Short-term clinical outcomes and second-look arthroscopic findings of high tibial osteotomy combined with medial meniscus posterior root repair / 中华骨科杂志

ABSTRACT

Objective To investigate the clinical outcomes and second-look arthroscopic findings after high tibial osteotomy (HTO) combined with medial meniscus posterior root (MMPR) repair.Methods Twenty-five patients who underwent HTO combined with MMPR repair were subjected to second-look arthroscopy and retrospectively analyzed.Biplane HTO combined with MMPR repair was performed on these patients.Arthroscopic transtibial pullout repair was employed to repair the MMPR.The relative degree of the medial meniscus extrusion (MME) were measured.Cartilage regeneration and the healing of MMPR were evaluated at the time of second-look arthroscopy.Clinical outcomes were assessed based on Hospital for Special Surgery (HSS) scores and Lysholm scores.Results The MMPRs were completely healed in 12 cases (48％),partially healed in 9 cases (36％),healed with scarring in 3 cases (12％),and no healed in 1 case (4％).Follow-up duration was 13.04±1.06 months (12-16 months).There were no statistically significant differences in the Kellgren-Lawrence classifications of the cases before and after surgery (x2=0.786,P=0.675).The relative position of the mechanical axis of the lower extremity through the tibial plateau was 19.88％±t6.44％ preoperatively and 58.68％±17.71％ after operation with significant difference (t=-18.561,P ＜ 0.001).The Lysholm scores was increased significantly from 34.76±3.62 points to 82.08±4.35 points after operation (t=-52.717,P ＜ 0.001).The HSS scores was increased significantly from 33.52±6.48 points to 81.52±4.79 points after operation (t=-38.685,P ＜ 0.001).The degree of MME was changed from 51.12％± 13.55％ to 50.48％± 15.15％ without statistical difference (t=0.550,P=0.588).The comparison between different degrees of healing groups revealed no statistical differences in all variables (P ＞ 0.05).The comparison between different degree of cartilage regeneration groups revealed no statistical differences in all variables (P ＞ 0.05).Conclusion HTO combined with MMPR repair can effectively improve the lower limb alignment and patients' symptoms with a satisfactory healing rate of MMPR.The effects of post-root repair after a short period is not obvious.The longer-term clinical effects is worthy of further observation.