Comparison of Bone Healing in Open-Wedge High Tibial Osteotomy between the Use of Allograft Bone Chips with Autologous Bone Marrow and the Use of Allograft Bone Chips Alone for Gap Filling

The present study aimed to evaluate whether the use of allograft bone chips mixed with autologous bone marrow (BM) in the high tibial osteotomy (HTO) gap could improve the radiological and clinical results of HTO. This study analyzed 36 patients who underwent HTO with locking plate (mean age: 58.0 years). Allograft bone chips mixed with autologous BM aspirated from anterior superior iliac spine were used in 19 patients (group A) and allograft chips only were used in 17 patients (group B). The radiological and clinical results between two groups were compared during examination at 6 weeks, 3 months, 6 months, and 12 months after surgery. Clinical evaluations involving the Hospital for Special Surgery score, Knee Society knee score, and function score were performed at each assessment point. The osteotomy filling and osteoconductivity using the modified van Hemert's score were compared in each period. The clinical results were not different between the groups at all assessment points. Osteotomy filling was higher at 6 weeks and 3 months in group A than in group B (p = 0.004 and 0.005, respectively). Osteoconductivity was higher at 6 weeks and 3 months in the most medial zone in group A than in group B (p = 0.025 and 0.031, respectively). Our data shows it is beneficial to mix the allograft bone chips mixed with autologous BM after open-wedge HTO.