Journal of orthopaedic surgery and research · 2026
Arthroscopic all-in technique combined with high tibial osteotomy for osteoarthritis with posterior root tear of the medial meniscus: a short-term study with second-look arthroscopy.
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Zhang Xinda, Zheng Yi, Tian Siman, Niu Yingzhen, Dong Conglei, Zhang Zhuangdai, Dong Jiangtao
Аннотация
BACKGROUND: Medial Meniscus Posterior Root Tears (MMPRTs) are known to accelerate medial compartment knee osteoarthritis (OA). This study aimed to evaluate the short-term clinical outcomes of arthroscopic all-suture anchor (ASA) repair combined with high tibial osteotomy (HTO) for patients with medial compartment OA and MMPRTs, offering a potential new surgical approach for this condition.
METHODS: This study retrospectively reviewed 36 patients undergoing arthroscopic ASA repair combined with HTO for medial compartment OA with MMPRTs at our institution between June 2022 and June 2023. All patients underwent second-look arthroscopy during hardware removal. We collected demographic data (age, sex, affected side, duration of symptoms, complications), preoperative and postoperative Tegner activity scores, Lysholm scores, International Knee Documentation Committee (IKDC) scores, and Knee injury and Osteoarthritis Outcome Scores (KOOS). Radiographic comparisons (pre- and post-op) included Kellgren-Lawrence (K-L) grading, hip-knee-ankle angle (HKA), medial proximal tibial angle (MPTA), joint line convergence angle (JLCA), and posterior tibial slope (PTS). Medial meniscus extrusion rate (MMER) was also assessed. At second-look arthroscopy, the healing status of the medial meniscus posterior root was evaluated. Patients were subgrouped based on root healing status to examine correlations with clinical scores, MMER, K-L grade, and symptom duration.
RESULTS: The cohort comprised 30 females (83.3%) and 6 males (16.7%), with a mean age of 59 years. Mean follow-up was 24.8 ± 2.4 months. Significant improvements were observed in all final scores: Lysholm (46.58 ± 16.04 to 79.08 ± 14.29), IKDC (37.08 ± 14.57 to 65.81 ± 12.33), KOOS total scores (116.50 ± 26.13 to 65.89 ± 15.50), and Tegner (1.00 ± 1.27 to 2.33 ± 1.15) (all P < 0.001). Subgroup analysis revealed no significant differences between healed and non-healed groups regarding Lysholm, IKDC, KOOS, Tegner scores, symptom duration, or K-L grade. No complications (infection, nonunion, neurovascular issues) occurred by final follow-up.
CONCLUSION: ASA repair combined with HTO provides significant short-term improvement in clinical outcomes for MMPRTs with medial compartment OA. However, meniscal root healing did not correlate with clinical improvement, suggesting mechanical realignment plays a primary role.
METHODS: This study retrospectively reviewed 36 patients undergoing arthroscopic ASA repair combined with HTO for medial compartment OA with MMPRTs at our institution between June 2022 and June 2023. All patients underwent second-look arthroscopy during hardware removal. We collected demographic data (age, sex, affected side, duration of symptoms, complications), preoperative and postoperative Tegner activity scores, Lysholm scores, International Knee Documentation Committee (IKDC) scores, and Knee injury and Osteoarthritis Outcome Scores (KOOS). Radiographic comparisons (pre- and post-op) included Kellgren-Lawrence (K-L) grading, hip-knee-ankle angle (HKA), medial proximal tibial angle (MPTA), joint line convergence angle (JLCA), and posterior tibial slope (PTS). Medial meniscus extrusion rate (MMER) was also assessed. At second-look arthroscopy, the healing status of the medial meniscus posterior root was evaluated. Patients were subgrouped based on root healing status to examine correlations with clinical scores, MMER, K-L grade, and symptom duration.
RESULTS: The cohort comprised 30 females (83.3%) and 6 males (16.7%), with a mean age of 59 years. Mean follow-up was 24.8 ± 2.4 months. Significant improvements were observed in all final scores: Lysholm (46.58 ± 16.04 to 79.08 ± 14.29), IKDC (37.08 ± 14.57 to 65.81 ± 12.33), KOOS total scores (116.50 ± 26.13 to 65.89 ± 15.50), and Tegner (1.00 ± 1.27 to 2.33 ± 1.15) (all P < 0.001). Subgroup analysis revealed no significant differences between healed and non-healed groups regarding Lysholm, IKDC, KOOS, Tegner scores, symptom duration, or K-L grade. No complications (infection, nonunion, neurovascular issues) occurred by final follow-up.
CONCLUSION: ASA repair combined with HTO provides significant short-term improvement in clinical outcomes for MMPRTs with medial compartment OA. However, meniscal root healing did not correlate with clinical improvement, suggesting mechanical realignment plays a primary role.