Skip to main content

Advertisement

SpringerLink
Log in

Biological intra-articular augmentation for osteotomy in knee osteoarthritis: strategies and results

A systematic review of the literature from the ESSKA Orthobiologics Initiative

  • KNEE
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To assess whether there is evidence supporting the use of augmentation strategies, either cartilage surgical procedures or injective orthobiologic options, to improve the results of osteotomies in knees with osteoarthritis (OA).

Methods

A systematic review of the literature was performed on the PubMed, Web of Science and the Cochrane databases in January 2023 on osteotomies around the knee associated with augmentation strategies (either cartilage surgical procedures or injective orthobiologic options), reporting clinical, radiological, or second-look/histological outcomes at any follow-up. The methodological quality of the included studies was assessed with the Coleman Methodology Score (CMS).

Results

Out of the 7650 records identified from the databases, 42 articles were included for a total of 3580 patients and 3609 knees treated; 33 articles focused on surgical treatments and 9 on injective treatments performed in association with knee osteotomy. Out of the 17 comparative studies with surgical augmentation, only 1 showed a significant clinical benefit of an augmentation procedure with a regenerative approach. Overall, other studies showed no differences with reparative techniques and even detrimental outcomes with microfractures. Regarding injective procedures, viscosupplementation showed no improvement, while the use of platelet-rich plasma or cell-based products derived from both bone marrow and adipose tissue showed overall positive tissue changes which translated into a clinical benefit. The mean modified CMS score was 60.0 ± 12.1.

Conclusion

There is no evidence to support the effectiveness of cartilage surgical treatments combined with osteotomies in terms of pain relief and functional recovery of patients affected by OA in misaligned joints. Orthobiologic injective treatments targeting the whole joint environment showed promising findings. However, overall the available literature presents a limited quality with only few heterogeneous studies investigating each treatment option. This ORBIT systematic analysis will help surgeons to choose their therapeutic strategy according to the available evidence, and to plan further and better studies to optimize biologic intra-articular osteotomy augmentation.

Level of evidence

Level IV.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Akizuki S, Yasukawa Y, Takizawa T (1997) Does arthroscopic abrasion arthroplasty promote cartilage regeneration in osteoarthritic knees with eburnation? A prospective study of high tibial osteotomy with abrasion arthroplasty versus high tibial osteotomy alone. Arthroscopy 13:9–17

    Article  CAS  PubMed  Google Scholar 

  2. Andriolo L, Reale D, Di Martino A, Zaffagnini S, Vannini F, Ferruzzi A et al (2019) High rate of failure after matrix-assisted autologous chondrocyte transplantation in osteoarthritic knees at 15 years of follow-up. Am J Sports Med 47:2116–2122

    Article  PubMed  Google Scholar 

  3. Angele P, Niemeyer P, Steinwachs M, Filardo G, Gomoll AH, Kon E et al (2016) Chondral and osteochondral operative treatment in early osteoarthritis. Knee Surg Sports Traumatol Arthrosc 24:1743–1752

    Article  PubMed  Google Scholar 

  4. Bauer S, Khan RJ, Ebert JR, Robertson WB, Breidahl W, Ackland TR et al (2012) Knee joint preservation with combined neutralising high tibial osteotomy (HTO) and matrix-induced autologous chondrocyte implantation (MACI) in younger patients with medial knee osteoarthritis: a case series with prospective clinical and MRI follow-up over 5 years. Knee 19:431–439

    Article  CAS  PubMed  Google Scholar 

  5. Bode G, Schmal H, Pestka JM, Ogon P, Südkamp NP, Niemeyer P (2013) A non-randomized controlled clinical trial on autologous chondrocyte implantation (ACI) in cartilage defects of the medial femoral condyle with or without high tibial osteotomy in patients with varus deformity of less than 5°. Arch Orthop Trauma Surg 133:43–49

    Article  PubMed  Google Scholar 

  6. Boffa A, Andriolo L, Franceschini M, Martino AD, Asunis E, Grassi A et al (2021) Minimal clinically important difference and patient acceptable symptom state in patients with knee osteoarthritis treated with PRP injection. Orthop J Sports Med 9:23259671211026240

