Effect Of Allogeneic Bone Grafting In High Tibial Osteotomy On Early Postoperative Bony Healing And Rehabilitation

Objective: To compare the effects of allograft and no graft on the curative effect,early bone healing speed and functional recovery after open wedge high osteotomy(OWHTO).Methods: This retrospective study collected relevant data of 140 patients who received OWHTO from January 2018 to December 2020 in the Department of Sports Medicine,Provincial Hospital Affiliated to Anhui Medical University.A total of 65 patients were finally included in the study,including 30 cases in the allograft bone graft group and35 cases in the non-bone graft group.In this study,the subjective pain perception,clinical function score,imaging data and postoperative complications of the two groups of patients at different time periods after operation were compared to evaluate the clinical efficacy;The healing insertion point of the gap was located,and the healing rate of the osteotomy gap was calculated and compared at 3 months,6 months,12 months and the last follow-up,and the risk factors that might affect the healing rate of the osteotomy gap were discussed.In terms of postoperative rehabilitation,the range of motion(ROM)of the knee joint on the operated side and the ROM before operation,3months after operation and 6 months after operation were extracted and recorded in the two groups of patients.The peak torque(peak torque,PT)of lateral knee flexors and extensors was used to evaluate the postoperative rehabilitation process of the two groups of patients.Results: In terms of imaging,there was no significant difference between the two groups in the postoperative correction of internal derangement of the knee,and the bone healing rate was significantly higher in the allograft group than in the non-graft group at 3 months and 6 months postoperatively(P< 0.05),but not at 1 year postoperative and final follow-up.In the clinical assessment,the visual analogue of pain(VAS)score was significantly lower in the bone graft group than in the un-implanted group at the first partial weight-bearing postoperative period and at 2month postoperative.The peak moments of flexor and extensor muscles measured in the bone grafted group were significantly stronger than those in the un-implanted group at 1 month and 3 months postoperatively.Conclusions: Compared with the non-grafting group,implanting allograft bone in the osteotomy gap can improve the healing speed of the osteotomy gap in the early postoperative period and improve the early limb function of patients;it is of great significance to the early rehabilitation of patients.However,in the middle and late postoperative period,this advantage is no longer obvious over time.