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. 2019 Feb 22:10:112-117.
doi: 10.1016/j.reth.2019.02.001. eCollection 2019 Jun.

Preliminary results of high fibular osteotomy (HFO) and cartilage regeneration procedure for medial compartment osteoarthritis of knee with varus deformity

Hussain S H Jaheer  1 , Asode Ananthram Shetty  2 , Nam Yong Choi  3 , Ki-Won Kim  3 , Selvan V Thirumal  1 , Jun Seob Song  4 , Ki Seong Kim  5 , You Seung Chun  3 , Seok Jung Kim  3
Affiliations

Preliminary results of high fibular osteotomy (HFO) and cartilage regeneration procedure for medial compartment osteoarthritis of knee with varus deformity

Hussain S H Jaheer et al. Regen Ther. .

Abstract

Purpose: High fibular osteotomy (HFO) is a simple surgical technique to reduce pain and improve function in patients with osteoarthritis via fibular osteotomy. We report short-term results of HFO and mesenchymal cell induced chondrogenesis (MCIC) for the treatment of osteoarthritis of knee with varus deformity.

Patients and methods: 45 symptomatic patients with 14 males and 31 females age ranging from 40 to 75 years were treated by HFO and MCIC. Main lesions involved medial compartment of knee and lateral compartment with normal to mild lesions of lateral meniscus and articular cartilage, amenable to treatment via partial meniscectomy or observation.

Results: Knee injury and Osteoarthritis Outcome score and Lysholm showed a statistically significant increase and VAS, varus angle in X-ray showed a statistically significant decrease. A statistically significant difference between preoperative and postoperative scores was detected in male and female patients without any sexual differences.

Conclusion: High fibular osteotomy and mesenchymal cell induced chondrogenesis can be considered as a good treatment option for medial compartment osteoarthritis of knee with varus deformity.

Keywords: BMAC, bone marrow aspirate concentrate; HA, hyaluronic acid; HFO, High fibular osteotomy; HTO, high tibial osteotomy; High fibular osteotomy; KOOS, Knee injury and Osteoarthritis Outcome score; Knee; MCIC, mesenchymal cell induced chondrogenesis; Mesenchymal cell induced chondrogenesis (MCIC); Osteoarthritis; VAS, visual analogue score; Varus deformity.

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Figures

Fig. 1
Fig. 1
A) Using BMAC(bone marrow aspirate concentrate) kit, BMAC is aspirated after centrifugation of bone marrow aspirate. B) 0.2 ml of hyaluronic acid and 0.8 ml of fibrinogen are loaded in 1 ml syringe and 0.8 ml of BMAC and 0.2 ml of thrombin are loaded in other 1 ml syringe. Two syringes are connected by Y-shape catheter for injection to the cartilage defect.
Fig. 2
Fig. 2
A) Clinical photo of arthroscopy and CO2 infusion setup for MCIC operation. B) BMAC mixed with hyaluronic acid and fibrinogen is injected to the cartilage defect under CO2 insufflation.
Fig. 3
Fig. 3
Knee standing AP radiograph of 70 years old female with medial compartment osteoarthritis. A) 8 degree of varus deformity in anatomical axis of right knee, preoperatively, B) 1 degree of varus deformity in post-operative 6 months.
Fig. 4
Fig. 4
Lower extremity standing AP radiograph of 54 years old female with medial compartment osteoarthritis. A) 7 degree of varus deformity in mechanical axis of left knee, B) 1 degree of varus deformity in post-operative 6 months.
See this image and copyright information in PMC

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