Skip to main content

Advertisement

SpringerLink
Log in

Type of medial meniscus tear does not affect the clinical and radiological outcomes of medial opening-wedge high tibial osteotomy

  • KNEE
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The current study aimed to evaluate the effect of medial meniscus posterior root tear (MMPRT) on radiological and clinical outcomes after medial opening-wedge high tibial osteotomy (MOWHTO).

Methods

This retrospective cohort study included patients who underwent MOWHTO (113 knees) at our hospital between September 2012 and June 2020 and who were followed up for > 2 years. The radiological and clinical outcomes were compared between the MMPRT group (52 knees), who included patients with MMPRT, and the non-MMPRT group (61 knees), who comprised patients without meniscal tear or with any type of meniscal tear other than MMPRT. Logistic regression analysis was performed to evaluate factors affecting osteoarthritis (OA) progression after MOWHTO.

Results

The mean follow-up period was 40.6 ± 14.2 months. The mean ages of the MMPRT and non-MMPRT groups were 56.9 ± 6.4 and 54.4 ± 6.1 years, respectively (p = 0.031). There was no significant difference in the last follow-up radiological and clinical outcomes between the two groups. In the logistic regression analysis, the postoperative hip–knee–ankle angle was a risk factor of OA progression after MOWHTO (odds ratio 0.7; 95% confidence interval 0.5–0.9; p = 0.006), and the type of medial meniscus tear was not associated with OA progression (p = n.s.).

Conclusions

In the short- to mid-term follow-up of MOWHTO, the radiological or clinical outcomes of patients with MMPRT were not inferior to those of patients without MMPRT. Postoperative lower extremity alignment, but not MMPRT, was a factor influencing MOWHTO prognosis. Concurrent root repair in HTO will restore the anatomy better; however, its effect on progression of OA is yet to be proven.

Level of evidence

IV.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Allaire R, Muriuki M, Gilbertson L, Harner CD (2008) Biomechanical consequences of a tear of the posterior root of the medial meniscus. Similar to total meniscectomy. J Bone Joint Surg Am 90(9):1922–1931

    Article  PubMed  Google Scholar 

  2. Bhatia S, LaPrade CM, Ellman MB, LaPrade RF (2014) Meniscal root tears: significance, diagnosis, and treatment. Am J Sports Med 42(12):3016–3030

    Article  PubMed  Google Scholar 

  3. Chang PS, Radtke L, Ward P, Brophy RH (2022) Midterm outcomes of posterior medial meniscus root tear repair: a systematic review. Am J Sports Med 50(2):545–553

    Article  PubMed  Google Scholar 

  4. Choi ES, Park SJ (2015) Clinical evaluation of the root tear of the posterior horn of the medial meniscus in total knee arthroplasty for osteoarthritis. Knee Surg Relat Res 27(2):90–94

    Article  PubMed  PubMed Central  Google Scholar 

  5. Chung KS, Ha JK, Ra HJ, Kim JG (2016) A meta-analysis of clinical and radiographic outcomes of posterior horn medial meniscus root repairs. Knee Surg Sports Traumatol Arthrosc 24(5):1455–1468

    Article  PubMed  Google Scholar 

  6. Fujisawa Y, Masuhara K, Shiomi S (1979) The effect of high tibial osteotomy on osteoarthritis of the knee. An arthroscopic study of 54 knee joints. Orthop Clin N Am 10(3):585–608

    Article  CAS  Google Scholar 

  7. Hwang BY, Kim SJ, Lee SW, Lee HE, Lee CK, Hunter DJ, Jung KA (2012) Risk factors for medial meniscus posterior root tear. Am J Sports Med 40(7):1606–1610

    Article  PubMed  Google Scholar 

  8. Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res 248:13–14

    Article  Google Scholar 

  9. Jiang EX, Abouljoud MM, Everhart JS, DiBartola AC, Kaeding CC, Magnussen RA, Flanigan DC (2019) Clinical factors associated with successful meniscal root repairs: a systematic review. Knee 26(2):285–291

