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KMID : 0950120120110010030
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Jouranl of Korean Orthopaedic Sports Medicine
2012 Volume.11 No. 1 p.30 ~ p.36
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The comparative study of arthroscopic meniscectomy with or without high tibial osteotomy in patients with degenerative medial meniscus posterior horn tear
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Moon Jae-Young
Seon Jong-Keun
Song Eun-Kyoo
Kim Hyung-Soon
Yim Ji-Hyeon
Cho Hyun-Jong
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Abstract
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Purpose: We compared the clinical and radiological results of meniscectomy with HTO or without HTO for degenerative medial meniscus posterior horn with varus deformity.
Materials and Methods: Forty-two patients who had medial meniscus degenerative root tear with varus deformity more than 3 degrees were included for this study. Among them, 30 patients were performed meniscectomy combined with open wedge HTO and 12 patients were performed only meniscectomy without HTO. The mean follow-up period was 52.5 months. The clinical results were evaluated based on symptom improvement, patients’ subjective satisfaction for surgery and HSS score. We also compared
the osteoarthritic progression between the group on preoperative and at the final follow up radiographs.
Results: Symptom improvement was achieved in 83.3% (25 cases) with HTO group and 66.7% (8
cases) without HTO group at final follow up with a significant difference. Patients’ satisfaction was achieved in 83.3% (25 cases) with HTO group and 58.3% (7 cases) without HTO group which has a significant difference. The HSS score was improved in both group (90.8: with HTO group, 89.0:without HTO group) at the final follow up without significant difference. WOMAC score was improved in both groups at the final follow up without significant difference. There were no significant differences in the osteoarthritic progression between two groups.
Conclusion: The good clinical result for treatment of patient who have medial meniscus degenerative root tear with varus deformity, proximal high tibial osteotomy is considered absolutely necessary. However, the progression of degenerative arthritis, its effect on long term follow up will be needed.
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KEYWORD
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Medial meniscus degenerative root tear, Arthroscopic meniscectomy, Open wedge high tibial osteotomy, Osteoarthritis progressionresult and patient’s subjective satisfaction
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