Title : Therapeutic effect analysis of repair versus non-repair of Medial Meniscus Posterior Root Tear (MMPRT) combined with High Tibial Osteotomy (HTO)
Abstract:
Objective: To compare the clinical efficacy of repair versus non-repair of Medial Meniscus Posterior Root Tear (MMPRT) combined with High Tibial Osteotomy (HTO) in the treatment of varus knee with MMPRT, and to explore the clinical value of MMPRT repair and the rational selection of surgical strategies.
Methods: A retrospective analysis was performed on 80 patients with MMPRT treated with HTO in our department from January 2020 to January 2025. Patients were divided into combined repair group (40 cases, HTO combined with MMPRT repair) and isolated HTO group (40 cases, HTO alone). MMPRT repair was performed using the trans-tibial tunnel technique and fixed on the lateral tibial cortex. Preoperative general data (age, gender, disease duration, degree of knee joint degeneration, etc.) showed no significant differences between the two groups (P>0.05). All patients were followed up for 12–50 months. Knee function and pain were evaluated using the International Knee Documentation Committee (IKDC) score, Lysholm score, and Visual Analogue Scale (VAS) score. Lower extremity alignment was assessed by Hip-Knee-Ankle (HKA) angle and Medial Proximal Tibial Angle (MPTA). Complications were recorded.
Results: The MMPRT healing rate in the combined repair group (88.4%) was significantly higher than that in the isolated HTO group (72.1%) (P<0.05). Postoperative HKA and MPTA were significantly improved in both groups compared with preoperative values, with satisfactory alignment correction, and no significant intergroup difference was observed (P>0.05). Postoperative IKDC and Lysholm scores were significantly increased, while VAS scores were significantly decreased in both groups (all P<0.001). Subgroup analysis showed that in the isolated HTO group, patients with alignment corrected to the Fujisawa point had a higher MMPRT healing rate than those with neutral alignment (P<0.05), whereas no significant difference in healing rate was found between alignment subgroups in the combined repair group (P>0.05). The incidence of complications (infection, nonunion, neurovascular injury, etc.) was comparable between the two groups (P>0.05).
Conclusions: HTO combined with MMPRT repair significantly improves the healing rate of MMPRT, and is particularly suitable for patients with insufficient lower extremity alignment correction or high activity demand. Isolated HTO can achieve satisfactory MMPRT healing and clinical outcomes through precise alignment correction, with short-term knee function improvement similar to that of combined repair. Surgical strategy should be individualized based on patient age, activity demand, and alignment correction status.
Keywords: Medial meniscus posterior root tear, High tibial osteotomy, Meniscus posterior root repair, Lower extremity alignment, Cartilage regeneration, Clinical efficacy.
