High tibial osteotomy with cartilage regeneration surgery using human umbilical cord blood-derived mesenchymal stem cells for medial compartment osteoarthritis of the knee

Abstract

Background: To compare clinical and radiological outcomes in high tibial osteotomy (HTO) with or without cartilage regeneration surgery using human umbilical cord blood-derived mesenchymal stem cells (hUCB-MSCs) for medial compartment osteoarthritis of the knee.

Methods: Patients who underwent HTO only (group H) or HTO with cartilage regeneration surgery using hUCB-MSCs (group HS) were retrospectively reviewed, and these patients had a minimum radiographic and clinical follow-up period of 12 months. The following radiologic parameters were evaluated: hip-knee-ankle angle, tibia plateau inclination, knee joint line orientation, ankle joint line orientation, medial and lateral joint width, and joint line convergence angle. Moreover, the clinical score was evaluated according to the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and International Knee Documentation Committee (IKDC) scores.

Results: A total of 44 knees (group H: 32, group HS: 12) were enrolled. The mean age of group H and group HS were 57.2 and 55.1 respectively. No significant difference in preoperative radiologic parameters and clinical outcomes was observed between the two groups (all P > 0.05). Significant improvements were observed between pre- and postoperative radiologic parameters, except for medial joint width, in both groups. However, these parameters were not significantly different in both groups (all P > 0.05). At the last follow-up, significant improvements were observed in WOMAC and IKDC scores compared with the preoperative score in both groups. However, no differences were observed between the two groups (all P > 0.05).

Conclusion: Satisfactory clinical and radiological outcomes were observed in both groups in short-term follow-up. However, no significant difference in clinical and radiological outcomes was observed between the two groups at the last follow-up moment. In the future, a study with medium- to long-term follow-up is needed.