Medial Meniscus Posterior Root Reconstruction and Open-Wedge High-Tibial Osteotomy for Medial Meniscus Posterior Root Tear With Varus Knee Alignment: A Retrospective Study on Short-Term Outcomes

Hiroki Okamura; Hiroki Ishikawa; Takuya Ohno; Shogo Fujita; Shota Yamamoto; Shigeo Yamakami; Kei Nagasaki; Yoshifumi Kudo

doi:10.7759/cureus.57170

Medial Meniscus Posterior Root Reconstruction and Open-Wedge High-Tibial Osteotomy for Medial Meniscus Posterior Root Tear With Varus Knee Alignment: A Retrospective Study on Short-Term Outcomes

Cureus. 2024 Mar 29;16(3):e57170. doi: 10.7759/cureus.57170. eCollection 2024 Mar.

Authors

Hiroki Okamura¹, Hiroki Ishikawa¹, Takuya Ohno¹, Shogo Fujita¹, Shota Yamamoto¹, Shigeo Yamakami¹, Kei Nagasaki², Yoshifumi Kudo²

Affiliations

¹ Department of Orthopaedic Surgery, Nihon Koukan Hospital, Kanagawa, JPN.
² Department of Orthopaedic Surgery, Showa University School of Medicine, Tokyo, JPN.

Abstract

Purpose: We describe 13 cases of medial meniscus posterior root tear (MMPRT) with varus knee alignment treated with medial meniscus posterior root reconstruction (MMPR-R) and open-wedge high-tibial osteotomy (OWHTO) to identify an optimal MMPRT treatment.

Methods: We retrospectively reviewed 13 patients (mean age: 66.3 ± 8.0 years) who underwent MMPR-R and OWHTO. The Knee Injury and Osteoarthritis Outcome Score (KOOS), femorotibial angle (FTA), percentage mechanical axis (%MA) on radiography, and medial meniscus extrusion (MME) on magnetic resonance imaging (MRI) between the preoperative period and last follow-up were compared. Moreover, meniscus healing status and the International Cartilage Repair Society (ICRS) classification of the medial femoral condyle and medial tibial plateau on arthroscopy between the initial surgery and second-look arthroscopy were compared.

Results: The mean follow-up duration was 12.8 ± 2.2 months. At the last follow-up, the KOOS significantly improved (P < 0.01). Based on the FTA and %MA, the varus alignment was predominantly corrected at the last follow-up (P < 0.01). The MME was increased in nine (62.9%) patients, and the mean MME significantly increased at the last follow-up (P = 0.04). Second-look arthroscopy revealed improvements in the ICRS grade for the medial femoral condyle and medial tibial plateau in six (46.2%) patients. However, the results did not significantly differ. Regarding meniscus healing, four (30.8%) patients presented with complete healing, eight (57.1%) with partial healing, and one (7.7%) with failed healing.

Conclusions: The MMPRT with varus knee alignment significantly improved with MMPR-R and OWHTO. However, the MME and meniscus healing were unsatisfactory.

Keywords: knee; medial meniscus posterior root reconstruction; medial meniscus posterior root tear; meniscus tear; open-wedge high-tibial osteotomy; osteoarthritis.