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Second-Look Arthroscopic Findings After Open Wedging High Tibia Osteotomy Focusing on the Posterior Root Tears of the Medial Meniscus


Kyung-Wook Nha, Prof.
KOREA, REPUBLIC OF

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Second-Look Arthroscopic Findings After Open Wedging High Tibia Osteotomy Focusing on the Posterior Root Tears of the Medial Meniscus

Kyung-Wook Nha, Prof., KOREA, REPUBLIC OF Jae Ho Kwon, MD, KOREA, REPUBLIC OF Jong In Kim, MD, KOREA, REPUBLIC OF Dae-Hee Hwang, MD, KOREA, REPUBLIC OF Yong-Seuk Lee, MD, PhD, Prof., KOREA, REPUBLIC OF Dong Hwan Kim, MD, KOREA, REPUBLIC OF Dong Hyun Seo, MD, KOREA, REPUBLIC OF

Inje University Ilsan Paik, Goyangsi, Gyeonggido, SOUTH KOREA

2013 Congress   Paper Abstract   2013 Congress   Not yet rated

 

Anatomic Location

Knee

Anatomic Structure

Cartilage Meniscus Medial

Diagnosis / Condition

Osteoarthritis Arthritis Tears

Diagnosis Method

Arthro-MRI

Treatment / Technique

Arthroscopy Osteotomy Repair / Reconstruction

Summary: Our study demonstrated a high rate of healing of RTMMP after HTO without attempted repair.

Purpose

This study examined the results of open wedge High tibial osteotomy (HTO) focusing on root tear of the medial meniscus posterior horn (RTMMP) by second-look arthroscopy.

Methods

Among 31 consecutive patients, who underwent HTO without a meniscectomy or pullout repair about RTMMP, 20 patients were available for second-look arthroscopic evaluation. All patients were medial unicompartmental arthritis. The healing status of the RTMMP was classified as complete, incomplete and no healing. The difference in the weight bearing line between pre-operation and at the last follow up was evaluated. Osteoarthritis and chondral lesion were evaluated and the clinical results were also evaluated. The correlation between healing status and other variables (weight bearing line, cartilage status, and clinical scores) were evaluated. We also compared other variables between healed (10 patients) and non-healed (incomplete 7 + no healing 3 patients) groups.

Results

There were 10 (50 %) cases with complete haling, 6 (30 %) with incomplete healing, 4 (20 %) with no healing. The Kellgren-Lawrence grade was not improved with the standing plain radiograph (P=.09), but no progression of the chondral lesion was observed in second-look arthroscopy; some improvement was even observed (P=.002). The mean median
Lysholm score improved from 58 preoperatively to 88.5.0 at the last follow-up. The median Hospital for Special Surgery (HSS) score also increased significantly from 62.4 (range, 50 to 76) to 87.2 (range, 80 to 92; P = .003). The comparison between healed and non-healed group showed no statistical differences in all variables.

Conclusion

Our study demonstrated a high rate of healing of RTMMP after HTO without attempted repair. However, the healing was not strongly associated with other variables.