2026 COA Annual Meeting: Combined High Tibial Osteotomy and Root Repair Improves Patient-Reported Outcomes and Meniscal Healing in Medial Meniscus Posterior Root Tears

13 studies involving 725 patients were included in this systematic review and meta-analysis, including 7 comparative studies suitable for quantitative analysis comparing high tibial osteotomy with medial meniscus root repair (HTO-MRR) vs high tibial osteotomy (HTO) alone. Pooled outcomes included patient-reported outcome measures (PROMs), meniscal healing, range of motion (ROM), radiographic outcomes, and osteoarthritis progression. Patients undergoing HTO-MRR demonstrated significantly better postoperative Hospital for Special Surgery (HSS) and International Knee Documentation Committee (IKDC) scores, as well as substantially higher rates of complete meniscal healing on second-look arthroscopy compared with HTO alone. Radiographic outcomes and ROM were similar between groups. These findings suggest that adding root repair to HTO provides meaningful functional and biological benefits without compromising alignment correction or knee motion.