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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 4/2023

09-09-2022 | Osteoarthrosis | KNEE

Increased medial meniscus extrusion led to worse clinical outcomes after medial opening-wedge high tibial osteotomy

Authors: Chang-Hyun Lee, Hong-Yeol Yang, Jong-Keun Seon

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 4/2023

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Abstract

Purpose

Given that no studies have assessed the correlation between improvements in medial meniscus extrusion (MME) and clinical outcomes after medial opening-wedge high tibial osteotomy (MOWHTO), the present study aimed to measure the improvement in MME after MOWHTO and to investigate the correlation between the remaining postoperative MME and MOWHTO clinical outcomes by subgroup analysis.

Methods

This study included 79 patients (80 knees) who underwent MOWHTO with a minimum follow-up of 2 years. MME was measured pre- and postoperatively through magnetic resonance imaging after an average of 19.8 months following MOWHTO surgery. Clinical outcomes were evaluated according to the Knee Injury and Osteoarthritis Outcome Score (KOOS), the Tegner Activity Scale, and the Short-Form 36 questionnaire. In subgroup analysis, postoperative MME was classified into non-pathologic (≤ 3 mm) and pathologic (> 3 mm) groups. The clinical outcomes of the two groups were compared using Mann–Whitney U tests. A regression analysis was performed to determine the preoperative and postoperative characteristics associated with the improvement of MME.

Results

The mean (± standard deviation) values for pre- and postoperative MME were 3.6 (± 1.8) mm and 2.8 (± 1.5) mm, respectively (p < 0.001). In the subgroup analysis of postoperative MME, the non-pathologic group showed better improvement of KOOS than the pathologic group. Preoperative hip-knee-ankle angle was correlated with the improvement of medial meniscal extrusion in both univariate (p = 0.049) and multivariate (p = 0.015) analyses.

Conclusion

The MME improved after MOWHTO, and the clinical outcomes were better for patients with a postoperative MME of less than 3 mm than for those with more than 3 mm. MME improvement after MOWHTO was correlated with preoperative varus alignment of the lower extremities.

Level of evidence

III (Retrospective cohort study).
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Metadata
Title
Increased medial meniscus extrusion led to worse clinical outcomes after medial opening-wedge high tibial osteotomy
Authors
Chang-Hyun Lee
Hong-Yeol Yang
Jong-Keun Seon
Publication date
09-09-2022
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 4/2023
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-022-07148-3

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