    Article  PubMed  PubMed Central  Google Scholar 

  7. Boffa A, Salerno M, Merli G, De Girolamo L, Laver L, Magalon J et al (2021) Platelet-rich plasma injections induce disease-modifying effects in the treatment of osteoarthritis in animal models. Knee Surg Sports Traumatol Arthrosc 29:4100–4121

    Article  PubMed  Google Scholar 

  8. Calcei JG, Varshneya K, Sochacki KR, Safran MR, Abrams GD, Sherman SL (2021) Concomitant osteotomy reduces risk of reoperation following cartilage restoration procedures of the knee: a matched cohort analysis. Cartilage 13:1250s–1257s

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Cavallo M, Sayyed-Hosseinian SH, Parma A, Buda R, Mosca M, Giannini S (2018) Combination of High Tibial Osteotomy and Autologous Bone Marrow Derived Cell Implantation in Early Osteoarthritis of Knee: A Preliminary Study. Arch Bone Jt Surg 6(2):112–118

  10. Chareancholvanich K, Pornrattanamaneewong C, Narkbunnam R (2014) Increased cartilage volume after injection of hyaluronic acid in osteoarthritis knee patients who underwent high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 22:1415–1423

    Article  PubMed  Google Scholar 

  11. Chung YW, Yang HY, Kang SJ, Song EK, Seon JK (2021) Allogeneic umbilical cord blood-derived mesenchymal stem cells combined with high tibial osteotomy: a retrospective study on safety and early results. Int Orthop 45:481–488

    Article  PubMed  Google Scholar 

  12. Drexler M, Gross A, Dwyer T, Safir O, Backstein D, Chaudhry H, Goulding A, Kosashvili Y (2015) Distal femoral varus osteotomy combined with tibial plateau fresh osteochondral allograft for post-traumatic osteoarthritis of the knee. Knee Surg Sports Traumatol Arthrosc 23(5):1317–1323. https://doi.org/10.1007/s00167-013-2828-x

    Article  PubMed  Google Scholar 

  13. Dong C, Zhao C, Wang F (2022) Clinical benefit of high tibial osteotomy combined with the intervention of platelet-rich plasma for severe knee osteoarthritis. J Orthop Surg Res 17:405. https://doi.org/10.1186/s13018-022-03304-0

    Article  PubMed  PubMed Central  Google Scholar 

  14. Ferrera A, Menetrey J (2022) Optimizing indications and technique in osteotomies around the knee. EFORT Open Rev 7:396–403

    Article  PubMed  PubMed Central  Google Scholar 

  15. Ferruzzi A, Buda R, Cavallo M, Timoncini A, Natali S, Giannini S (2014) Cartilage repair procedures associated with high tibial osteotomy in varus knees: clinical results at 11 years’ follow-up. Knee 21:445–450

    Article  CAS  PubMed  Google Scholar 

  16. Filardo G, Kon E, Andriolo L, Vannini F, Buda R, Ferruzzi A et al (2013) Does patient sex influence cartilage surgery outcome? Analysis of results at 5-year follow-up in a large cohort of patients treated with matrix-assisted autologous chondrocyte transplantation. Am J Sports Med 41:1827–1834

    Article  PubMed  Google Scholar 

  17. Filardo G, Kon E, Di Martino A, Patella S, Altadonna G, Balboni F et al (2012) Second-generation arthroscopic autologous chondrocyte implantation for the treatment of degenerative cartilage lesions. Knee Surg Sports Traumatol Arthrosc 20:1704–1713

    Article  PubMed  Google Scholar 

  18. Filardo G, Kon E, Longo UG, Madry H, Marchettini P, Marmotti A et al (2016) Non-surgical treatments for the management of early osteoarthritis. Knee Surg Sports Traumatol Arthrosc 24:1775–1785

    Article  PubMed  Google Scholar 

  19. Filardo G, Perdisa F, Roffi A, Marcacci M, Kon E (2016) Stem cells in articular cartilage regeneration. J Orthop Surg Res 11:42. https://doi.org/10.1186/s13018-016-0378-x

    Article  PubMed  PubMed Central  Google Scholar 

  20. Filardo G, Zaffagnini S, De Filippis R, Perdisa F, Andriolo L, Candrian C (2018) No evidence for combining cartilage treatment and knee osteotomy in osteoarthritic joints: a systematic literature review. Knee Surg Sports Traumatol Arthrosc 26:3290–3299

