Han Joo Hyung, Jung Min, Chung Kwangho, Jung Se-Han, Choi Chong-Hyuk, Kim Sung-Hwan
Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea.
Department of Orthopedic Surgery, Arthroscopy and Joint Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
Knee Surg Relat Res. 2024 Mar 28;36(1):13. doi: 10.1186/s43019-024-00221-w.
This systematic review aimed to evaluate the effects of concurrent cartilage procedures on cartilage regeneration when performed alongside high tibial osteotomy (HTO).
The systematic review followed the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). A comprehensive search was conducted on databases including PubMed, Embase, Cochrane Library, and Google Scholar, covering articles published until August 31, 2023.
Sixteen studies (1277 patients) revealed that HTO, with or without concurrent cartilage procedures, leads to cartilage regeneration based on the International Cartilage Repair Society (ICRS) grade during second-look arthroscopy. No concurrent procedure showed improvement in ICRS grade (mean difference: - 0.80 to - 0.49). Microfracture (mean difference: - 0.75 to - 0.22), bone marrow aspirate concentrate (BMAC) (mean difference: - 1.37 to - 0.67), and human umbilical cord blood-derived mesenchymal stem cell (hUCB-MSC) (mean difference: - 2.46 to - 1.81) procedures also demonstrated positive outcomes. Clinical outcome assessments for each cartilage procedure were also improved during postoperative follow-up, and no specific complications were reported.
HTO with or without concurrent cartilage procedures promotes cartilage regeneration observed during second-look arthroscopy, with improved clinical outcomes. Future randomized controlled trials on the same topic, along with subsequent meta-analyses, are necessary for conclusive findings.
本系统评价旨在评估同期软骨手术与高位胫骨截骨术（HTO）联合进行时对软骨再生的影响。
本系统评价遵循系统评价和Meta分析的首选报告项目（PRISMA）中概述的指南。对包括PubMed、Embase、Cochrane图书馆和谷歌学术在内的数据库进行了全面检索，涵盖截至2023年8月31日发表的文章。
16项研究（1277例患者）显示，无论是否同期进行软骨手术，HTO在二次关节镜检查时均可根据国际软骨修复协会（ICRS）分级实现软骨再生。没有同期手术显示ICRS分级有改善（平均差：-0.80至-0.49）。微骨折（平均差：-0.75至-0.22）、骨髓抽吸浓缩物（BMAC）（平均差：-1.37至-0.67）和人脐带血间充质干细胞（hUCB-MSC）（平均差：-2.46至-1.81）手术也显示出积极的结果。术后随访期间，每种软骨手术的临床结局评估也有所改善，且未报告特定并发症。
无论是否同期进行软骨手术，HTO均可促进二次关节镜检查时观察到的软骨再生，临床结局得到改善。未来关于同一主题的随机对照试验以及后续的Meta分析对于得出确凿结论是必要的。
