Second-look arthroscopic findings after open-wedge high tibia osteotomy focusing on the posterior root tears of the medial meniscus.
OBJECTIVE
This study examined, at second-look arthroscopy, the results of open-wedge high tibial osteotomy (HTO) focusing on root tear of the medial meniscus posterior horn (RTMMP).


METHODS
Among 31 consecutive patients who underwent HTO without a meniscectomy or pullout repair for RTMMP, 20 patients were available for second-look arthroscopic evaluation. All patients had medial unicompartmental arthritis. The healing status of the RTMMP was classified as complete, incomplete, and no healing. The difference in the weight bearing line from presurgery to the last follow-up was evaluated. Osteoarthritis and chondral lesions were evaluated, as were clinical results. Correlations between healing status and other variables (weight bearing line, cartilage status, and clinical scores) were assessed. The healed (10 patients) and nonhealed (incomplete 6 patients + no healing 4 patients) groups were also evaluated with respect to other variables.


RESULTS
There were 10 (50%) cases with complete healing, 6 (30%) with incomplete healing, and 4 (20%) with no healing. Kellgren-Lawrence grade did not improve according to the standing plain radiograph (P = .09). Progression of chondral lesions was not observed at second-look arthroscopy; some improvement was even observed (P = .002). The median Lysholm score improved from 58 preoperatively to 88.5 at the last follow-up. The median Hospital for Special Surgery (HSS) score also increased significantly from 62.4 (range, 50 to 76) to 87.2 (range, 80 to 92; P = .003). The comparison between healed and nonhealed groups revealed no statistical differences in all variables.


CONCLUSIONS
This study revealed a high rate of healing of RTMMP after HTO without attempted repair. Healing of the meniscus was not associated with an improved clinical outcome.


METHODS
Level IV, therapeutic case series.
Department of Orthopaedic Surgery, Ilsanpaik Hospital, Inje University, Ilsan, Korea.
Kyung-Wook
KW
Nha
Yong Seuk
YS
Lee
Dae-Hee
DH
Hwang
Jae Ho
JH
Kwon
Dong Ju
DJ
Chae
Young Jee
YJ
Park
Jong In
JI
Kim
D001182:Arthroscopy; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000503:physiopathology / Q000601:surgery*; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008592:Menisci, Tibial / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D010027:Osteotomy; D024162:Second-Look Surgery; D013977:Tibia / Q000601:surgery*; D014945:Wound Healing