Background:Medial opening-wedge high tibial osteotomy (MOWHTO) is performed to treat young adults with medial compartment knee osteoarthritis associated with varus deformity. However, factors influencing joint space width (JSW) vary according to the type of medial meniscal tear and have not yet been completely elucidated.Purpose:To examine changes in JSW according to the type of medial meniscal tear after MOWHTO and analyze the influencing factors.Study Design:Cohort study; Level of evidence, 3.Methods:This study was conducted on 134 patients who underwent MOWHTO for medial osteoarthritis and were followed up for >2 years. The patients were classified into 3 groups based on medial meniscal status: intact, nonroot tear, and root tear. The authors then measured the JSW preoperatively and at 3 months, 6 months, 1 year, and >2 years postoperatively; analyzed whether the change in JSW varied according to meniscal status; and determined the association of these changes with the preoperative cartilage grade of the medial femoral condyle (MFC) and medial tibial plateau (MTP). International Knee Documentation Committee (IKDC) scores were used to evaluate clinical function.Results:Of the 134 patients, the medial meniscus was intact in 29 patients, a nonroot tear was observed in 58 patients, and a root tear was observed in 47 patients. Postoperatively, JSW increased for all groups, but the timing of the increase varied between the groups ( P < .001). JSW increased the most 6 months postoperatively in the intact group and 3 months postoperatively in the nonroot tear and root tear groups ( P < .001). Additionally, the increase in JSW was the greatest in the root tear group. Preoperatively, MFC and MTP cartilage status differed among the groups; MTP status did not affect the JSW, but MFC status did ( P < .001). The IKDC score increased from the preoperative to postoperative time point in all groups, but there was no significant difference between groups.Conclusion:The authors observed that the amount and timing of increase in JSW were dependent on the pattern of medial meniscal tear observed when MOWHTO was performed. In addition, the cartilage grade of MFC before surgery was associated with changes in JSW. The IKDC score was not significantly different between groups. However, a longer follow-up period is needed to analyze the correlation with the meniscal tear pattern and JSW.

中文翻译：

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半月板撕裂模式和术前软骨状态对胫骨内侧开口楔形高位截骨术后关节间隙宽度的影响

背景：内侧开口楔形高位胫骨截骨术（MOWHTO）用于治疗患有与内翻畸形相关的内侧间室膝骨关节炎的年轻人。然而，影响关节间隙宽度（JSW）的因素根据内侧半月板撕裂的类型而不同，尚未完全阐明。目的：根据MOWHTO术后内侧半月板撕裂的类型检查JSW的变化并分析其影响因素。研究设计：队列研究；证据级别，3。方法：本研究对 134 名因内侧骨关节炎接受 MOWHTO 的患者进行，并随访了 2 年以上。根据内侧半月板状态将患者分为三组：完整组、非根部撕裂和根部撕裂。然后作者在术前和术后 3 个月、6 个月、1 年和 2 年以上时测量了 JSW；分析 JSW 的变化是否随半月板状态而变化；并确定这些变化与术前股骨内侧髁（MFC）和胫骨平台内侧（MTP）软骨等级的关系。采用国际膝关节文献委员会（IKDC）评分来评估临床功能。结果：134例患者中，29例患者内侧半月板完整，58例患者出现非根部撕裂，47例患者出现根部撕裂。术后，所有组的 JSW 均有所增加，但各组之间增加的时间有所不同 ( P < .001)。 JSW 在完整组术后 6 个月增加最多，在非牙根撕裂和牙根撕裂组术后 3 个月增加最多 (P < .001)。此外，牙根撕裂组中 JSW 的增加最大。术前，各组的 MFC 和 MTP 软骨状态不同； MTP 状态不会影响 JSW，但 MFC 状态会影响 ( P < .001)。所有组的 IKDC 评分从术前到术后时间点均有所增加，但组间无显着差异。 结论：作者观察到 JSW 增加的量和时间取决于 MOWHTO 时观察到的内侧半月板撕裂的模式被执行。此外，术前MFC的软骨等级与JSW的变化相关。 IKDC 评分在各组之间没有显着差异。然而，需要更长的随访时间来分析半月板撕裂模式和 JSW 的相关性。