Posteromedial opening wedge high tibial osteotomy has favourable outcomes in simultaneous medial meniscus posterior root repair and varus medial knee osteoarthritis patients without concomitant root tear

Abstract Purpose To evaluate the radiological and clinical outcomes in two patient groups: first, varus aligned medial meniscus posterior root tear (MMPRT) patients who underwent posteromedial open wedge high tibial osteotomy (PMOWHTO) and simultaneous root repair; second, patients with varus medial...

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Main Authors: Ali Engin Dastan, Elcil Kaya Bicer, Huseyin Kaya, Mehmet Argin, Emin Taskiran
Format: Article
Language:English
Published: BMC 2025-01-01
Series:Journal of Orthopaedic Surgery and Research
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Online Access:https://doi.org/10.1186/s13018-025-05519-3
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author Ali Engin Dastan
Elcil Kaya Bicer
Huseyin Kaya
Mehmet Argin
Emin Taskiran
author_facet Ali Engin Dastan
Elcil Kaya Bicer
Huseyin Kaya
Mehmet Argin
Emin Taskiran
author_sort Ali Engin Dastan
collection DOAJ
description Abstract Purpose To evaluate the radiological and clinical outcomes in two patient groups: first, varus aligned medial meniscus posterior root tear (MMPRT) patients who underwent posteromedial open wedge high tibial osteotomy (PMOWHTO) and simultaneous root repair; second, patients with varus medial knee osteoarthritis without MMPRT who underwent PMOWHTO. Methods Patients had MMPRT repair concomitant with PMOWHTO and varus medial knee osteoarthritis without concomitant root tear patients who underwent PMOWHTO and were reviewed. Radiographic parameters, medial meniscus extrusion (MME) and Knee Society Scores [KSSs, including the following subscores: knee score (KS) and knee function score (KFS)] were evaluated. Continious variables are expressed as the median and interquartile range (IQR) [IQR: (Q1;Q3); Q1: median of lower half, Q3: median of upper half]. The minimum follow-up period was 24 months [29 (28;35) months]. Results A total of 36 knees of 34 patients underwent PMOWHTO were included. Patients were divided into two groups according to the presence or absence of a MMPRT. Nineteen of the 36 knees had MMPRTs, and all of them had concomitant root repair (Group 1). Seventeen of the 36 patients did not have MMPRTs (Group 2). The posterior tibial slope (PTS) decreased postoperatively in a total of 36 knees (p < 0.001). There were no significant changes in MME postoperatively in any intragroup comparison. The preoperative and follow-up MMEs of Group 1 were greater than those of Group 2 (p < 0.001). The KSs and KFSs in both Group 1 and Group 2 increased during follow-up [KS; Group 1: 43 (36;53) vs. 86 (84;95), p < 0.001. Group 2: 49 (45;57) vs. 89 (80;93), p < 0.001. KFS; Group 1: 60 (50;60) vs. 90 (80;100), p < 0.001. Group 2: 60 (50;60) vs. 80 (80;90), p < 0.001]. All knees achieved minimal clinically important difference (MCID) in terms of KSs. Eighteen (95%) knees achieved MCID in Group 1, and 17 (100%) achieved MCID in Group 2 in terms of KFSs. There were no differences between Groups 1 and 2 in terms of preoperative and follow-up KSs or preoperative KFSs. The follow-up KFSs in Group 1 was significantly greater than that in Group 2 (p = 0.032). Conclusions PMOWHTO has favourable clinical and radiological outcomes and prevents PTS increase in simultaneous MMPRT repair and varus medial knee osteoarthritis patients without concomitant root tear. Level of evidence Level IV, case series.