    Article  CAS  PubMed  Google Scholar 

  21. Gao L, Madry H, Chugaev DV, Denti M, Frolov A, Burtsev M et al (2019) Advances in modern osteotomies around the knee: report on the Association of Sports Traumatology, Arthroscopy, Orthopaedic surgery, Rehabilitation (ASTAOR) Moscow International Osteotomy Congress 2017. J Exp Orthop 6:9. https://doi.org/10.1186/s40634-019-0177-5

    Article  PubMed  PubMed Central  Google Scholar 

  22. Gomoll AH (2011) High tibial osteotomy for the treatment of unicompartmental knee osteoarthritis: a review of the literature, indications, and technique. Phys Sportsmed 39:45–54

    Article  PubMed  Google Scholar 

  23. Gomoll AH, Filardo G, Almqvist FK, Bugbee WD, Jelic M, Monllau JC et al (2012) Surgical treatment for early osteoarthritis. Part II: allografts and concurrent procedures. Knee Surg Sports Traumatol Arthrosc 20:468–486

    Article  CAS  PubMed  Google Scholar 

  24. Hamahashi K, Toyoda E, Ishihara M, Mitani G, Takagaki T, Kaneshiro N, Maehara M, Takahashi T, Okada E, Watanabe A, Nakamura Y, Kato R, Matoba R, Takagi T, Akutsu H, Umezawa A, Kobayashi H, Akamatsu T, Yamato M, Okano T, Watanabe M, Sato M (2022) Polydactyly-derived allogeneic chondrocyte cell-sheet transplantation with high tibial osteotomy as regenerative therapy for knee osteoarthritis. NPJ Regen Med 7(1):71. https://doi.org/10.1038/s41536-022-00272-1

  25. Heijink A, Gomoll AH, Madry H, Drobnič M, Filardo G, Espregueira-Mendes J et al (2012) Biomechanical considerations in the pathogenesis of osteoarthritis of the knee. Knee Surg Sports Traumatol Arthrosc 20:423–435

    Article  PubMed  Google Scholar 

  26. Hofmann S, Lobenhoffer P, Staubli A, Van Heerwaarden R (2009) Osteotomies of the knee joint in patients with monocompartmental arthritis. Orthopade 38:755–769 (quiz 770)

    Article  CAS  PubMed  Google Scholar 

  27. Huizinga MR, Gorter J, Demmer A, Bierma-Zeinstra SMA, Brouwer RW (2017) Progression of medial compartmental osteoarthritis 2–8 years after lateral closing-wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 25:3679–3686

    Article  CAS  PubMed  Google Scholar 

  28. Iida K, Hashimoto Y, Nishida Y, Yamasaki S, Nakamura H (2021) Evaluation of regenerated cartilage using T2 mapping methods after opening-wedge high tibial osteotomy with microfracture at the cartilage defect: a preliminary study. J Exp Orthop 8:91. https://doi.org/10.1186/s40634-021-00413-3

    Article  PubMed  PubMed Central  Google Scholar 

  29. Jang S, Lee K, Ju JH (2021) Recent updates of diagnosis, pathophysiology, and treatment on osteoarthritis of the knee. Int J Mol Sci. https://doi.org/10.3390/ijms22052619

    Article  PubMed  PubMed Central  Google Scholar 

  30. Jung WH, Takeuchi R, Chun CW, Lee JS, Jeong JH (2015) Comparison of results of medial opening-wedge high tibial osteotomy with and without subchondral drilling. Arthroscopy 31:673–679

    Article  PubMed  Google Scholar 

  31. Kahlenberg CA, Nwachukwu BU, Hamid KS, Steinhaus ME, Williams RJ 3rd (2017) Analysis of outcomes for high tibial osteotomies performed with cartilage restoration techniques. Arthroscopy 33:486–492

    Article  PubMed  Google Scholar 

  32. Kanamiya T, Naito M, Hara M, Yoshimura I (2002) The influences of biomechanical factors on cartilage regeneration after high tibial osteotomy for knees with medial compartment osteoarthritis: clinical and arthroscopic observations. Arthroscopy 18:725–729

