胫骨高位截骨术联合富血小板血浆治疗老年内侧间室骨关节炎的早期价值研究

doi:10.3969/j.issn.1003-9198.2026.04.014

Abstract

Abstract: Objective To evaluate the efficacy of high tibial osteotomy (HTO) combined with platelet-rich plasma (PRP) in the treatment of medial compartment osteoarthritis in the elderly patients. Methods In this double-blind, randomized controlled trial, 50 patients were randomly assigned into group A (HTO + intra-articular PRP injection) and group B (HTO + intra-articular saline injection) via computer-generated randomization. PRP was prepared preoperatively from autologous blood and administered during surgery and 14 d after operation. Follow-ups were conducted for 3 months, with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Visual Analogue Scale (VAS) scores recorded at each visit. The differences were compared between the two groups. Results 3 months after operation, the total WOMAC scores and VAS scores were significantly lower in both groups compared with those before operation, especially in group A(P＜0.05). Conclusions HTO combined with PRP may represent a more rational treatment option for alleviating knee pain and improving knee joint function of medial compartment osteoarthritis in elderly patients.

Key words: aged, high tibial osteotomy, platelet-rich plasma, medial compartment osteoarthritis

CLC Number:

R 684

QI Rongfu, XIE Tong, ZHOU Jie, ZHOU Liwu, YIN Haijian. Early application value of high tibial osteotomy combined with platelet-rich plasma in the treatment of elderly patients with medial compartment osteoarthritis[J]. Practical Geriatrics, 2026, 40(4): 400-405.

