未经治疗的内侧半月板后根撕裂的开楔高胫骨截骨术患者的中期患者报告结果较差。

IF 2 Q2 ORTHOPEDICS Journal of Experimental Orthopaedics Pub Date : 2024-10-21 DOI:10.1002/jeo2.70064

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

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引用次数: 0

摘要

目的：在开楔式高胫骨截骨术（OWHTO）中，未经治疗的内侧半月板后根（MMPR）撕裂（MMPRT）对患者报告结果（PROs）的影响仍鲜为人知。这项回顾性队列研究旨在调查接受OWHTO手术的患者MMPRT的存在与术后PROs之间的关系：方法：共纳入83名接受过OWHTO手术的膝关节患者，随访6.6年。使用膝关节损伤和骨关节炎结果评分（KOOS）分量表评估术后PROs。内侧半月板挤压（MME）通过磁共振成像（MRI）进行测量。MMPRT根据术前磁共振成像和术中关节镜检查结果进行诊断。受试者被分为MMPRT组和MMPR完好组（MMPRI），并对他们的KOOS分量表进行了比较。此外，还进行了逻辑回归分析，以探讨 KOOS 与 MMPRT 存在之间的相关性：80个膝关节中，共有29个（36.3%）被归入MMPRT组，3个膝关节接受了全膝关节置换术。术前MME为3.5 ± 1.9（范围0-8.9）毫米，回归分析显示与MMPRT的存在相关（p = 0.004）。MMPRT组的术后KOOS分量表在疼痛（p = 0.017）、日常生活活动（ADLs）（p = 0.001）、运动（p = 0.041）、日常生活活动（ADLs）（p = 0.011）、运动（p = 0.002）方面均低于MMPRI组：结论：在接受 OWHTO 的患者中，术前 MMPRT 与使用 KOOS 评估的术后中期 PROs 下降相关。外科医生应考虑在进行 OWHTO 时进行 MMPRT：证据等级：IV 级。

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

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.