High Tibia Osteotomy for a Posterior Root Tear of the Medial Meniscus

Jong Seong Lee; Yong Suk Chang; Hyun Joo Park; Hyung Hwa Yoon; Hyeong Tak Ko; Kyung Wook Nha

doi:10.4055/jkoa.2015.50.5.372

Journal List > J Korean Orthop Assoc > v.50(5) > 1013397

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Lee, Chang, Park, Yoon, Ko, and Nha: High Tibia Osteotomy for a Posterior Root Tear of the Medial Meniscus

Symposium

Medial Meniscus Posterior Root Tear

Journal of the Korean Orthopaedic Association 2015; 50(5): 372-378.

Published online: 23 October 2015

DOI: https://doi.org/10.4055/jkoa.2015.50.5.372

High Tibia Osteotomy for a Posterior Root Tear of the Medial Meniscus

Jong Seong Lee, M.D., Yong Suk Chang, M.D., Hyun Joo Park, M.D., Hyung Hwa Yoon, M.D., Hyeong Tak Ko, M.D., Kyung Wook Nha, M.D.

Department of Orthopedic Surgery, Inje University Ilsan Paik Hospital, Goyang, Korea.

Correspondence to: Kyung Wook Nha, M.D. Department of Orthopedic Surgery, Inje University Ilsan Paik Hospital, 170 Juhwa-ro, Ilsanseo-gu, Goyang 10380, Korea. TEL: +82-31-910-7968, FAX: +82-31-910-7967, kwnhamj@hotmail.com

Received 3 July 2015 Revised 11 August 2015 Accepted 2 October 2015

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Posterior root tear of the medial meniscus which is frequently unrecognized is a common injury of meniscus that often results in serious consequences in a knee joint. After medial meniscus posterior root tear (MMPR), there is a significant increase in tibio-femoral contact pressure concomitant with altered knee joint kinematics. This injury frequently leads to meniscal extrusion, and thus the transmission of circumferential hoop stresses would be impaired, which condition is biomechanically similar to that of total meniscectomy. For these reasons, several methods (conservative treatment, meniscectomy, repair, or unicompartmental knee arthroplasty) have been developed for treatment of MMPR, many of which have shown good clinical results. However, the methods of MMPR treatment are still debatable. This article presents a review of the current strategies for treatment of common injuries to these MMPR and clinical results of high tibia osteotomy for MMPR after failed conservative treatment.

Keywords: medial meniscus, posterior root, high tibia osteotomy

Figures and Tables

Figure 1

(A) An 18-year-old man's traumatic radial rupture of the medial meniscus posterior root. (B) Two-year follow-up arthroscopic finding after pullout suture. It shows complete healing of the medial meniscus posterior root.

Figure 2

(A) Pullout suture for degenerative rupture of the medial meniscus posterior root (arrow). (B) Postoperative 2-year follow-up arthroscopic finding (arrow). It shows re-rupture of the medial meniscus posterior root.

Figure 3

(A) Arthroscopic finding of the ruptured medial meniscus posterior root. (B) Two-year follow-up arthroscopic finding after high tibia osteotomy. It shows natural healing of the medial meniscus posterior root.

Figure 4

Schematic diagram of posterior opening vertical suture. A complete posterior MM root tear (arrow). MM, medial meniscus; MTC, medial tibial condyle.

Figure 5

(A) Six-month follow-up arthroscopic finding after suture anchor. (B) It shows the re-ruptured medial meniscus posterior root. After high tibia osteotomy, this patient's symptom has disappeared.

Figure 6

Treatment of degenerative MM posterior root tear. MM, medial meniscus; HTO, high tibial osteotomy; OA, osteoarthritis.

Table 1

Overview of Surgical Techniques and Results

MRI, magnetic resonance imaging.

Notes

^{CONFLICTS OF INTEREST} The authors have nothing to disclose.

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