By correcting the lower extremity alignment of the proximal tibial osteotomy, the force of the knee osteoarthritis can be redistributed to the healthy part of the knee joint, so as to slow down the degenerative changes of the knee joint, which is beneficial to the bone joint with malalignment. inflammation treatment. It is an important method for the treatment of knee osteoarthritis.

By searching Chinese biomedical literature, China national knowledge infrastructure(CNKI), Wanfang, Database for Chinese Technical Periodicals(VIP), Excerpta Medica Database(Embase), PubMed, Cochrane Library, Web of Science and China Biology Medicine disc(CBM), the retrieval time was from the establishment of the database to November 2022. All comparative studies comparing autogenous bone graft with other bone graft materials in open wedge high tibial osteotomy were searched. The research types, subjects, interventions and evaluation indicators of the literature were comprehensively screened, the quality of the literature was evaluated and the data were extracted. Revman Manager5.4 software was used for meta-analysis. The primary outcome measures were operation time, healing time, postoperative femoro tibial angle (FTA), postoperative Knee Society score (KSS) knee score, postoperative Hospital for Special Surgery (HSS) knee function score, delayed union rate, postoperative lateral hinge fracture, and complications.

A total of nine articles were included, with a total of 437 cases of knee joints undergoing high tibial osteotomy, of which 203 cases underwent autograft and 234 cases underwent allograft or artificial bone graft. The results of meta-analysis showed that the operative time of the autogenous bone group was longer than that of the other bone graft groups[mean difference(MD)=13.94, 95% confidence interval(CI) (11.39, 16.50), P< 0.001]. The healing time of autogenous group was shorter than that of other bone graft groups[standardized mean difference(SMD)=-0.45, 95%CI (-0.87, -0.02), Z =2.04, P=0.04]. Postoperative FTA [MD=0.02, 95%CI: (-0.33, 0.37), Z=0.11, P=0.91], postoperative KSS knee score [MD=2.16, 95%CI (-3.17, 7.49), P=0.43], postoperative HSS knee function score [MD=0.25, 95%CI (-0.38, 0.87), P=0.44], delayed healing rate [risk difference(RD) =-0.02, 95%CI(-0.08, 0.05), Z=0.51, P=0.61], postoperative lateral hinge fracture [risk ratio(RR)=0.72, 95%CI(0.42, 1.23), P=0.23] and complications [RD=-0.00, 95%CI(-0.06, 0.06), P=0.98], showed no statistically significant difference between the two groups.

Autologous bone can better promote the healing of the osteotomy end without increasing the occurrence of complications in the open cuneiform high tibial osteotomy, but the intraoperative time is also increased accordingly. It is recommended to routinely use autologous bone graft to better promote the healing of the hinge end. However, due to the limited quantity and quality of literature included in this study, the conclusions still need to be further verified by large-sample/high-quality prospective randomized controlled studies.