Mid-term patient-reported outcomes are inferior in opening-wedge high tibial osteotomy patients with untreated medial meniscus posterior root tear

Eiji Sasaki; Shugo Maeda; Takahiro Tsushima; Yuka Kimura; Yukiko Sakamoto; Eiichi Tsuda; Yasuyuki Ishibashi

doi:10.1002/jeo2.70064

Mid-term patient-reported outcomes are inferior in opening-wedge high tibial osteotomy patients with untreated medial meniscus posterior root tear

J Exp Orthop. 2024 Oct 21;11(4):e70064. doi: 10.1002/jeo2.70064. eCollection 2024 Oct.

Authors

Eiji Sasaki¹, Shugo Maeda², Takahiro Tsushima¹, Yuka Kimura¹, Yukiko Sakamoto¹, Eiichi Tsuda³, Yasuyuki Ishibashi¹

Affiliations

¹ Department of Orthopaedic Surgery Hirosaki University Graduate School of Medicine Hirosaki Japan.
² Department of Orthopaedic Surgery Aomori Rosai Hospital Hachinohe Japan.
³ Department of Rehabilitation Medicine Hirosaki University Graduate School of Medicine Hirosaki Japan.

Abstract

Purpose: The impact of untreated medial meniscus posterior root (MMPR) tear (MMPRT) during opening-wedge high tibial osteotomy (OWHTO) on patient-reported outcomes (PROs) remains poorly understood. This retrospective cohort study aimed to investigate the association between the presence of MMPRT and post-operative PROs in patients who underwent OWHTO.

Methods: A total of 83 knees that underwent OWHTO that were followed up for 6.6 years were included. Post-operative PROs were assessed using the knee injury and osteoarthritis outcome score (KOOS) subscales. Medial meniscus extrusion (MME) was measured by magnetic resonance imaging (MRI). MMPRT was diagnosed based on preoperative MRI and intraoperative arthroscopy findings. The participants were categorized into the MMPRT and MMPR intact (MMPRI) groups, and their KOOS subscales were compared. Additionally, logistic regression analysis was conducted to explore the correlation between KOOS and MMPRT presence.

Results: In total, 29 out of 80 (36.3%) knees were classified into the MMPRT group, while three knees underwent total knee arthroplasty. Preoperative MME was 3.5 ± 1.9 (range 0-8.9) mm, showing correlation with the presence of MMPRT (p = 0.004) by regression analysis. The post-operative KOOS subscales of the MMPRT group were lower than the MMPRI group for pain (p = 0.017), activities of daily living (ADLs) (p = 0.001), sports (p < 0.001) and quality of life (QOL) (p < 0.001). Additionally, regression analysis showed the presence of MMPRT was correlated with lower KOOS subscale scores for pain (p = 0.041), ADLs (p = 0.011), sports (p < 0.001) and QOL (p = 0.002).

Conclusion: Preoperative MMPRT correlated with a reduction in mid-term post-operative PROs, as assessed using the KOOS, among patients who underwent OWHTO. Surgeons should consider addressing an MMPRT at the time of OWHTO.

Level of evidence: Level IV.

Keywords: high tibial osteotomy; medial meniscus posterior root tear; mid‐term outcome; patient‐reported outcome; untreated.