Kellgren JH, Lawrence JS. “Radiological assessment of osteo-arthrosis”. Ann Rheum Dis. 1957;16:494–502. doi: 10.1136/ard.16.4.494.
16. Russo A, Screpis D, Di Donato SL, Bonetti S, Piovan G, Zorzi C. “Autologous micro-fragmented adipose tissue for the treatment of diffuse degenerative knee osteoarthritis: an update at 3 year follow-up”. Journal of Experimental Orthopaedics (2018) 5:52
17. Su X, Li C, Liao W, Liu J, Zhang H, Li J, Li Z “Comparison of arthroscopic and conservative treatments for knee osteoarthritis: a 5-year retrospective comparative study”. Arthroscopy 34(3):652–659. 2018.
18. Cattaneo G, De Caro A, Napoli F, Chiapale D, Trada P, Camera A. “Micro-fragmented adipose tissue injection associated with arthroscopic procedures in patients with symptomatic knee osteoarthritis” BMC Musculoskelet Disord. 2018; 19: 176
19. Bisicchia S, Bernardi G, Pagnotta SM, Tudisco C. “Micro‑fragmented stromal‑vascular fraction plus microfractures provides better clinical results than microfractures alone in symptomatic focal chondral lesions of the knee” Knee Surgery, Sports Traumatology, Arthroscopy Jun;28(6):1876-1884. 2020.
20. Malanga GA, Chirichella PS, Hogaboom NS, Capella T. “Clinical evaluation of micro-fragmented adipose tissue as a treatment option for patients with meniscus tears with osteoarthritis: a prospective pilot study” International Orthopaedics (SICOT) (2020).
21. Kim YS, Koh YG. “Comparative Matched-Pair Analysis of Open-Wedge High Tibial Osteotomy With Versus Without an Injection of Adipose-Derived Mesenchymal Stem Cells for Varus Knee Osteoarthritis”. Am J Sports Med 2018 Sep;46(11):2669-2677

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