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

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