Xiurong Ke1, Jiandi Qiu1, Shanxi Chen2, Xiaoliang Sun1, Fanghui Wu1, Guojing Yang1, Lei Zhang3. 1. Department of Sports Medicine, The Third Affiliated Hospital of Wenzhou Medical University, No. 108, Wansong Road, Ruian, Wenzhou, 325200, Zhejiang, China. 2. Department of Radiology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325200, Zhejiang, China. 3. Department of Sports Medicine, The Third Affiliated Hospital of Wenzhou Medical University, No. 108, Wansong Road, Ruian, Wenzhou, 325200, Zhejiang, China. zhanglei@wmu.edu.cn.
Abstract
PURPOSE: This prospective study aimed to investigate the clinical benefits of meniscal repair during open-wedge high tibial osteotomies (OWHTOs) in patients with medial meniscus posterior root tears (MMPRTs) and to identify potential risk factors for meniscal healing. METHODS:Ninety patients with degenerative MMPRTs were included in the final cohort and randomized into three groups. The patients in Group A (n = 30) underwent OWHTO and arthroscopic all-inside meniscal repair concurrently, those in Group B (n = 34) underwent OWHTO only, and those in Group C (n = 26) underwent arthroscopic partial meniscectomy. Clinical and radiological outcomes were recorded, and meniscal healing was evaluated during second-look arthroscopy. Logistic regression analysis was performed to identify risk factors for meniscal healing. RESULTS: After a minimum follow-up of 24 months, no significant differences between Groups A and B regarding the final Lysholm (p = 0.689) or Hospital for Special Surgery (HSS) scores (p = 0.256) were observed. There were significant differences among the three groups regarding the hip-knee-ankle angle (HKA), weight-bearing line (WBL) ratio, medial proximal tibial angle (MPTA), and joint line convergence angle (JLCA) (p < 0.001, respectively), but the differences between Groups A and B were not significant. During second-look arthroscopy, the healing rate of the MMPRTs was significantly higher in Group A (63.3%) than in Group B (35.3%). Concurrent meniscal repair and changes in the HKA, and MPTA were risk factors for meniscal healing. CONCLUSION: Concurrent arthroscopic meniscal repair during OWHTO did not lead to significant clinical benefits in the treatment of MMPRTs, except for an increased rate of meniscal healing, which was not associated with clinical outcomes. LEVEL OF EVIDENCE: II, prospective comparative study.
RCT Entities:
PURPOSE: This prospective study aimed to investigate the clinical benefits of meniscal repair during open-wedge high tibial osteotomies (OWHTOs) in patients with medial meniscus posterior root tears (MMPRTs) and to identify potential risk factors for meniscal healing. METHODS: Ninety patients with degenerative MMPRTs were included in the final cohort and randomized into three groups. The patients in Group A (n = 30) underwent OWHTO and arthroscopic all-inside meniscal repair concurrently, those in Group B (n = 34) underwent OWHTO only, and those in Group C (n = 26) underwent arthroscopic partial meniscectomy. Clinical and radiological outcomes were recorded, and meniscal healing was evaluated during second-look arthroscopy. Logistic regression analysis was performed to identify risk factors for meniscal healing. RESULTS: After a minimum follow-up of 24 months, no significant differences between Groups A and B regarding the final Lysholm (p = 0.689) or Hospital for Special Surgery (HSS) scores (p = 0.256) were observed. There were significant differences among the three groups regarding the hip-knee-ankle angle (HKA), weight-bearing line (WBL) ratio, medial proximal tibial angle (MPTA), and joint line convergence angle (JLCA) (p < 0.001, respectively), but the differences between Groups A and B were not significant. During second-look arthroscopy, the healing rate of the MMPRTs was significantly higher in Group A (63.3%) than in Group B (35.3%). Concurrent meniscal repair and changes in the HKA, and MPTA were risk factors for meniscal healing. CONCLUSION: Concurrent arthroscopic meniscal repair during OWHTO did not lead to significant clinical benefits in the treatment of MMPRTs, except for an increased rate of meniscal healing, which was not associated with clinical outcomes. LEVEL OF EVIDENCE: II, prospective comparative study.
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