Effects of autologous osteophyte grafting for medial open-wedge high tibial osteotomy using beta-tricalcium phosphate spacer

Abstract

Purpose: To compare the gap filling rate and clinical outcome of osteophyte grafting and non-grafting in medial open-wedge high tibial osteotomy using beta-tricalcium phosphate spacer. Methods: A prospective comparative cohort study was conducted with 40 consecutive patients (50 knees) who underwent open-wedge high tibial osteotomy between 2015 and 2016. In Group N (25 knees), only the beta-tricalcium phosphate spacer was implanted in the opening space. In Group O (25 knees), osteophytes harvested by arthroscopy and beta-tricalcium phosphate spacer were implanted. All patients underwent clinical and radiological examinations at 2 years after surgery. Results: Postoperatively, the mean functional knee score significantly improved in each group (p<0.0001). The weight-bearing line percentage shifted to pass through a point 62% and 64% lateral from the medial edge of tibial plateau in Groups O and N, respectively. The gap filling rate of the Group O was significantly faster than that of the Group N (p=0.0008). Discussions: Osteophyte grafting was significantly faster in the gap filling rate than non-grafting in open-wedge high tibial osteotomy. These results suggested that autologous osteophyte grafting can be a useful method for accelerating bone union and therefore enabling weight bearing from an early stage after surgery.