Abstract
Purpose
To compare the clinical efficacy of the patients with medial compartment knee osteoarthritis
who underwent either opening-wedge high tibial osteotomy alone (HTO) or simultaneous
HTO and pure platelet-rich plasma therapy (HTO+P-PRP).
Methods
Eighty patients were divided into 2 groups randomly, the HTO-alone group (n = 41)
and the HTO+P-PRP group (n = 39). Patients were matched for preoperative age, sex,
and body mass index. The outcomes studied included visual analogue scale (VAS) score,
Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Lysholm
score. The minimum width of medial knee joint (MJSW), medial proximal tibial angle
(MPTA), femoral tibial angle (FTA), and weightbearing line (WBL) were measured preoperatively,
immediately postoperatively, and 1, 6, 12, and 24 months postoperatively. Paired t test and chi-squared test were used for statistical analysis.
Results
All patients were followed up at 1, 6, 12, and 24 months postoperatively. At 1, 6,
and 12 months, pain and function scores in the HTO+P-PRP group were better than those
in the HTO-alone group, especially at 6 months in Lysholm score (HTO alone, 72.5 ±
10.6; HTO+P-PRP, 83.1 ± 14.7; P = .003, 95% CI –14.13 to –10.42) and WOMAC (HTO alone, 90.3 ± 11.9; HTO+P-PRP, 75.6
± 15.4; P < .001, 95% CI 13.36 to 20.11). For both groups, no difference was found preoperatively
(HTO alone, varus 3.5 ± 3.9; HTO+P-PRP, varus 4.1 ± 4.0; P = .898) or postoperatively (HTO alone, valgus 6.7 ± 4.5; HTO+P-PRP, valgus 7.7 ±
2.3; P = .768) in FTA or WBL. The increase of the MJSW in the HTO+P-PRP group was significantly
greater than that in the HTO-alone group during the first year, especially at 6 months
(HTO alone, 3.8 ± 1.2 mm; HTO+P-PRP, 4.6 ± 1.1 mm; P = .001, 95% CI –1.27 to –0.35).
Conclusions
Compared with HTO alone, HTO combined with intra-articular P-PRP improved the minimum
medial knee joint space width during the first year postoperatively. Clinically, a
higher proportion of patients in the HTO+P-PRP group exceeded the minimal clinically
important difference (MCID) in the first year, especially at 6 months in Lysholm score
(HTO alone, 65.9%; HTO+P-PRP, 97.4%) and WOMAC (HTO alone, 82.9%; HTO+P-PRP, 100.0%).
Level of Evidence
2, prospective comparative study.
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Article info
Publication history
Published online: September 24, 2021
Accepted:
September 7,
2021
Received:
April 28,
2021
See commentary on page 486Footnotes
The authors report that they have no conflicts of interest in the authorship and publication of this article. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Q. Zhang and W. Xu contributed equally to this article.
Identification
Copyright
© 2021 by the Arthroscopy Association of North America
