Abstract：
BACKGROUND: Medial meniscal posterior root tear (MMPRTs) is a common lesion of the knee joint, and repair surgery is a well-established treatment option. However, patients with obvious varus alignment are at an increased risk for MMPRT and can suffer from a greater degree of medial meniscus extrusion, which leads to the development of osteoarthritis following repair. The efficacy of high tibial osteotomy (HTO) as a means of correcting this malformation, and its potential benefits for MMPRT repair, remains unclear.
OBJECTIVE: To explore whether HTO influenced the outcome of MMPRT repair in clinical scores and radiological findings.
METHODS: Systematic review.
METHODS: According to the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyses) guidelines, we searched PubMed, Embase, Web of Science, and the Cochrane Library databases for studies reporting the outcomes of MMPRT repair and extracted data about characteristics of patients, clinical functional scores and radiologic outcomes. One reviewer extracted the data and 2 reviewers assessed the risk of bias and performed a synthesis of the evidence. Articles were eligible if they reported the results of MMPRT repair with exact mechanical axis (registered in the International Prospective Register of Systematic Reviews, CRD42021292057).
RESULTS: Fifteen studies with 625 cases of high methodological quality were identified. Eleven studies were assigned to the MMPRT repair group (M) with 478 cases performing MMPRT repair only, and others belonged to the MMPRT repair and HTO group (M and T) performing HTO and MMPRT repair. Most of the studies had significantly improved clinical outcome scores, especially in M groups. And the radiologic outcomes showed that the osteoarthritis deteriorated in both groups with similar degree in about 2-year follow-up.
CONCLUSIONS: HTO is a useful supplement in treating MMPRT patients with severe osteoarthritis and the clinical and radiological outcomes were similar with MMPRT repair alone. Which would be better for patients\' prognosis generally, performing MMPRT repair alone or a combination of HTO and MMPRT repair, was still controversial. We suggested taking K-L grade into account. Large-scale randomized control studies were called for in the future to help make better clinical decisions.
METHODS: III.
OBJECTIVE: To explore whether HTO influenced the outcome of MMPRT repair in clinical scores and radiological findings.
METHODS: Systematic review.
METHODS: According to the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyses) guidelines, we searched PubMed, Embase, Web of Science, and the Cochrane Library databases for studies reporting the outcomes of MMPRT repair and extracted data about characteristics of patients, clinical functional scores and radiologic outcomes. One reviewer extracted the data and 2 reviewers assessed the risk of bias and performed a synthesis of the evidence. Articles were eligible if they reported the results of MMPRT repair with exact mechanical axis (registered in the International Prospective Register of Systematic Reviews, CRD42021292057).
RESULTS: Fifteen studies with 625 cases of high methodological quality were identified. Eleven studies were assigned to the MMPRT repair group (M) with 478 cases performing MMPRT repair only, and others belonged to the MMPRT repair and HTO group (M and T) performing HTO and MMPRT repair. Most of the studies had significantly improved clinical outcome scores, especially in M groups. And the radiologic outcomes showed that the osteoarthritis deteriorated in both groups with similar degree in about 2-year follow-up.
CONCLUSIONS: HTO is a useful supplement in treating MMPRT patients with severe osteoarthritis and the clinical and radiological outcomes were similar with MMPRT repair alone. Which would be better for patients\' prognosis generally, performing MMPRT repair alone or a combination of HTO and MMPRT repair, was still controversial. We suggested taking K-L grade into account. Large-scale randomized control studies were called for in the future to help make better clinical decisions.
METHODS: III.
摘要：
背景：内侧半月板后根撕裂（MMPRTs）是膝关节的常见病变，修复手术是一种公认的治疗选择。然而,明显内翻排列的患者MMPRT的风险增加，并且可能遭受更大程度的内侧半月板挤压，导致骨性关节炎在修复后的发展。胫骨高位截骨术（HTO）作为纠正这种畸形的手段的功效，以及它对MMPRT修复的潜在好处，尚不清楚。
目的：探讨HTO是否影响MMPRT修复的临床评分和放射学结果。
方法：系统评价。
方法：根据PRISMA（系统评价和荟萃分析的首选报告项目）指南，我们搜索了PubMed,Embase,WebofScience,和Cochrane图书馆数据库，用于报告MMPRT修复的结果和提取的患者特征数据的研究，临床功能评分和放射学结果。一名审阅者提取了数据，两名审阅者评估了偏倚的风险，并对证据进行了综合。如果文章报告了具有精确机械轴的MMPRT修复结果，则符合资格（在国际前瞻性系统审查登记册中注册，CRD42021292057）。
结果：确定了15项研究，其中625例具有较高的方法学质量。11项研究被分配到MMPRT修复组（M），其中478例仅进行MMPRT修复，其他人属于MMPRT修复和HTO组（M和T）执行HTO和MMPRT修复。大多数研究的临床结果评分都有显著改善，尤其是M组。放射学结果显示，在大约2年的随访中，两组的骨关节炎恶化程度相似。
结论：HTO是治疗严重骨关节炎的MMPRT患者的有效补充，其临床和放射学结果与单纯MMPRT修复相似。一般对患者预后更好，单独执行MMPRT修复或HTO和MMPRT修复的组合，仍然有争议。我们建议考虑K-L等级。未来需要进行大规模的随机对照研究，以帮助做出更好的临床决策。
方法：III.
目的：探讨HTO是否影响MMPRT修复的临床评分和放射学结果。
方法：系统评价。
方法：根据PRISMA（系统评价和荟萃分析的首选报告项目）指南，我们搜索了PubMed,Embase,WebofScience,和Cochrane图书馆数据库，用于报告MMPRT修复的结果和提取的患者特征数据的研究，临床功能评分和放射学结果。一名审阅者提取了数据，两名审阅者评估了偏倚的风险，并对证据进行了综合。如果文章报告了具有精确机械轴的MMPRT修复结果，则符合资格（在国际前瞻性系统审查登记册中注册，CRD42021292057）。
结果：确定了15项研究，其中625例具有较高的方法学质量。11项研究被分配到MMPRT修复组（M），其中478例仅进行MMPRT修复，其他人属于MMPRT修复和HTO组（M和T）执行HTO和MMPRT修复。大多数研究的临床结果评分都有显著改善，尤其是M组。放射学结果显示，在大约2年的随访中，两组的骨关节炎恶化程度相似。
结论：HTO是治疗严重骨关节炎的MMPRT患者的有效补充，其临床和放射学结果与单纯MMPRT修复相似。一般对患者预后更好，单独执行MMPRT修复或HTO和MMPRT修复的组合，仍然有争议。我们建议考虑K-L等级。未来需要进行大规模的随机对照研究，以帮助做出更好的临床决策。
方法：III.
