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Updated: Jan 14, 2026
The Lower Body Positive Pressure Treadmill for Knee Osteoarthritis Rehabilitation
Published on: July 22, 2019
Clinical outcomes of open-wedge high-tibial osteotomy with bone marrow stimulation techniques in knee osteoarthritis:
Shaun Kai Kiat Chua1, Ashton Kai Shun Tan1, Don Thong Siang Koh1
1Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.
Introduction:
The clinical outcomes of open-wedge high-tibial osteotomy (HTO) combined with bone marrow stimulation techniques (BMSTs) (microfracture [MF], subchondral drilling [SD], microdrilling [MD] and abrasion arthroplasty[AA]) in patients with knee osteoarthritis are unclear. The aim of this systematic review was to present an up-to-date summary of the clinical outcomes associated with HTO combined with BMST in patients with knee osteoarthritis.
Methods:
A systematic database search on PubMed, Embase, Web of Science, and CINAHL was performed from inception up to 3 March 2024 in accordance with the PRISMA guideline. A narrative synthesis was undertaken to complement the quantitative analysis done.
Results:
A total of 11 studies involving 516 patients were included. Six studies reported HTO with MF, one reported HTO with SD, two reported HTO with MD, one reported HTO with AA, and one reported HTO with chondral resurfacing. The average mean follow-up period was 33 months (range 12-120). Overall, most of the studies reported an improvement in cartilage regeneration and clinical scores above the minimal clinically important difference.
Conclusion:
While HTO with BMST shows good clinical outcomes and postoperative cartilage regeneration, the reported outcomes are highly heterogeneous. More comparative studies are needed to establish whether HTO with BMST should be recommended over isolated HTO in practice.
