2025 ISAKOS Biennial Congress ePoster
Medial Open Wedge High Tibial Osteotomy with Bone Marrow Derived Stem Cell for Medial Knee Osteoarthritis
WhanYong Chung, MD, PhD, Prof, Seoul, MapoGu KOREA, REPUBLIC OF
Hyun Hee Lee, MD, Incheon, --- Select One --- KOREA, REPUBLIC OF
CatholicKwandong University International St. Marys Hspital, Incheon, SeoGu, KOREA, REPUBLIC OF
FDA Status Cleared
Summary
Stem cell transplantation improves regeneration of chondral lesions in old patients with knee osteoarthritis
ePosters will be available shortly before Congress
Abstract
Objectives:
To analyze the results of isolated autologous bone marrow derived mesenchymal stem cell (MSC) transplantation in conjunction with multiple drilling and medial open wedge high tibial osteotomy (MOHTO).
Methods
Thirty knees in 29 patients with medial uni-compartmental osteoarthritic knee with genu varum were allocated to the cell-recipient group (n=15) or control group (n=15). Patients who had more than 2 compartment osteoarthritic knee joint, malalignment of the knee from femoral causes or more than 15 degree varus deformity were excluded. All patients underwent MOHTO and cartilage restoration procedure (multiple drilling or micro fracture). The cell-recipient group received transplantation of isolated bone marrow concentrate containing MSCs with hyaluronic biomaterial and fibrin glue whereas the control group only received microfracture alone. The primary outcome measure was International Knee Documentation Committee (IKDC) score at intervals of 3, 6, 9 months and 1 year postoperatively. Secondary outcome measures were 1-year postoperative Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) scores and secondary arthroscopic findings at implant removal surgery.
Results
Preoperatively defect size and ICRS grade were larger and more severe in the study group. Postoperatively filling up size with cartilage and recovery rate of chondral lesion were superior in the study group. Coverage size of study and control group were 4.4 ± 1.0 and 0.9 ± 0.4, and recovery rate were 79.6 ± 15.4 and 32.0 ± 20.9, respectively. (p < 0.001, both categories) MOCART and Koshino score were also better in the stem cell therapy group. (73.7 ± 10.4 and 51.5 ± 10.6 in MOCART and 2.8 ± 0.4 and 1.6 ±0.5 in Koshino score, p < 0.001, both categories) IKDC scores improved from 51.9 ± 12.3 to 81.1 ± 5.5 in the study group and 50.5 ± 12.8 to 80.2 ± 4.6 in the control group, respectively. (p<0.001 , both groups) However there were no difference between two groups.
Conclusions
MOHTO and cartilage restoration procedure improved knee symptom in medial compartment knee osteoarthritic patients. And regenerative ability of chondral lesion was superior in isolated autologous bone marrow derived MSC transplantation group of patients over 50 years old.