[Impact of high tibial osteotomy alone or combined with medial meniscus posterior root repair on medial meniscus posterior root tear healing and its correlation with clinical outcomes].

Objective: To compare the healing status of medial meniscus posterior root tear (MMPRT) in patients treated with either isolated high tibial osteotomy (HTO) or HTO combined with MMPRT repair, and to analyze its relationship with clinical outcomes. Methods: A retrospective analysis was conducted on 38 patients who underwent isolated HTO and 26 patients who underwent HTO combined with MMPRT repair at the Hebei Medical University Third Hospital between June 2022 and June 2024. The MMPRT healing rates (complete/partial/failure) were compared between the two groups during second-look arthroscopy. Based on MMPRT healing status, the patients were divided into the Healed group (n=44) and the Non-healed group (n=20). The cartilage repair status of the medial femoral condyle (MFC) and medial tibial plateau (MTP) was compared between these two groups using the International Cartilage Repair Society (ICRS) grading system during second-look arthroscopy. The clinical outcomes were assessed using the visual analog scale (VAS) of pain, Lysholm score, and Tegner score prior to the second-look arthroscopy. The radiographic evaluations included the hip-knee-ankle angle (HKA), joint line convergence angle (JLCA), posterior tibial slope (PTS), medial proximal tibial angle (MPTA), and Kellgren-Lawrence grading. Results: A total of 64 cases were enrolled, there were 28 males and 36 females with a mean age of (50.9±6.6) years. Although the MMPRT healing rate was slightly higher in the HTO+MMPRT group, there was no statistically significant difference between the two groups [88.5%(23/26) vs 81.6%(31/38), P=0.456]. Cartilage regeneration in the Healed group was superior to that in the Non-healed group. For patients in the Healed group and the Non-healed group, the improvement rates of ICRS grade for the MFC was 59.1% (26/44) and 25.0% (5/20), respectively, and the improvement rates of ICRS grade for the MTP was 50.0% (22/44) and 15.0% (3/20), respectively, and there were statistically significant differences in both comparisons between the two groups (both P<0.001). At the final follow-up, the VAS, Lysholm, and Tegner scores of patients in both the Healed group and the Non-healed group were significantly improved when compared with the preoperative values (all P<0.05), but there was no statistically significant differences between the two groups[(1.3±1.1) vs (1.7±1.1) points, (87.9±5.3) vs (86.6±2.5) points, and (3.7±1.4) vs (3.5±1.1) points, respectively] (all P>0.05). At the final follow-up, the HKA and MPTA in the Healed group and the Non-healed group were all significantly increased when compared with those before the operation (all P<0.05), while the JLCA was significantly decreased (P<0.05); however, no statistically significant differences was found between the two groups (182.3°±1.9° vs 181.7°±1.4°, 92.7°±3.1° vs 93.1°±2.0°, and 2.2°±0.9° vs 2.1°±0.7°, respectively) (all P>0.05). At the final follow-up, neither group showed significant improvement in Kellgren-Lawrence grade compared to preoperative assessments (all P>0.05), with no statistically significant difference between the two groups (P=0.590). Conclusions: During short-term follow-up, HTO combined with MMPRT repair does not significantly improve the MMPRT healing rate when compared to isolated HTO. Although patients with healed MMPRT exhibit better cartilage repair, they show no superior improvement in clinical and radiographic outcomes.