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spelling doaj-art-ea6ba80189b145749deb66eec17119912025-01-26T12:43:22ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2025-01-0120111310.1186/s13018-025-05519-3Posteromedial opening wedge high tibial osteotomy has favourable outcomes in simultaneous medial meniscus posterior root repair and varus medial knee osteoarthritis patients without concomitant root tearAli Engin Dastan0Elcil Kaya Bicer1Huseyin Kaya2Mehmet Argin3Emin Taskiran4Department of Orthopedics and Traumatology, Faculty of Medicine, Ege UniversityDepartment of Orthopedics and Traumatology, Faculty of Medicine, Ege UniversityDepartment of Orthopedics and Traumatology, Faculty of Medicine, Ege UniversityDepartment of Radiology, EMOT HospitalDepartment of Orthopedics and Traumatology, Faculty of Medicine, Ege UniversityAbstract Purpose To evaluate the radiological and clinical outcomes in two patient groups: first, varus aligned medial meniscus posterior root tear (MMPRT) patients who underwent posteromedial open wedge high tibial osteotomy (PMOWHTO) and simultaneous root repair; second, patients with varus medial knee osteoarthritis without MMPRT who underwent PMOWHTO. Methods Patients had MMPRT repair concomitant with PMOWHTO and varus medial knee osteoarthritis without concomitant root tear patients who underwent PMOWHTO and were reviewed. Radiographic parameters, medial meniscus extrusion (MME) and Knee Society Scores [KSSs, including the following subscores: knee score (KS) and knee function score (KFS)] were evaluated. Continious variables are expressed as the median and interquartile range (IQR) [IQR: (Q1;Q3); Q1: median of lower half, Q3: median of upper half]. The minimum follow-up period was 24 months [29 (28;35) months]. Results A total of 36 knees of 34 patients underwent PMOWHTO were included. Patients were divided into two groups according to the presence or absence of a MMPRT. Nineteen of the 36 knees had MMPRTs, and all of them had concomitant root repair (Group 1). Seventeen of the 36 patients did not have MMPRTs (Group 2). The posterior tibial slope (PTS) decreased postoperatively in a total of 36 knees (p < 0.001). There were no significant changes in MME postoperatively in any intragroup comparison. The preoperative and follow-up MMEs of Group 1 were greater than those of Group 2 (p < 0.001). The KSs and KFSs in both Group 1 and Group 2 increased during follow-up [KS; Group 1: 43 (36;53) vs. 86 (84;95), p < 0.001. Group 2: 49 (45;57) vs. 89 (80;93), p < 0.001. KFS; Group 1: 60 (50;60) vs. 90 (80;100), p < 0.001. Group 2: 60 (50;60) vs. 80 (80;90), p < 0.001]. All knees achieved minimal clinically important difference (MCID) in terms of KSs. Eighteen (95%) knees achieved MCID in Group 1, and 17 (100%) achieved MCID in Group 2 in terms of KFSs. There were no differences between Groups 1 and 2 in terms of preoperative and follow-up KSs or preoperative KFSs. The follow-up KFSs in Group 1 was significantly greater than that in Group 2 (p = 0.032). Conclusions PMOWHTO has favourable clinical and radiological outcomes and prevents PTS increase in simultaneous MMPRT repair and varus medial knee osteoarthritis patients without concomitant root tear. Level of evidence Level IV, case series.https://doi.org/10.1186/s13018-025-05519-3High tibial osteotomyPosteromedial high tibial osteotomyTibial slopeMeniscus root tearRoot repairPull-out repair
spellingShingle Ali Engin Dastan
Elcil Kaya Bicer
Huseyin Kaya
Mehmet Argin
Emin Taskiran
Posteromedial opening wedge high tibial osteotomy has favourable outcomes in simultaneous medial meniscus posterior root repair and varus medial knee osteoarthritis patients without concomitant root tear
Journal of Orthopaedic Surgery and Research
High tibial osteotomy
Posteromedial high tibial osteotomy
Tibial slope
Meniscus root tear
Root repair
Pull-out repair
title Posteromedial opening wedge high tibial osteotomy has favourable outcomes in simultaneous medial meniscus posterior root repair and varus medial knee osteoarthritis patients without concomitant root tear
title_full Posteromedial opening wedge high tibial osteotomy has favourable outcomes in simultaneous medial meniscus posterior root repair and varus medial knee osteoarthritis patients without concomitant root tear
title_fullStr Posteromedial opening wedge high tibial osteotomy has favourable outcomes in simultaneous medial meniscus posterior root repair and varus medial knee osteoarthritis patients without concomitant root tear
title_full_unstemmed Posteromedial opening wedge high tibial osteotomy has favourable outcomes in simultaneous medial meniscus posterior root repair and varus medial knee osteoarthritis patients without concomitant root tear
title_short Posteromedial opening wedge high tibial osteotomy has favourable outcomes in simultaneous medial meniscus posterior root repair and varus medial knee osteoarthritis patients without concomitant root tear
title_sort posteromedial opening wedge high tibial osteotomy has favourable outcomes in simultaneous medial meniscus posterior root repair and varus medial knee osteoarthritis patients without concomitant root tear
topic High tibial osteotomy
Posteromedial high tibial osteotomy
Tibial slope
Meniscus root tear
Root repair
Pull-out repair
url https://doi.org/10.1186/s13018-025-05519-3
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