Description
Title : Repair of medial meniscus posterior root tear is effective for root healing and cartilage regeneration in opening wedge high tibial osteotomy
Objectives: This study aimed to determine whether the repair of a medial meniscus posterior root tear (MMPRT) is effective for MMPRT healing, cartilage regeneration, and clinical outcomes in opening wedge high tibial osteotomy (OWHTO).
Methods: This retrospective study included 80 patients who underwent OWHTO and subsequent second-look arthroscopy. The patients were divided into OWHTO-with-MMPRT-repair (n = 40) and OWHTO alone (n = 40) groups, and the healing rates (complete/partial/failure) were compared. Each group was further divided into over- and under-corrected subgroups to compare healing rates. The International Cartilage Repair Society (ICRS) grade, cartilage defect size, Koshino stage, ICRS cartilage repair assessment score of the medial femoral condyle (MFC), and International Knee Documentation Committee (IKDC) scores were compared between the OWHTO-with-MMPRT-repair and OWHTO alone groups.
Results: The overall healing rate of the MMPRT was higher in the OWHTO-with-MMPRT-repair group than that in the OWHTO alone group. In addition, in the subgroup analysis, the MMPRT healing rate in the under-correction group was not inferior to that in the over-correction group when MMPRT repair was performed. In contrast, without MMPRT repair, the healing rate was lower in the under-correction group than that in the over-correction group. Cartilage regeneration was better in the OWHTO-with-MMPRT-repair group than that in the OWHTO alone group. The IKDC subjective scores of the OWHTO-with-MMPRT-repair and OWHTO alone groups were 34.5 and 33.1 before surgery (P = 0.249) and 50 and 47.2 at one year after surgery, respectively (P = 0.179). These differences between the two groups for cartilage regeneration and IKDC subjective scores showed the same pattern regardless of microfractures.
Conclusions: MMPRT repair during OWHTO improved MMPRT healing, even with under-correction, and cartilage regeneration of the MFC, regardless of microfracture. However, better outcomes in subsequent second-look arthroscopy did not achieve short-term clinical improvement.
Acknowledgement: This work was carried out with financial support from Bio & Medical Technology Development Program of the National Research Foundation (NRF) funded by the Korean government (2021K1A3A1A49098116).
