Restoration of the Knee Medial Collateral Ligament and Complete Soft-tissue Coverage After Medial Open-Wedge High Tibial Osteotomy

Release or transection of superficial medial collateral ligament during open‐wedge high tibial osteotomy demonstrated similar clinical outcomes and valgus laxity

“…Some authors reported that sMCL should be kept to a minimum or fixed after manipulation to preserve stability [11][12][13]. Pape et al [13] reported an increased medial joint opening after release of the sMCL and possible late valgus instability.…”

“…Pape et al [13] reported an increased medial joint opening after release of the sMCL and possible late valgus instability. Others have suggested techniques for reattaching the sMCL using a suture anchor or suturing it back into position after manipulation [11,12]. However, some authors have reported that valgus laxity does not increase after HTO [6,7,15].…”

“…While both techniques are widely performed by surgeons during MOWHTO, concerns have been raised about valgus laxity following sMCL release based on previous biomechanical studies and attempts to restore the sMCL after the release are being made [11][12][13][14]. However, some authors have reported that neither release nor transection increases valgus instability [7,15].…”

Plate Hooking Transtibial Medial Meniscus Posterior Root Pull-Out Repair with Medial Open-Wedge High Tibial Osteotomy for Knee Osteoarthritis with Medial Meniscus Posterior Root Tear

“…For this procedure, we incise the subcutaneous tissues and sartorius fascia as described previously. 13 , 14 Gracilis (G) tendon and semitendinosus (ST) tendon are deployed with a gauze over the G and ST, and the dissection proceeds from between the joint capsule and the shallow layer of MCL ( Fig 3 a). This process detaches the adhesions between the shallow and deep layers of the MCL, facilitating the visualization of the inside of the joint ( Fig 3 b).…”

“…The MCL is reduced to its anatomic position and the complete coverage of the osteotomy is performed after β-TCP insertion ( Fig 4 c). 13 The AC plate (Omic Co., Ritto, Japan) is placed on the anteromedial side of the tibia and temporarily fixed with the Kirschner wire under fluoroscopy. After the proximal locking screw is inserted, the distal locking screw is inserted to secure the plate ( Fig 5 a, b).…”