Similar Outcomes between Open-wedge High Tibial Osteotomy Alone and Root Repair for Isolated Meniscal Root Tears in Patients without Severe Varus Deformity or Advanced Osteoarthritis

Background: The suitability of open-wedge high tibial osteotomy (HTO) alone versus root repair alone for medial meniscus posterior root tears (MMPRTs) in patients without severe varus deformity or advanced osteoarthritis remains uncertain. Objectives: In this study, clinical outcomes were compared between patients who underwent open-wedge HTO alone or root repair alone for root tear. Materials and Methods: In this retrospective comparative study, patients with medial compartment knee osteoarthritis and MMPRTs were consecutively included, and those with severe varus deformity (varus >8°) or advanced osteoarthritis (Kellgren–Lawrence Grade IV) were excluded. Patients were divided into two groups: open-wedge HTO alone and root repair alone groups. Pain reduction and functional recovery were assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores at preoperative baseline and 6, 12, and 24 months after surgery. Results: In total, 13 patients (14 knees) with a mean age of 63.0 ± 5.1 were included in the open-wedge HTO group, and 16 patients (16 knees) with a mean age of 59.7 ± 7.4 were included in the root repair group. The follow-up duration was 24 months for all patients. After surgery, the patients in both groups exhibited significant improvement in WOMAC pain and functional scores at the 6-, 12-, and 24-month follow-ups. No significant differences were observed between the groups in WOMAC pain and functional scores during the follow-up period. No complications were observed in either group. Conclusion: Similar outcomes can be achieved for patients receiving either open-wedge HTO alone or root repair alone for treatment of MMPRTs without severe deformity or advanced osteoarthritis.