References

[1] MOSENG T, VLIET VLIELAND T P M, BATTISTA S, et al. EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis:2023 update[J]. Ann Rheum Dis, 2024, 83(6):730-740.
[2] LONG H, LIU Q, YIN H, et al. Prevalence trends of site-specific osteoarthritis from 1990 to 2019:findings from the global burden of disease study 2019[J]. Arthritis Rheumatol, 2022, 74(7):1172-1183.
[3] FLOERKEMEIER S, STAUBLI A E, SCHROETER S, et al. Outcome after high tibial open-wedge osteotomy:a retrospective evaluation of 533 patients[J]. Knee Surg Sports Traumatol Arthrosc, 2013, 21(1):170-180.
[4] HARRIS J D, MCNEILAN R, SISTON R A, et al. Survival and clinical outcome of isolated high tibial osteotomy and combined biological knee reconstruction[J]. Knee, 2013, 20(3):154-161.
[5] LIU X, CHEN Z, GAO Y, et al. High tibial osteotomy:review of techniques and biomechanics[J]. J Healthc Eng, 2019, 2019:8363128.
[6] BUCKWALTER J A, MARTIN J, MANKIN H J. Synovial joint degeneration and the syndrome of osteoarthritis[J]. Instr Course Lect, 2000, 49:481-489.
[7] WU Q, YAO X, SHAN N, et al. Platelet-rich plasma ameliorates cartilage degradation in rat models of osteoarthritis via the OPG/RANKL/RANK system[J]. Folia Histochem Cytobiol, 2024, 62(3):154-164.
[8] MIGLIORINI F, DRIESSEN A, QUACK V, et al. Comparison between intra-articular infiltrations of placebo, steroids, hyaluronic and PRP for knee osteoarthritis:a Bayesian network meta-analysis[J]. Arch Orthop Trauma Surg, 2021, 141(9):1473-1490.
[9] FAMILIARI F, AMMENDOLIA A, RUPP M C, et al. Efficacy of intra-articular injections of hyaluronic acid in patients with glenohumeral joint osteoarthritis:a systematic review and meta-analysis[J]. J Orthop Res, 2023, 41(11):2345-2358.
[10] PAGET L D A, REURINK G, DE VOS R J, et al. Platelet-rich plasma injections for the treatment of ankle osteoarthritis[J]. Am J Sports Med, 2023, 51(10):2625-2634.
[11] FAUL F, ERDFELDER E, LANG A G, et al. G*Power 3:a flexible statistical power analysis program for the social, behavioral, and biomedical sciences[J]. Behav Res Methods, 2007, 39(2):175-191.
[12] HOPEWELL S, BOUTRON I, ALTMAN D G, et al. Impact of a web-based tool (WebCONSORT) to improve the reporting of randomised trials:results of a randomised controlled trial[J]. BMC Med, 2016, 14(1):199.
[13] GAASBEEK R D A, WELSING R T C, VERDONSCHOT N, et al. Accuracy and initial stability of open- and closed-wedge high tibial osteotomy:a cadaveric RSA study[J]. Knee Surg Sports Traumatol Arthrosc, 2005, 13(8):689-694.
[14] OGDEN S, MUKHERJEE D P, KEATING M E, et al. Changes in load distribution in the knee after opening-wedge or closing-wedge high tibial osteotomy[J]. J Arthroplasty, 2009, 24(1):101-109.
[15] SAFDARI M, DASTJERDI A, MAKHMALBAF N, et al. Closing-wedge and opening-wedge high tibial osteotomy as successful treatments of symptomatic medial osteoarthritis of the knee:a randomized controlled trial[J]. Arch Bone Jt Surg, 2023, 11(6):421-428.
[16] SCHUSTER P, GEßLEIN M, SCHLUMBERGER M, et al. Ten-year results of medial open-wedge high tibial osteotomy and chondral resurfacing in severe medial osteoarthritis and varus malalignment[J]. Am J Sports Med, 2018, 46(6):1362-1370.
[17] SMITH T O, SEXTON D, MITCHELL P, et al. Opening- or closing-wedged high tibial osteotomy:a meta-analysis of clinical and radiological outcomes[J]. Knee, 2011, 18(6):361-368.
[18] SPRENGER T R, DOERZBACHER J F. Tibial osteotomy for the treatment of varus gonarthrosis. Survival and failure analysis to twenty-two years[J]. J Bone Joint Surg Am, 2003, 85(3):469-474.
[19] KUMAGAI K, AKAMATSU Y, KOBAYASHI H, et al. Factors affecting cartilage repair after medial opening-wedge high tibial osteotomy[J]. Knee Surg Sports Traumatol Arthrosc, 2017, 25(3):779-784.
[20] TANG Y, WANG H, SUN Y, et al. Using platelet-rich plasma hydrogel to deliver mesenchymal stem cells into three-dimensional PLGA scaffold for cartilage tissue engineering[J]. ACS Appl Bio Mater, 2021, 4(12):8607-8614.
[21] VINOD E, AMIRTHAM S M, KACHROO U, et al. Articular chondroprogenitors in platelet rich plasma for treatment of osteoarthritis and osteochondral defects in a rabbit knee model[J]. Knee, 2021, 30:51-62.
[22] JEYA LISHA J, PARASURAMAN G, AMIRTHAM S M, et al. Comparative assessment of chondral defect repair using migratory chondroprogenitors suspended in either gelled or freeze-dried platelet-rich plasma:an in vitro and ex vivo human osteochondral unit model study[J]. Knee, 2024, 48:105-119.
[23] HUANG P, WANG R, PANG X, et al. Platelet-rich plasma combined with ozone prevents cartilage destruction and improves weight-bearing asymmetry in a surgery-induced osteoarthritis rabbit model[J]. Ann Palliat Med, 2022, 11(2):442-451.
[24] YOSHIOKA T, ARAI N, SUGAYA H, et al. The effectiveness of leukocyte-poor platelet-rich plasma injections for symptomatic mild to moderate osteoarthritis of the knee with joint effusion or bone marrow lesions in a Japanese population:a randomized, double-blind, placebo-controlled clinical trial[J]. Am J Sports Med, 2024, 52(10):2493-2502.
[25] SAITA Y, KOBAYASHI Y, UCHINO S, et al. Platelet-rich plasma therapy for knee osteoarthritis:insights from real-world clinical data in Japan[J]. Regen Ther, 2025, 29:427-434.
[26] BELK J W, KRAEUTLER M J, HOUCK D A, et al. Platelet-rich plasma versus hyaluronic acid for knee osteoarthritis:a systematic review and meta-analysis of randomized controlled trials[J]. Am J Sports Med, 2021, 49(1):249-260.
[27] TOTLIS T, ACHLATIS V, EMFIETZIS P K, et al. A single intra-articular stromal vascular fraction with platelet-rich plasma injection yields superior clinical outcomes than a hyaluronic acid injection in patients with knee osteoarthritis:a prospective comparative study[J]. Knee Surg Sports Traumatol Arthrosc, 2025. doi:10.1002/ksa.70068.
[28] GHORBANI O, MAHDIBARZI D, YOUSEFI-TOODDESHKI P. Comparison of the short-term effect of intra-articular hyaluronic acid and platelet-rich plasma injections in knee osteoarthritis:a randomized clinical trial[J]. J Prev Med Hyg, 2024, 65(2):E214-E220.
[29] CERZA F, CARNì S, CARCANGIU A, et al. Comparison between hyaluronic acid and platelet-rich plasma, intra-articular infiltration in the treatment of gonarthrosis[J]. Am J Sports Med, 2012, 40(12):2822-2827.
[30] BAKI N M A, NAWITO Z O, ABDELSALAM N M S, et al. Does intra-articular injection of platelet-rich plasma have an effect on cartilage thickness in patients with primary knee osteoarthritis?[J]. Curr Rheumatol Rev, 2021, 17(3):294-302.
[31] KON E, DE GIROLAMO L, LAVER L, et al. Platelet-rich plasma injections for the management of knee osteoarthritis:The ESSKA-ICRS consensus. Recommendations using the RAND/UCLA appropriateness method for different clinical scenarios[J]. Knee Surg Sports Traumatol Arthrosc, 2024, 32(11):2938-2949.
[32] LAVER L, FILARDO G, SANCHEZ M, et al. The use of injectable orthobiologics for knee osteoarthritis:a European ESSKA-ORBIT consensus. Part 1-Blood-derived products (platelet-rich plasma)[J]. Knee Surg Sports Traumatol Arthrosc, 2024, 32(4):783-797.
[33] JOSHI JUBERT N, RODRÍGUEZ L, REVERTÉ-VINAIXA M M, et al. Platelet-rich plasma injections for advanced knee osteoarthritis:a prospective, randomized, double-blinded clinical trial[J]. Orthop J Sports Med, 2017, 5(2):2325967116689386.
[34] JOHNSON D S, DHIMAN N, BADHAL S, et al. Effects of intra-articular platelet rich plasma on cartilage thickness, clinical and functional outcomes in knee osteoarthritis[J]. Cureus, 2022, 14(12):e32256.

Early application value of high tibial osteotomy combined with platelet-rich plasma in the treatment of elderly patients with medial compartment osteoarthritis

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