    Article  CAS  PubMed  Google Scholar 

  10. Jing L, Liu K, Wang X, Wang X, Li Z, Zhang X, Wang S, Yang J (2020) Second-look arthroscopic findings after medial open-wedge high tibial osteotomy combined with all-inside repair of medial meniscus posterior root tears. J Orthop Surg (Hong Kong) 28(1):2309499019888836

    Article  PubMed  Google Scholar 

  11. Kang BY, Lee DK, Kim HS, Wang JH (2022) How to achieve an optimal alignment in medial opening wedge high tibial osteotomy? Knee Surg Relat Res 34(1):3

    Article  PubMed  PubMed Central  Google Scholar 

  12. Ke X, Qiu J, Chen S, Sun X, Wu F, Yang G, Zhang L (2021) Concurrent arthroscopic meniscal repair during open-wedge high tibial osteotomy is not clinically beneficial for medial meniscus posterior root tears. Knee Surg Sports Traumatol Arthrosc 29(3):955–965

    Article  PubMed  Google Scholar 

  13. Kellgren JH, Lawrence JS (1957) Radiological assessment of osteo-arthrosis. Ann Rheum Dis 16(4):494–502

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Kim JS, Lim JK, Choi HG, Jeong HW, Park SB, Shim SJ, Lee YS (2022) Excessively increased joint-line obliquity after medial opening-wedge high tibial osteotomy is associated with inferior radiologic and clinical outcomes: what is permissible joint-line obliquity. Arthroscopy 38(6):1904–1915

    Article  PubMed  Google Scholar 

  15. Kim KI, Bae JK, Jeon SW, Kim GB (2021) Medial meniscus posterior root tear does not affect the outcome of medial open-wedge high tibial osteotomy. J Arthroplasty 36(2):423–428

    Article  PubMed  Google Scholar 

  16. Kim YM, Joo YB, Lee WY, Kim YK (2021) Remodified Mason-Allen suture technique concomitant with high tibial osteotomy for medial meniscus posterior root tears improved the healing of the repaired root and suppressed osteoarthritis progression. Knee Surg Sports Traumatol Arthrosc 29(4):1258–1268

    Article  PubMed  Google Scholar 

  17. Kyun-Ho S, Hyun-Jae R, Ki-Mo J, Seung-Beom H (2021) Effect of concurrent repair of medial meniscal posterior root tears during high tibial osteotomy for medial osteoarthritis during short-term follow-up: a systematic review and meta-analysis. BMC Musculoskelet Disord 22(1):623

    Article  PubMed  PubMed Central  Google Scholar 

  18. Lee OS, Lee SH, Lee YS (2021) Comparison of the radiologic, arthroscopic, and clinical outcomes between repaired versus unrepaired medial meniscus posterior horn root tear during open wedge high tibial osteotomy. J Knee Surg 34(1):57–66

    Article  PubMed  Google Scholar 

  19. Moon HK, Koh YG, Kim YC, Park YS, Jo SB, Kwon SK (2012) Prognostic factors of arthroscopic pull-out repair for a posterior root tear of the medial meniscus. Am J Sports Med 40(5):1138–1143

    Article  PubMed  Google Scholar 

  20. Nejima S, Kumagai K, Yamada S, Sotozawa M, Kumagai D, Yamane H, Inaba Y (2022) Risk of interference between the tibial tunnel and locking screws in medial meniscus posterior root repair and open wedge high tibial osteotomy. J Exp Orthop 9(1):25

    Article  PubMed  PubMed Central  Google Scholar 

  21. Ollivier B, Berger P, Depuydt C, Vandenneucker H (2021) Good long-term survival and patient-reported outcomes after high tibial osteotomy for medial compartment osteoarthritis. Knee Surg Sports Traumatol Arthrosc 29(11):3569–3584

    Article  PubMed  Google Scholar 

  22. Ozkoc G, Circi E, Gonc U, Irgit K, Pourbagher A, Tandogan RN (2008) Radial tears in the root of the posterior horn of the medial meniscus. Knee Surg Sports Traumatol Arthrosc 16(9):849–854

