Functional Outcome Following Concurrent Medial Meniscus Posterior Horn Root Repair during High Tibial Osteotomy in Early Medial Compartment Osteoarthritis

Anoop Pilar, Madan Mohan M, Sunil L K, Surendra Babu S, P. Sekaran, R. Amaravathi
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Abstract

Background: Meniscal root tears cause biomechanical changes comparable to a total meniscectomy. The resultant compromise in hoop stress, leads to decreased tibiofemoral contact area and increased contact pressure. This will lead to early arthritis. The meniscus root tear causes more detrimental changes in people with varus alignment of the lower limb. This increases the chances of progression to arthritis, causing joint pain and functional limitation, eventually necessitating early replacement surgery. Surgical management with repair of the meniscus, with corrective osteotomy restoring the normal anatomy, has been reported to improve clinical and functional outcomes and delay the replacement surgery. This study aimed to evaluate the functional outcome following concurrent Medial meniscus posterior horn root (MMPHRTs) repair during open medial wedge high tibial osteotomy (HTO) with medial osteoarthritis. Methods: We performed posterior horn root repair with open medial wedge HTO in 9 patients, between 2016 and 2021. The mean follow-up of patients was 2 years. The mean Lysholm and IKDC scores showed significant improvement (7 had excellent and 2 had satisfactory scores). Patients returned to their expected activity of daily living. Conclusion: Concurrent MMPHRT repair along with medial open wedge HTO for medial compartmental osteoarthritis with varus alignment gives good results and has shown good clinical and radiological outcome on short term follow-up. Keywords: Meniscal root tear, Medial open wedge HTO, Preoperative planning, Outcome.
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并发内侧半月板后角根修复在胫骨高位截骨术中治疗早期内侧腔室骨关节炎的功能结果
背景:半月板根撕裂引起的生物力学变化与全半月板切除术相当。因此,在环应力妥协,导致减少胫股接触面积和增加接触压力。这将导致早期关节炎。对于下肢内翻的患者,半月板根部撕裂会导致更有害的变化。这增加了发展为关节炎的机会,引起关节疼痛和功能限制,最终需要早期的置换手术。手术治疗修复半月板,矫正截骨恢复正常解剖结构,已被报道改善临床和功能结果,并延迟置换手术。本研究旨在评估开放式楔形胫骨高位截骨术(HTO)并发内侧半月板后角根(MMPHRTs)修复后内侧骨关节炎的功能结果。方法:我们在2016年至2021年期间对9例患者进行了开放内侧楔形HTO后角根修复。患者平均随访2年。平均Lysholm和IKDC评分有显著改善(7分为优,2分为满意)。患者恢复了预期的日常生活活动。结论:MMPHRT联合内侧开楔HTO治疗内侧室性骨关节炎内翻对齐效果良好,短期随访显示临床和影像学预后良好。关键词:半月板根撕裂,内侧开楔HTO,术前计划,预后。
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