High Tibial Osteotomy in Combination With Chondrogenesis After Stem Cell Therapy: A Histologic Report of 8 Cases.

نویسندگان

  • Khay-Yong Saw
  • Adam Anz
  • Caroline Siew-Yoke Jee
  • Reza Ching-Soong Ng
  • Norhafizah Mohtarrudin
  • Kunaseegaran Ragavanaidu
چکیده

PURPOSE To histologically evaluate the quality of articular cartilage regeneration from the medial compartment after arthroscopic subchondral drilling followed by postoperative intra-articular injections of autologous peripheral blood stem cells (PBSCs) and hyaluronic acid with concomitant medial open-wedge high tibial osteotomy (HTO) in patients with varus deformity of the knee joint. METHODS Eight patients with varus deformity of the knee joint underwent arthroscopic subchondral drilling of International Cartilage Repair Society (ICRS) grade 4 bone-on-bone lesions of the medial compartment with concomitant HTO. These patients were part of a larger pilot study in which 18 patients underwent the same procedure. PBSCs were harvested and cryopreserved preoperatively. At 1 week after surgery, 8 mL of PBSCs was mixed with 2 mL of hyaluronic acid and injected intra-articularly into the knee joint; this was repeated once a week for 5 consecutive weeks. Three additional intra-articular injections were administered weekly at intervals of 6, 12, and 18 months postoperatively. Informed consent was obtained at the time of hardware removal for opportunistic second-look arthroscopy and chondral biopsy. Biopsy specimens were stained with H&E, safranin O, and immunohistochemical staining for type I and II collagen. Specimens were graded using the 14 components of the ICRS Visual Assessment Scale II, and a total score was obtained. RESULTS Second-look arthroscopy showed satisfactory healing of the regenerated cartilage. Histologic analysis showed significant amounts of proteoglycan and type II collagen. The total ICRS Visual Assessment Scale II histologic scores comparing the regenerated articular cartilage (mean, 1,274) with normal articular cartilage (mean, 1,340) indicated that the repair cartilage score approached 95% of the normal articular cartilage score. There were no infections, delayed unions, or nonunions. CONCLUSIONS Chondrogenesis with stem cells in combination with medial open-wedge HTO for varus deformity correction of the knee joint regenerates cartilage that closely resembles the native articular cartilage. LEVEL OF EVIDENCE Level IV, therapeutic case series.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

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 osteoar...

متن کامل

Does a Previous High Tibial Osteotomy (HTO) Influence the Long-term Function or Survival of a Total Knee Arthroplasty (TKA)?

 High tibial osteotomy (HTO) is a well established technique for the treatment of medial osteoarthritis ofthe knee with varus malalignment. The outcome of total knee arthroplasty (TKA) after HTO remains uncertain.The aim of this paper is to revise the literature with the aim of answering the following question: Does a previous (HTO)influence the long-term function or survival of a TKA?. The sea...

متن کامل

The effect of high frequency electric field on enhancement of chondrogenesis in human adipose-derived stem cells

Objective(s):Osteoarthritis (OA) is globally one of the most common diseases from the middle age onwards. Cartilage is an avascular tissue therefore it cannot be repaired in the body. Conservative treatments have failed as a good remedy and cell therapy as a decisive cure is needed. One of the best and easily accessible cell sources for this purpose is adipose-derived stem cells which can be di...

متن کامل

Unicompartmental Knee Osteoarthritis (UKOA): Unicompartmental Knee Arthroplasty (UKA) or High Tibial Osteotomy (HTO)?

  Background: The aim of this review article is to analyze the results of high tibial osteotomy compared to unicompartmental knee arthroplasty in patients with unicompartmental knee osteoarthritis.   Methods: The search engine used was PubMed. The keywords were: "high tibial osteotomy versus unicompartmental knee arthroplasty". Twenty-one articles were found on 28 February 2015, but only eighte...

متن کامل

The clinical Outcome of One-stage High Tibial Osteotomy and Anterior Cruciate Ligament Reconstruction. A Current Concept Systematic and Comprehensive Review

  Background: Patients with an anterior cruciate ligament-deficient varus-angulated knee may need not only an isolated high tibial osteotomy (HTO), but also an additional anterior cruciate ligament reconstruction (ACLR). A number of prospective clinical trials have been published considering the combination of HTO and ACL reconstruction. Our aim was to investigate whether one-stage combined HTO...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association

دوره 31 10  شماره 

صفحات  -

تاریخ انتشار 2015