    Article  PubMed  Google Scholar 

  23. Pache S, Aman ZS, Kennedy M, Nakama GY, Moatshe G, Ziegler C, LaPrade RF (2018) Meniscal root tears: current concepts review. Arch Bone Jt Surg 6(4):250–259

    PubMed  PubMed Central  Google Scholar 

  24. Park HJ, Chang MJ, Cho HJ, Hong E, Kim TW, Chang CB, Bae TS, Kwak DS, Kang SB (2023) Medial meniscus posterior root repair restores contact pressure and contact area to its native state even after opening-wedge high tibial osteotomy: a cadaveric biomechanical study. Arthroscopy 39(3):638–646

    Article  PubMed  Google Scholar 

  25. Petersen W, Forkel P, Feucht MJ, Zantop T, Imhoff AB, Brucker PU (2014) Posterior root tear of the medial and lateral meniscus. Arch Orthop Trauma Surg 134(2):237–255

    Article  PubMed  Google Scholar 

  26. Song IS, Kwon J (2022) Analysis of changes in tibial torsion angle on open-wedge high tibial osteotomy depending on the osteotomy level. Knee Surg Relat Res 34(1):17

    Article  PubMed  PubMed Central  Google Scholar 

  27. Song JH, Bin SI, Kim JM, Lee BS, Park JG, Lee SM (2022) Risk factors for increase in posterior slope after medial open-wedge high tibial osteotomy. Orthop J Sports Med 10(11):23259671221137040

    PubMed  PubMed Central  Google Scholar 

  28. Suh DW, Yeo WJ, Han SB, So SY, Kyung BS (2021) Simple medial meniscus posterior horn root repair using an all-inside meniscal repair device combined with high tibial osteotomy to maintain joint-space width in a patient with a repairable tear. Indian J Orthop 55(2):397–404

    Article  PubMed  Google Scholar 

  29. Wang H, Man Q, Gao Y, Xu L, Zhang J, Ma Y, Meng Q (2023) The efficacy of medial meniscal posterior Root tear Repair with or without high tibial osteotomy: a systematic review. BMC Musculoskelet Disord 24(1):464

    Article  PubMed  PubMed Central  Google Scholar 

  30. Yang JH, Yoon JR, Jeong HI, Hwang DH, Woo SJ, Kwon JH, Nha KW (2012) Second-look arthroscopic assessment of arthroscopic single-bundle posterior cruciate ligament reconstruction: comparison of mixed graft versus achilles tendon allograft. Am J Sports Med 40(9):2052–2060

    Article  PubMed  Google Scholar 

  31. Zhu S, Li X, Wu JL, Bao L, Wang P, Gu H, Wang C, Wang J (2021) Non-anatomic repair of medial meniscus posterior root tears to the posterior capsule provided favourable outcomes in middle-aged and older patients. Knee Surg Sports Traumatol Arthrosc 29(12):4261–4269

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

Statistical analysis of this study was supported by Inje University Busan Paik Hospital.

Funding

This work was supported by a grant from Research year of Inje University in 2019 (No. 20190035).

Author information

Authors and Affiliations

  1. Department of Orthopedic Surgery, Inje University Busan Paik Hospital, 75, Bokji-ro, Busanjin-gu, Busan, 47392, Republic of Korea

    Chang-Wan Kim, Chang-Rack Lee & Gyu-Ha Son

Authors
  1. Chang-Wan Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Chang-Rack Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gyu-Ha Son
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Chang-Rack Lee.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study was approved by the institutional review board in our institution (Inje University Busan Paik Hospital, IRB No, 2022-12-015).

Informed consent

Formal consent was not required for the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 19 kb)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kim, CW., Lee, CR. & Son, GH. Type of medial meniscus tear does not affect the clinical and radiological outcomes of medial opening-wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 31, 5025–5033 (2023). https://doi.org/10.1007/s00167-023-07542-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-023-07542-5

Keywords

Search

Navigation