    Article  PubMed  Google Scholar 

  33. Kennedy MI, Whitney K, Evans T, LaPrade RF (2018) Platelet-rich plasma and cartilage repair. Curr Rev Musculoskelet Med 11:573–582

    Article  PubMed  PubMed Central  Google Scholar 

  34. Kim JH, Kim KI, Yoon WK, Song SJ, Jin W (2022) Intra-articular injection of mesenchymal stem cells after high tibial osteotomy in osteoarthritic knee: two-year follow-up of randomized control trial. Stem Cells Transl Med 11:572–585

    Article  PubMed  PubMed Central  Google Scholar 

  35. Kim MK, Ko BS, Park JH (2019) The proper correction of the mechanical axis in high tibial osteotomy with concomitant cartilage procedures-a retrospective comparative study. J Orthop Surg Res 14:281. https://doi.org/10.1186/s13018-019-1333-4

    Article  PubMed  PubMed Central  Google Scholar 

  36. Kim MS, Koh IJ, Choi YJ, Pak KH, In Y (2017) Collagen augmentation improves the quality of cartilage repair after microfracture in patients undergoing high tibial osteotomy: a randomized controlled trial. Am J Sports Med 45:1845–1855

    Article  PubMed  Google Scholar 

  37. Kim YS, Chung PK, Suh DS, Heo DB, Tak DH, Koh YG (2020) Implantation of mesenchymal stem cells in combination with allogenic cartilage improves cartilage regeneration and clinical outcomes in patients with concomitant high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 28:544–554

    Article  CAS  PubMed  Google Scholar 

  38. Kim YS, Koh YG (2018) 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: clinical and second-look arthroscopic results. Am J Sports Med 46:2669–2677

    Article  PubMed  Google Scholar 

  39. Koh YG, Kwon OR, Kim YS, Choi YJ (2014) Comparative outcomes of open-wedge high tibial osteotomy with platelet-rich plasma alone or in combination with mesenchymal stem cell treatment: a prospective study. Arthroscopy 30:1453–1460

    Article  PubMed  Google Scholar 

  40. Kim YS, Suh DS, Tak DH, Chung PK, Kwon YB, Kim TY, Koh YG (2021) Factors Influencing Clinical and MRI Outcomes of Mesenchymal Stem Cell Implantation With Concomitant High Tibial Osteotomy for Varus Knee Osteoarthritis. Orthop J Sports Med 9(2):2325967120979987. https://doi.org/10.1177/2325967120979987

  41. Kon E, Verdonk P, Condello V, Delcogliano M, Dhollander A, Filardo G et al (2009) Matrix-assisted autologous chondrocyte transplantation for the repair of cartilage defects of the knee: systematic clinical data review and study quality analysis. Am J Sports Med 37(Suppl 1):156s–166s

    Article  PubMed  Google Scholar 

  42. Koshino T, Wada S, Ara Y, Saito T (2003) Regeneration of degenerated articular cartilage after high tibial valgus osteotomy for medial compartmental osteoarthritis of the knee. Knee 10:229–236

    Article  PubMed  Google Scholar 

  43. Lee NH, Na SM, Ahn HW, Kang JK, Seon JK, Song EK (2021) Allogenic human umbilical cord blood-derived mesenchymal stem cells are more effective than bone marrow aspiration concentrate for cartilage regeneration after high tibial osteotomy in medial unicompartmental osteoarthritis of knee. Arthroscopy 37:2521–2530

    Article  PubMed  Google Scholar 

  44. Lee OS, Lee SH, Mok SJ, Lee YS (2019) Comparison of the regeneration of cartilage and the clinical outcomes after the open wedge high tibial osteotomy with or without microfracture: a retrospective case control study. BMC Musculoskelet Disord 20:267. https://doi.org/10.1186/s12891-019-2607-z

    Article  PubMed  PubMed Central  Google Scholar 

  45. Lu Y, Wang X, Yang B, Xu Z, Zhang B, Jia B et al (2022) Application of solid works software in preoperative planning of high tibial osteotomy. Front Surg 9:951820. https://doi.org/10.3389/fsurg.2022.951820

    Article  PubMed  Google Scholar 

  46. Madry H, Kon E, Condello V, Peretti GM, Steinwachs M, Seil R et al (2016) Early osteoarthritis of the knee. Knee Surg Sports Traumatol Arthrosc 24:1753–1762

