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Repair of medial meniscus posterior root tear is effective for root healing and cartilage regeneration in opening wedge high tibial osteotomy

Knee Surgery, Sports Traumatology, Arthroscopy (2023)Cite this article

Abstract

Purpose

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 between the OWHTO-with-MMPRT-repair and OWHTO alone groups were compared according to whether microfracture was performed on the MFC.

Results

The overall healing rate of the MMPRT was higher in the OWHTO-with-MMPRT-repair group than that in the OWHTO alone group (P < 0.001). In addition, in the subgroup analysis, no difference in the MMPRT healing rate between the over-correction and under-correction groups when MMPRT repair was performed (n.s). In contrast, without MMPRT repair, the healing rate was lower in the under-correction group than that in the over-correction group (P = 0.03). Cartilage regeneration of the OWHTO-with-MMPRT-repair group was superior to that of the OWHTO alone group (P < 0.05). The IKDC subjective scores of the OWHTO-with-MMPRT-repair and OWHTO alone groups were 34.5 and 33.1 before surgery (n.s) and 50 and 47.2 at one year after surgery, respectively (n.s). 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 might improve MMPRT healing, even with under-correction, and cartilage regeneration of MFC, regardless of microfracture. However, OWHTO with MMPRT repair might not improve short-term clinical outcomes compared to OWHTO alone. Further randomized clinical trials are necessary.

Level of evidence

III, Retrospective cohort study.

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Data availability

The data that support the findings of this study are not openly available due to reasons of sensitivity and are available from the corresponding author upon reasonable request.

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Acknowledgements

Not applicable.

Funding

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).

Author information

Author notes

  1. Yun Seong Choi and Moon Jong Chang contributed equally to this work as first authors.

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Veterans Health Service Medical Center, Seoul, South Korea

    Yun Seong Choi & Jae Hee Lee

  2. Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, South Korea

    Moon Jong Chang, Tae Woo Kim, Chong Bum Chang & Seung-Baik Kang

  3. Department of Orthopedic Surgery, Seoul National University College of Medicine, SMG-SNU Boramae Medical Center, Seoul, South Korea

    Moon Jong Chang, Tae Woo Kim & Seung-Baik Kang

  4. Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul, South Korea

    Ji Han Lee

  5. Shiley Center for Orthopaedic Research and Education at Scripps Clinic, La Jolla, CA, USA

    Darryl D. D’Lima

  6. Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam-si, South Korea

    Chong Bum Chang

Authors
  1. Yun Seong Choi
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Contributions

YSC: data acquisition, data analysis, data interpretation, drafting manuscript, MJC: design, data interpretation, drafting manuscript; JHL: data acquisition; JHL: data acquisition; DDD: data interpretation; TWK: data acquisition, data analysis, data interpretation; CBC: Design, data interpretation; S-BK: Design, data interpretation, manuscript revision.

Corresponding author

Correspondence to Seung-Baik Kang.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the institutional review board (IRB) of Seoul Metropolitan Government—Seoul National University Boramae Medical Center (SMG-SNU BMC) (IRB NO: 20-2022-14).

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Choi, Y.S., Chang, M.J., Lee, J.H. et al. Repair of medial meniscus posterior root tear is effective for root healing and cartilage regeneration in opening wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc (2023). https://doi.org/10.1007/s00167-023-07637-z

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