What question did this study set out to answer?

The aim is to determine if meniscus centralization during osteotomy improves outcomes for patients with medial meniscus posterior root tears.

March 24, 2026

Concurrent Arthroscopic Meniscus Centralization With All‐Inside Root Repair During Open‐Wedge High Tibial Osteotomy Fails to Enhance Clinical Outcomes in Medial Meniscus Posterior Root Tear

Key Points

The aim is to determine if meniscus centralization during osteotomy improves outcomes for patients with medial meniscus posterior root tears.
Enrolled 82 patients with medial meniscus posterior root tears from January 2020 to December 2021.
Randomized into two groups: isolated OWHTO and OWHTO with meniscus centralization and all-inside root repair.
Compared clinical outcomes, radiographic parameters, and second-look arthroscopy results between groups after surgery.
No significant differences in clinical outcomes (Lysholm scores, HSS scores) between both groups.
Group A showed a greater increase in knee flexion compared to Group B (Δflexion P = .036).
Group B experienced a significant knee flexion loss post-operation compared to Group A (36.8% vs 13.6%, P < .001).
Group B had improved meniscal healing rates but no differences in clinical scores between healed and nonhealed patients.

Abstract

Purpose To investigate whether concurrent arthroscopic meniscus centralization with all‐inside side‐to‐side root repair during open‐wedge high tibial osteotomy (OWHTO) provides superior clinical, radiological, and second‐look arthroscopic outcomes compared with isolated OWHTO in patients with medial meniscus posterior root tears (MMPRTs). Methods Between January 2020 and December 2021, 82 patients with symptomatic medial meniscus posterior root tears meeting prespecified criteria were prospectively enrolled and randomized into two groups: isolated OWHTO (Group A, n = 44) or OWHTO combined with arthroscopic meniscus centralization and all‐inside side‐to‐side root repair (Group B, n = 38). Inclusion criteria included age 50‐75 years, mild‐to‐moderate varus alignment, medial meniscus extrusion (MME) > 3 mm, flexion contracture 130°, with the incidence of 66.7%. Regarding clinically relevant values, the cohort‐specific MCID was calculated as 4.0 points for Lysholm score and 2.5° for Δflexion. All patients (100%) met the MCID threshold for Lysholm score, while 58.5% (48/82) achieved it for Δflexion. Notably, Group B had a higher proportion of patients failing to reach Δflexion MCID compared with Group A (44.7% vs 38.6%). Group B showed significantly decreased MME at final follow‐up compared with Group A (0.8 mm vs 4.2 mm, P < .001) but no differences in other radiologic variables (including hip‐knee‐ankle angle and medial proximal tibial angle). Second‐look arthroscopy revealed a significantly higher meniscal healing rate in Group B (28.9% vs 13.6%, P < .001). Nevertheless, no significant differences in postoperative Lysholm or Hospital for Special Surgery scores were observed between healed and nonhealed patients. Conclusions Compared with isolated OWHTO, concurrent meniscus centralization with all‐inside root repair resulted in reduced MME and improved meniscal healing, but did not confer superior clinical outcomes and was associated with a greater loss of knee flexion, particularly in patients with preoperative hyperflexion. Level of Evidence Level II, lesser‐quality randomized controlled trial.

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Cite This Study

Wang et al. (Sun,) studied this question.

synapsesocial.com/papers/69c22982aeb5a845df0d414f https://doi.org/https://doi.org/10.1002/arj.70079

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