    Article  PubMed  Google Scholar 

  47. Magnanelli S, Screpis D, Di Benedetto P, Natali S, Causero A, Zorzi C (2020) Open-wedge high tibial osteotomy associated with Lipogems® intra-articular injection for the treatment of varus knee osteoarthritis—retrospective study. Acta Biomed 91:e2020022. https://doi.org/10.23750/abm.v91i14-S.10992

    Article  PubMed  PubMed Central  Google Scholar 

  48. Marcacci M, Filardo G, Kon E (2013) Treatment of cartilage lesions: what works and why? Injury 44(Suppl 1):S11-15

    Article  PubMed  Google Scholar 

  49. Matsunaga D, Akizuki S, Takizawa T, Yamazaki I, Kuraishi J (2007) Repair of articular cartilage and clinical outcome after osteotomy with microfracture or abrasion arthroplasty for medial gonarthrosis. Knee 14:465–471

    Article  PubMed  Google Scholar 

  50. Miller BS, Joseph TA, Barry EM, Rich VJ, Sterett WI (2007) Patient satisfaction after medial opening high tibial osteotomy and microfracture. J Knee Surg 20:129–133

    Article  PubMed  Google Scholar 

  51. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD et al (2021) The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 372:n71. https://doi.org/10.1136/bmj.n71

    Article  PubMed  PubMed Central  Google Scholar 

  52. Parker DA, Beatty KT, Giuffre B, Scholes CJ, Coolican MR (2011) Articular cartilage changes in patients with osteoarthritis after osteotomy. Am J Sports Med 39:1039–1045

    Article  PubMed  Google Scholar 

  53. Pascale W, Luraghi S, Perico L, Pascale V (2011) Do microfractures improve high tibial osteotomy outcome? Orthopedics 34:e251–e255

    Article  PubMed  Google Scholar 

  54. Perdisa F, Gostynska N, Roffi A, Filardo G, Marcacci M, Kon E (2015) Adipose-derived mesenchymal stem cells for the treatment of articular cartilage: a systematic review on preclinical and clinical evidence. Stem Cells Int 2015:597652. https://doi.org/10.1155/2015/597652

    Article  PubMed  PubMed Central  Google Scholar 

  55. Perucca Orfei C, Boffa A, Sourugeon Y, Laver L, Magalon J, Sánchez M et al (2023) Cell-based therapies have disease-modifying effects on osteoarthritis in animal models. A systematic review by the ESSKA Orthobiologic Initiative. Part 1: adipose tissue-derived cell-based injectable therapies. Knee Surg Sports Traumatol Arthrosc 31:641–655

    Article  PubMed  Google Scholar 

  56. Primeau CA, Birmingham TB, Leitch KM, Willits KR, Litchfield RB, Fowler PJ et al (2021) Total knee replacement after high tibial osteotomy: time-to-event analysis and predictors. CMAJ 193:E158-e166

    Article  PubMed  PubMed Central  Google Scholar 

  57. Pulsatelli L, Addimanda O, Brusi V, Pavloska B, Meliconi R (2013) New findings in osteoarthritis pathogenesis: therapeutic implications. Ther Adv Chronic Dis 4:23–43

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  58. Saw KY, Anz A, Jee CS, Ng RC, Mohtarrudin N, Ragavanaidu K (2015) High Tibial Osteotomy in Combination With Chondrogenesis After Stem Cell Therapy: A Histologic Report of 8 Cases. Arthroscopy 31(10):1909–1920. https://doi.org/10.1016/j.arthro.2015.03.038

  59. Schultz W, Göbel D (1999) Articular cartilage regeneration of the knee joint after proximal tibial valgus osteotomy: a prospective study of different intra- and extra-articular operative techniques. Knee Surg Sports Traumatol Arthrosc 7:29–36

    Article  CAS  PubMed  Google Scholar 

  60. Schuster P, Geßlein M, Schlumberger M, Mayer P, Mayr R, Oremek D et al (2018) Ten-Year results of medial open-wedge high tibial osteotomy and chondral resurfacing in severe medial osteoarthritis and varus malalignment. Am J Sports Med 46:1362–1370

