Simple Medial Meniscus Posterior Horn Root Repair Using an All-Inside Meniscal Repair Device Combined with High Tibial O
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ORIGINAL ARTICLE
Simple Medial Meniscus Posterior Horn Root Repair Using an All‑Inside Meniscal Repair Device Combined with High Tibial Osteotomy to Maintain Joint‑Space Width in a Patient with a Repairable Tear Dong Won Suh1 · Woo Jin Yeo1 · Seung Beom Han2 · Sang‑Yeon So1 · Bong Soo Kyung1 Received: 15 May 2020 / Accepted: 13 August 2020 © Indian Orthopaedics Association 2020
Abstract Purpose To compare the radiological and clinical outcomes using simple medial meniscus posterior horn (MMPH) root repair using an all-inside meniscal repair device combined with high tibial osteotomy (HTO) and HTO alone. Methods Between November 2013 and December 2016, patients treated for MMPH root tear along with HTO were enrolled. Based on the tear gap, the participants were divided into repairable ( 2 mm) categories. The participants in each group were divided into those amenable to simple MMPH root repair using an all-inside meniscal repair device and those that required no procedure for meniscus. Radiological parameters including mechanical femorotibial alignment (MA), posterior tibial slope (PTS) and medial joint-space width (JSW) were evaluated preoperatively and postoperatively at 2 years. For clinical evaluation, the WOMAC score was determined at the 2-year visit postoperatively. Results A total of 81 knees including 48 repairable (group R) and 33 unrepairable (group I) knees were enrolled. A total of 43 knees underwent simple MMPH root repair using an all-inside meniscal repair device (subgroup r), whereas the other 38 knees did not (subgroup n). The MA, PTS, and their postoperative changes as well as the WOMAC scores showed no differences. However, the JSW in group Rr increased from 3.1 to 3.6 mm, but decreased from 3.7 to 3.4 in group Rn, which was a statistically significant difference. Conclusion Simple MMPH root repair using an all-inside meniscal repair device combined with HTO was more effective for the maintenance of JSW compared with HTO without a meniscal procedure in patients with repairable MMPH root tear and varus alignment. However, other options are needed for unrepairable MMPH root tear. Keywords Knee · Medial meniscus posterior horn · Medial meniscus posterior horn root tear · Osteotomy · Simple all inside meniscal repair device repair · Joint-space width
Introduction Medial meniscus (MM) root tear, a complete radial tear of the posterior horn (PH) of the MM, interrupts the continuity of the circumferential fibers and leads to failure of meniscal function, which converts axial loads to transverse hoop stress [1–3]. This pathology also involves meniscal * Bong Soo Kyung id‑[email protected] 1
Joint Center, Barunsesang Hospital, #5, Yatap‑ro 75beon‑gil, Bundang‑gu, Seongnam‑si, Gyeonggi‑do 13497, South Korea
Department of Orthopedic Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
2
extrusion and medial joint-space narrowing [1, 3–6], and is closely related to progressive osteoarthritis of the medial compartment and varus alignment. A pull-out
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