PMID- 33600226 OWN - NLM STAT- MEDLINE DCOM- 20210427 LR - 20210427 IS - 1552-3365 (Electronic) IS - 0363-5465 (Linking) VI - 49 IP - 4 DP - 2021 Mar TI - Mild to Moderate Varus Alignment in Relation to Surgical Repair of a Medial Meniscus Root Tear: A Matched-Cohort Controlled Study With 2 Years of Follow-up. PG - 1005-1016 LID - 10.1177/0363546520988072 [doi] AB - BACKGROUND: Increased varus alignment of the lower extremity is known to be a poor prognostic factor for the surgical repair for a medial meniscus root tear (MMRT). However, given the concept of constitutional varus, which is present in a substantial portion of the normal population, the generally accepted surgical indication for MMRT concerning a varus alignment of 5 degrees may be unnecessarily narrow. PURPOSE: To compare the surgical outcomes of arthroscopic transtibial pullout repair of MMRT according to the degree of varus alignment of the lower extremity. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Patients who underwent isolated arthroscopic transtibial pullout repair of MMRT between January 2010 and July 2017 at one institution and had a minimum follow-up of 2 years were included in this study. Patients were classified into 1 of 2 groups: the experimental group (n = 22) included patients with a preoperative hip-knee-ankle angle between 5 degrees and 10 degrees varus (mild to moderate varus alignment) and the control group (n = 51) included those with a preoperative hip-knee-ankle angle <5 degrees varus (neutral alignment). Clinical scores and radiographic parameters were compared between the groups to assess surgical outcomes, which were statistically matched for potential confounders (age, body mass index, the severity of cartilage lesion) by use of the inverse probability of treatment weighting. A noninferiority trial was performed comparing the experimental and control groups in terms of subjective outcomes (International Knee Documentation Committee subjective and Lysholm scores) and objective outcomes (postoperative medial meniscal extrusion and the rate of osteoarthritis progression). RESULTS: There were no statistically significant differences in surgical outcomes between the groups in subjective and objective aspects, which were consistent before and after inverse probability of treatment weighting. Apart from the clinical improvement observed in both groups, overall degenerative changes in the knee were found, although progression rates did not differ between the groups. In terms of the noninferiority trial, the overall surgical outcomes in the experimental group were not inferior to those in the control group. CONCLUSION: The short-term surgical outcomes of arthroscopic transtibial pullout repair for MMRT of patients with mild to moderate varus alignment were not inferior to but rather comparable with those with neutral alignment in terms of subjective and objective aspects. Therefore, it would be inappropriate to exclude patients with a diagnosis of MMRT from being indicated for the surgery simply because of mild to moderate varus alignment. FAU - Moon, Hyun-Soo AU - Moon HS AD - Arthroscopy and Joint Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea. AD - Department of Orthopedic Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea. FAU - Choi, Chong-Hyuk AU - Choi CH AD - Arthroscopy and Joint Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea. AD - Department of Orthopedic Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. FAU - Yoo, Je-Hyun AU - Yoo JH AD - Arthroscopy and Joint Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea. AD - Department of Orthopedic Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea. FAU - Jung, Min AU - Jung M AD - Arthroscopy and Joint Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea. AD - Department of Orthopedic Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. FAU - Lee, Tae-Ho AU - Lee TH AD - Arthroscopy and Joint Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea. AD - Department of Orthopedic Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. FAU - Jeon, Byeong-Hun AU - Jeon BH AD - Department of Orthopedic Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. FAU - Kim, Sung-Hwan AU - Kim SH AD - Arthroscopy and Joint Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea. AD - Department of Orthopedic Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. LA - eng PT - Journal Article DEP - 20210218 PL - United States TA - Am J Sports Med JT - The American journal of sports medicine JID - 7609541 SB - IM MH - Arthroscopy MH - Cohort Studies MH - Follow-Up Studies MH - Humans MH - Magnetic Resonance Imaging MH - *Menisci, Tibial MH - Retrospective Studies MH - *Tibial Meniscus Injuries/surgery OTO - NOTNLM OT - arthroscopic transtibial pullout repair OT - medial meniscus root tear OT - prognostic factor OT - varus alignment EDAT- 2021/02/19 06:00 MHDA- 2021/04/28 06:00 CRDT- 2021/02/18 17:11 PHST- 2021/02/19 06:00 [pubmed] PHST- 2021/04/28 06:00 [medline] PHST- 2021/02/18 17:11 [entrez] AID - 10.1177/0363546520988072 [doi] PST - ppublish SO - Am J Sports Med. 2021 Mar;49(4):1005-1016. doi: 10.1177/0363546520988072. Epub 2021 Feb 18.