    Article  PubMed  Google Scholar 

  61. Schuster P, Schulz M, Mayer P, Schlumberger M, Immendoerfer M, Richter J (2015) Open-wedge high tibial osteotomy and combined abrasion/microfracture in severe medial osteoarthritis and varus malalignment: 5-year results and arthroscopic findings after 2 years. Arthroscopy 31:1279–1288

    Article  PubMed  Google Scholar 

  62. Schuster P, Schulz M, Richter J (2016) Combined biplanar high tibial osteotomy, anterior cruciate ligament reconstruction, and abrasion/microfracture in severe medial osteoarthritis of unstable varus knees. Arthroscopy 32:283–292

    Article  PubMed  Google Scholar 

  63. Solanki K, Shanmugasundaram S, Shetty N, Kim SJ (2021) Articular cartilage repair & joint preservation: a review of the current status of biological approach. J Clin Orthop Trauma 22:101602

    Article  PubMed  PubMed Central  Google Scholar 

  64. Song JS, Hong KT, Kong CG, Kim NM, Jung JY, Park HS et al (2020) High tibial osteotomy with human umbilical cord blood-derived mesenchymal stem cells implantation for knee cartilage regeneration. World J Stem Cells 12:514–526

    Article  PubMed  PubMed Central  Google Scholar 

  65. Souza LAB, Rocha VMD, Ramos MRF (2018) The role of microfractures with tibial osteotomy in the treatment of knee osteoarthritis with a varus deformity. Rev Bras Ortop 53:754–760

    Article  PubMed  PubMed Central  Google Scholar 

  66. Sterett WI, Steadman JR (2004) Chondral resurfacing and high tibial osteotomy in the varus knee. Am J Sports Med 32:1243–1249

    Article  PubMed  Google Scholar 

  67. Sterett WI, Steadman JR, Huang MJ, Matheny LM, Briggs KK (2010) Chondral resurfacing and high tibial osteotomy in the varus knee: survivorship analysis. Am J Sports Med 38:1420–1424

    Article  PubMed  Google Scholar 

  68. Suh DW, Han SB, Yeo WJ, Cheong K, So SY, Kyung BS (2021) Human umbilical cord-blood-derived mesenchymal stem cell can improve the clinical outcome and Joint space width after high tibial osteotomy. Knee 33:31–37

    Article  PubMed  Google Scholar 

  69. Vannini F, Spalding T, Andriolo L, Berruto M, Denti M, Espregueira-Mendes J et al (2016) Sport and early osteoarthritis: the role of sport in aetiology, progression and treatment of knee osteoarthritis. Knee Surg Sports Traumatol Arthrosc 24:1786–1796

    Article  CAS  PubMed  Google Scholar 

  70. Wakitani S, Imoto K, Yamamoto T, Saito M, Murata N, Yoneda M (2002) Human autologous culture expanded bone marrow mesenchymal cell transplantation for repair of cartilage defects in osteoarthritic knees. Osteoarthritis Cartilage 10:199–206

    Article  CAS  PubMed  Google Scholar 

  71. Wong KL, Lee KB, Tai BC, Law P, Lee EH, Hui JH (2013) Injectable cultured bone marrow-derived mesenchymal stem cells in varus knees with cartilage defects undergoing high tibial osteotomy: a prospective, randomized controlled clinical trial with 2 years’ follow-up. Arthroscopy 29:2020–2028

    Article  PubMed  Google Scholar 

  72. Yang HY, Song EK, Kang SJ, Kwak WK, Kang JK, Seon JK (2021) Allogenic umbilical cord blood-derived mesenchymal stromal cell implantation was superior to bone marrow aspirate concentrate augmentation for cartilage regeneration despite similar clinical outcomes. Knee Surg Sports Traumatol Arthrosc 30(1):208–218. https://doi.org/10.1007/s00167-021-06450-w

    Article  PubMed  Google Scholar 

  73. Yang J, Liu L, Xu X, Han Y, Yu W (2021) Percutaneous fixation with helical bridge combined fixation system for long split fractures involving the middle and upper humerus. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 35:1422–1426

    PubMed  Google Scholar 

  74. Zaffagnini S, Dal Fabbro G, Belvedere C, Leardini A, Caravelli S, Lucidi GA et al (2022) Custom-made devices represent a promising tool to increase correction accuracy of high tibial osteotomy: a systematic review of the literature and presentation of pilot cases with a new 3D-printed system. J Clin Med 11(19):5717

