Clinical Efficacy Analysis of High Tibial Osteotomy Combined with Meniscal Repair for the Treatment of Degenerative Medial Meniscus Posterior Root Tears

Objective: To compare the clinical efficacy and safety of high tibial osteotomy (HTO) combined with meniscal repair versus isolated meniscal repair in the treatment of degenerative medial meniscus posterior root tears (MMPRTs), and to provide evidence-based support for surgical decision-making in patients with concomitant knee osteoarthritis. Methods: A retrospective cohort study was conducted. Surgical allocation was based on lower limb alignment severity, activity demand, and comprehensive surgeon evaluation. A total of 62 patients were initially screened, and 7 were excluded; finally 55 patients with degenerative MMPRTs combined with Kellgren-Lawrence grade II - III knee osteoarthritis treated at Baise People’s Hospital from January 2019 to June 2025 were enrolled, all completed 12-month follow-up. Patients were divided into a combined group (30 cases, HTO + meniscal repair) and an isolated group (25 cases, isolated meniscal repair). All surgeries were performed by the same surgical team. A standardized transtibial pull-out technique was used for meniscal repair in all patients. Patients were followed up for 12 months. The visual analog scale (VAS), Lysholm knee score, Hospital for Special Surgery knee score (HSS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), hip-knee-ankle angle (HKA), and weight-bearing line ratio (WBLR) were used to assess pain, functional recovery, and alignment correction. Perioperative indicators and complications were recorded. Results: Baseline data including HKA and WBLR were comparable between the two groups (P > 0.05). HKA and WBLR were significantly improved postoperatively in the combined group (P < 0.05). At all postoperative time points, VAS and WOMAC scores in both groups were significantly lower than preoperative values, while Lysholm and HSS scores were significantly higher (all P < 0.001). Intergroup comparison showed that at 3, 6, and 12 months postoperatively, VAS and WOMAC scores in the combined group were lower than those in the isolated group, and HSS scores were higher (all P < 0.05). At 6 and 12 months postoperatively, Lysholm scores in the combined group were higher than those in the isolated group (P < 0.05), but no significant difference was found at 3 months (P > 0.05). The complication rate was 13.3% in the combined group and 20.0% in the isolated group, with no statistically significant difference (P > 0.05). Conclusion: Based on this single-center short-term retrospective data, for patients with degenerative MMPRTs complicated by