Fardis Vosoughi, Pouya Vahedi, Mobina Taghva Nakhjiri, Sohrab Keyhani, Mehran Soleymanha, Robert F. LaPrade, Luke V. Tollefson, Iman Menbari Oskouie
{"title":"与单独高位胫骨截骨相比，高位胫骨截骨联合内侧半月板根修复术在治疗膝骨性关节炎方面提供了更好的客观结果：一项系统综述。","authors":"Fardis Vosoughi, Pouya Vahedi, Mobina Taghva Nakhjiri, Sohrab Keyhani, Mehran Soleymanha, Robert F. LaPrade, Luke V. Tollefson, Iman Menbari Oskouie","doi":"10.1002/ksa.12796","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Purpose</h3>\n \n <p>High tibial osteotomy (HTO) is a cornerstone treatment for medial compartment osteoarthritis (OA) in active patients with varus deformity. However, managing the combination of varus alignment and the medial meniscus posterior root tears (MMPRT) remains controversial. The purpose of this systematic review was to synthesise data from recent comparative studies and evaluate whether adding an MMPRT repair to an HTO enhances outcomes, particularly with respect to meniscal healing, cartilage preservation, and patient function.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>We systematically searched MEDLINE, Embase, Scopus, and Web of Science through April 2025 for studies comparing isolated HTO with HTO plus MMPRT repair. Outcomes included meniscal healing, cartilage status, and patient-reported measures. Risk of bias was assessed using ROBINS-I.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Six studies (506 knees) were included, with 260 undergoing HTO plus MMPRT repair. The reported mean difference in complete meniscus healing ranged from 12.5% to 40% in the HTO plus MMPRT repair group, while it ranged from 0% to 15% in the isolated HTO group. Joint space width (JSW) was reported in three studies, with one study reporting a significant improvement in the HTO plus MMPRT repair group. Cartilage outcomes were superior in three of six studies. One study reported significant functional improvement with a concomitant repair. Despite methodological heterogeneity, all studies had a moderate risk of bias.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>While short-term subjective outcomes were similar between isolated HTO and HTO plus MMPRT repair, objective measures, namely higher meniscal healing rates and more stable cartilage scores, consistently favoured the combined approach. In the younger population, even short-term subjective outcomes showed significant improvements along with objective measures and return to sports. Long-term clinical trials are required to determine if these biological advantages translate into a delay in the progression of knee osteoarthritis, particularly in younger, active patients.</p>\n </section>\n \n <section>\n \n <h3> Level of Evidence</h3>\n \n <p>Level III, systematic review.</p>\n </section>\n </div>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"33 9","pages":"3361-3374"},"PeriodicalIF":5.0000,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"High tibial osteotomy and concurrent medial meniscus root repair provides improved objective outcomes compared to high tibial osteotomy alone for knee osteoarthritis: A systematic review\",\"authors\":\"Fardis Vosoughi, Pouya Vahedi, Mobina Taghva Nakhjiri, Sohrab Keyhani, Mehran Soleymanha, Robert F. LaPrade, Luke V. Tollefson, Iman Menbari Oskouie\",\"doi\":\"10.1002/ksa.12796\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Purpose</h3>\\n \\n <p>High tibial osteotomy (HTO) is a cornerstone treatment for medial compartment osteoarthritis (OA) in active patients with varus deformity. However, managing the combination of varus alignment and the medial meniscus posterior root tears (MMPRT) remains controversial. The purpose of this systematic review was to synthesise data from recent comparative studies and evaluate whether adding an MMPRT repair to an HTO enhances outcomes, particularly with respect to meniscal healing, cartilage preservation, and patient function.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>We systematically searched MEDLINE, Embase, Scopus, and Web of Science through April 2025 for studies comparing isolated HTO with HTO plus MMPRT repair. Outcomes included meniscal healing, cartilage status, and patient-reported measures. Risk of bias was assessed using ROBINS-I.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Six studies (506 knees) were included, with 260 undergoing HTO plus MMPRT repair. The reported mean difference in complete meniscus healing ranged from 12.5% to 40% in the HTO plus MMPRT repair group, while it ranged from 0% to 15% in the isolated HTO group. Joint space width (JSW) was reported in three studies, with one study reporting a significant improvement in the HTO plus MMPRT repair group. Cartilage outcomes were superior in three of six studies. One study reported significant functional improvement with a concomitant repair. 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Long-term clinical trials are required to determine if these biological advantages translate into a delay in the progression of knee osteoarthritis, particularly in younger, active patients.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Level of Evidence</h3>\\n \\n <p>Level III, systematic review.</p>\\n </section>\\n </div>\",\"PeriodicalId\":17880,\"journal\":{\"name\":\"Knee Surgery, Sports Traumatology, Arthroscopy\",\"volume\":\"33 9\",\"pages\":\"3361-3374\"},\"PeriodicalIF\":5.0000,\"publicationDate\":\"2025-07-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Knee Surgery, Sports Traumatology, Arthroscopy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://esskajournals.onlinelibrary.wiley.com/doi/10.1002/ksa.12796\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Knee Surgery, Sports Traumatology, Arthroscopy","FirstCategoryId":"3","ListUrlMain":"https://esskajournals.onlinelibrary.wiley.com/doi/10.1002/ksa.12796","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
High tibial osteotomy and concurrent medial meniscus root repair provides improved objective outcomes compared to high tibial osteotomy alone for knee osteoarthritis: A systematic review
Purpose
High tibial osteotomy (HTO) is a cornerstone treatment for medial compartment osteoarthritis (OA) in active patients with varus deformity. However, managing the combination of varus alignment and the medial meniscus posterior root tears (MMPRT) remains controversial. The purpose of this systematic review was to synthesise data from recent comparative studies and evaluate whether adding an MMPRT repair to an HTO enhances outcomes, particularly with respect to meniscal healing, cartilage preservation, and patient function.
Methods
We systematically searched MEDLINE, Embase, Scopus, and Web of Science through April 2025 for studies comparing isolated HTO with HTO plus MMPRT repair. Outcomes included meniscal healing, cartilage status, and patient-reported measures. Risk of bias was assessed using ROBINS-I.
Results
Six studies (506 knees) were included, with 260 undergoing HTO plus MMPRT repair. The reported mean difference in complete meniscus healing ranged from 12.5% to 40% in the HTO plus MMPRT repair group, while it ranged from 0% to 15% in the isolated HTO group. Joint space width (JSW) was reported in three studies, with one study reporting a significant improvement in the HTO plus MMPRT repair group. Cartilage outcomes were superior in three of six studies. One study reported significant functional improvement with a concomitant repair. Despite methodological heterogeneity, all studies had a moderate risk of bias.
Conclusions
While short-term subjective outcomes were similar between isolated HTO and HTO plus MMPRT repair, objective measures, namely higher meniscal healing rates and more stable cartilage scores, consistently favoured the combined approach. In the younger population, even short-term subjective outcomes showed significant improvements along with objective measures and return to sports. Long-term clinical trials are required to determine if these biological advantages translate into a delay in the progression of knee osteoarthritis, particularly in younger, active patients.
期刊介绍：
Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication.
The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance.
Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards.
Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).
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