Comparison Analysis of Short-Term Efficacy between High Tibial Osteotomy Combined with Medial Meniscus Posterior Root Repair or Partial Resection

Objective: Comparative analysis of the clinical efficacy of high tibial osteotomy combined with medial meniscus posterior root repair or partial meniscectomy in the treatment of medial compartment osteoarthritis with concomitant knee varus. Methods: Based on the inclusion and exclusion criteria, a retrospective analysis of clinical data was conducted on 42 patients who underwent medial open-wedge high tibial osteotomy in our department from January 2020 to January 2021. Group 1 consisted of 20 patients who underwent high tibial osteotomy combined with medial meniscus posterior root repair, while Group 2 consisted of 22 patients who underwent high tibial osteotomy combined with partial meniscectomy of the medial meniscus posterior root. Clinical and radiological evaluations were performed, comparing preoperative and postoperative 2-year VAS scores, IKDC scores, WOMAC scores, as well as KL grading, WBL, HKA, degree of medial meniscal extrusion, and width of medial joint space. The correlations between these parameters were analyzed. Furthermore, arthroscopic examination was performed at the 2-year follow-up to evaluate the healing condition of the medial meniscus posterior root and changes in the cartilage of the medial femoral condyle (MFC) and medial tibial plateau (MTC). Results: All patients showed significant improvements in VAS scores, IKDC scores, WOMAC scores, and medial joint space width, with statistically significant differences before and after surgery. However, there was no statistically significant difference in the degree of medial meniscal extrusion between the two groups before and after surgery. The healing rate of the medial meniscal root was higher in Group 1 (75%) than in Group 2 (54.5%). In terms of postoperative VAS, IKDC, WOMAC scores, postoperative medial joint space width, healing rate of the medial meniscal root, and medial compartment cartilage regeneration, Group 1 performed significantly better than Group 2. There was a significant negative correlation between changes in medial joint space width and changes in medial meniscal extrusion. No correlation was observed between other observed indicators and changes in medial meniscal extrusion. Conclusions: In patients with medial compartment osteoarthritis combined with medial meniscal root tear, the clinical efficacy of opening-wedge high tibial osteotomy combined with medial meniscal root repair is significantly better than OWHTO combined with partial meniscectomy of the medial meniscal root.