meniscal extrusion was greater and more severe in knees with a radial tear component than in knees without a radial component. The incidence and degree of major extrusion was similar in knees with root tears and non-root tears. A radial component and knee osteoarthritis severity were similarly predictive of absolute and relative extrusion. Meniscal extrusion in osteoarthritic knees was associated not only with degenerative meniscal tear but also with osteoarthritis severity. Therefore, arthroscopic meniscal procedures, especially meniscal repair, should be cautiously considered in patients with meniscal extrusion.

Our findings showed that MAT was an effective symptomatic treatment in knees with advanced bipolar chondral lesions. However, better graft survival can be expected when articular cartilage is intact or if chondral damage is limited to a unipolar lesion. MAT should be considered before the progression of chondral damage to a bipolar lesion for better graft survivorship and should be performed cautiously in arthritic knees.

The risk of graft extrusion increases as the axial plane trough angle increases. The angle can be reduced by ensuring that the bony trough starting point is not created in too lateral a position.

Meniscus allograft transplantation using bone fixation resulted in significant symptomatic and functional improvements. Magnetic resonance imaging or second-look arthroscopy was necessary to assess allograft status even after favorable clinical outcome. Meniscus allograft transplantation with bone fixation is considered effective for symptomatic, totally meniscectomized knees.

Background: Although joint-line obliquity (JLO) after open-wedge high tibial osteotomy (OWHTO) is commonly encountered, especially in cases of overcorrection, its effect has not been fully elucidated or has been assessed only in the short term. The acceptable range of JLO, often recognized as ≤4°, has not been determined as per the midterm outcomes of OWHTO. Hypothesis: Joint-line obliquity exceeding the acceptable limit after OWHTO would accelerate cartilage degeneration and adversely affect midterm clinical outcomes. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 109 patients who underwent OWHTO between 2010 and 2015 with a mean follow-up period of 55.0 months (range, 24-102 months) were reviewed. JLO was defined as the angle between the lines parallel to the floor and to the tibial plateau on a long-standing hip-to-ankle radiograph. For radiologic evaluation according to JLO, the medial joint space width (JSW) was measured on a standing 45° flexion posteroanterior view and standardized with the width of the tibial plateau as reference, after which changes in JSW (ΔJSW) between the 6- and 12-month postoperative period and the latest follow-up were calculated. ΔJSW was analyzed according to 2 different cutoff values of JLO: JLO of 4°, which is currently recognized as the acceptable limit, and that derived from the receiver operating characteristic (ROC) curve for the third quartile of ΔJSW. Multivariate regression analysis including JLO as well as other demographic and radiologic factors was performed. Clinical outcomes were evaluated in the same way using Knee Society (KS) objective and functional scores. Results: With a JLO cutoff of 4° in the multivariate regression analysis, JLO was not significantly associated with ΔJSW ( P = .545). However, in the KS objective and functional score analyses, JLO ≥4° was found to be a significant factor ( P = .045 and .005, respectively). The ROC curve showed a cutoff JLO of 6°, which was significantly associated with ΔJSW ( P = .001). JLO ≥6° remained significant in the analyses for KS objective and functional score ( P = .012 and .001, respectively). Conclusion: The adverse effect of JLO on radiologic outcomes was shown when JLO was ≥6°. In clinical aspects, worse outcomes were found in cases of JLO ≥4°.

IV.

After an arthroscopic partial meniscectomy for symptomatic DLM, unfavorable clinical outcomes were shown in > 30% of the patients during a mean follow-up of 10.0 years. Clinical outcomes based on the patient-reported outcome measures were related to durations of symptoms prior to surgery and alignment at the last follow-up. In radiological and MRI assessments, progression of degeneration of articular cartilages in the lateral compartments of the knees and residual menisci was observed.

Level III, therapeutic study.