2025 ISAKOS Congress in Munich, Germany

2025 ISAKOS Biennial Congress ePoster

 

Delay in progression of OA, better root healing and extrusion correction is seen in concurrent root repair with high tibial osteotomy (HTO) than isolated root repair for moderate varus aligned knees

Silvampatti Ramasamy Sundararajan, MS(Orth), COIMBATORE, TAMILNADU INDIA
Rajagopalakrishnan Ramakanth, D.ortho, DNB(ortho), D.SICOT, Coimbatore, Tamil Nadu INDIA
Ganga Medical centre and PVT LTD, Coimbatore, Tamil Nadu, INDIA

FDA Status Not Applicable

Summary

Patients undergoing combined medial open wedge high tibial osteotomy and root repair had significantly better reduction of extrusion, relatively better root healing and eventually delay in progression of arthritis than in patients operated for isolated root repair in moderate varus knees

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Abstract

Background

The ideal treatment for medial meniscus root tears(MMRT) in knees with moderate varus alignment is still debated, with some research indicating that open wedge high tibial osteotomy (OW-HTO) could be more than necessary. The most beneficial and appropriate therapy has yet to be determined.

Purpose

To compare extrusion reduction, meniscal healing, progression of Osteoarthritis(OA) and their influence on outcome in combined OW-HTO+ Medial meniscus root repair(MMRR) versus isolated MMRR.

STUDY DESIGN:
Retrospective Cohort, Level III evidence

Methods

Those patients who were diagnosed and operated for MMRT between 2015-2019. All repairable tears with 5°-10° varus with less than Kellgren-Lawrence (KL) grade 3 in medial compartment were included and excluded were those who had irreparable root tears, associated ligament injuries and obese patients. Patients were grouped into OW-HTO+MMRR (Group-A) and iMMRR (Group-B). Demographic data and functional scores (IKDC,Lysholm,KOOS) were obtained from pre-operative records and during final follow-up. A follow-up CT-arthrogram (Group-A) and MRI(Group-B) was done to assess the extrusion reduction, root healing, and cartilage status and statistically analyzed.

Results

Pre-operative data of both groups were comparable (n=64, 32 in group A and 32 group B). At mean follow-up of (Group A: 49.8±11.7, Group B: 51.8±11.9) months, extrusion reduction was better in group-A [1.7 ± 1.8mm (p-0.0001)]. 3/32 in Group-A and 5/32 in Group-B had non-healing(p-0.5). Functionally there was no significant difference between both the groups (IKDC-0.065, Lysholm-0.110, KOOS-0.202). Group-A patients had lower rate of progression of arthritis [6 patients in Group A and 14 patients in Group B had worsening by one KL grade during final follow up (p-0.043)].

Conclusion

Patients undergoing combined OW-HTO, and root repair had significantly better reduction of extrusion, relatively better root healing and eventually delay in progression of arthritis than in patients operated for isolated root repair in moderate varus knees.

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