    Article  PubMed  PubMed Central  Google Scholar 

  75. Zhang Q, Xu W, Wu K, Fu W, Yang H, Guo JJ(2022) Intra-articular Pure Platelet-Rich Plasma Combined With Open- Wedge High Tibial Osteotomy Improves Clinical Outcomes and Minimal Joint Space Width Compared With High Tibial Osteotomy Alone in Knee Osteoarthritis: A Prospective Study. Arthroscopy 38(2):476–485. https://doi.org/10.1016/j.arthro.2021.09.013

  76. Zhang Q, Xu W, Wu K, Fu W, Yang H, Guo JJ (2022) Intra-articular pure platelet-rich plasma combined with open-wedge high tibial osteotomy improves clinical outcomes and minimal joint space width compared with high tibial osteotomy alone in knee osteoarthritis: a prospective study. Arthroscopy 38:476–485

    Article  PubMed  Google Scholar 

  77. Zitsch BP, Stannard JP, Worley JR, Cook JL, Leary EV (2021) Patient-reported outcomes for large bipolar osteochondral allograft transplantation in combination with realignment osteotomies for the knee. J Knee Surg 34:1260–1266

    Article  PubMed  Google Scholar 

Download references

Funding

No funding was received for this work.

Author information

Author notes

  1. Davide Reale and Pietro Feltri equally contributed to this article.

Authors and Affiliations

  1. Ortopedia e Traumatologia, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy

    Davide Reale

  2. Service of Orthopaedics and Traumatology, Department of Surgery, EOC, 6900, Lugano, Switzerland

    Pietro Feltri & Giuseppe Filardo

  3. Clinica Ortopedica e Traumatologica 2, IRCCS Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli-1, 40136, Bologna, Italy

    Marco Franceschini

  4. Orthopaedic Biotechnology Laboratory, IRCCS Istituto Ortopedico Galeazzi, 20161, Milan, Italy

    Laura de Girolamo

  5. Department of Orthopaedics, Hillel Yaffe Medical Center (HYMC), 38100, Hadera, Israel

    Lior Laver

  6. Arthrosport Clinic, Tel-Aviv, Israel

    Lior Laver

  7. Rappaport Faculty of Medicine, Technion University Hospital, Israel Institute of Technology, 32000, Haifa, Israel

    Lior Laver

  8. Cell Therapy Department, Hôpital de la Conception, Assistance Publique des Hôpitaux de Marseille (AP-HM), INSERM CIC BT 1409, 13005, Marseille, France

    Jeremy Magalon

  9. INSERM, INRA, C2VN, Aix Marseille Univ, 13005, Marseille, France

    Jeremy Magalon

  10. SAS Remedex, 13008, Marseille, France

    Jeremy Magalon

  11. Arthroscopic Surgery Unit, Hospital Vithas Vitoria, 01008, Vitoria-Gasteiz, Spain

    Mikel Sanchez

  12. Advanced Biological Therapy Unit, Hospital Vithas Vitoria, 01008, Vitoria-Gasteiz, Spain

    Mikel Sanchez

  13. Department of Orthopaedic Surgery, University of Rostock, 18051, Rostock, Germany

    Thomas Tischer

  14. Faculty of Biomedical Sciences, Università della Svizzera Italiana, 6900, Lugano, Switzerland

    Giuseppe Filardo

  15. Applied and Translational Research Center, IRCCS Istituto Ortopedico Rizzoli, 40136, Bologna, Italy

    Giuseppe Filardo

Authors
  1. Davide Reale
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Pietro Feltri
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Marco Franceschini
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Laura de Girolamo
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Lior Laver
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jeremy Magalon
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Mikel Sanchez
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Thomas Tischer
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Giuseppe Filardo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Marco Franceschini.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Reale, D., Feltri, P., Franceschini, M. et al. Biological intra-articular augmentation for osteotomy in knee osteoarthritis: strategies and results. Knee Surg Sports Traumatol Arthrosc 31, 4327–4346 (2023). https://doi.org/10.1007/s00167-023-07469-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-023-07469-x

Keywords

Search

Navigation