Study Summary

13 studies including 725 patients with degenerative medial meniscus posterior root tears (MMPRTs) were included in this systematic review and meta-analysis comparing high tibial osteotomy combined with medial meniscus root repair (HTO-MRR) vs high tibial osteotomy (HTO) alone. Pooled outcomes of interest included patient-reported outcome measures (Lysholm, Hospital for Special Surgery (HSS), International Knee Documentation Committee (IKDC), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)), range of motion (ROM), radiographic outcomes, meniscal healing rates, and osteoarthritis progression. HTO-MRR was associated with significantly improved HSS and IKDC scores compared with HTO alone, while Lysholm scores showed a trend toward improvement. No significant differences were observed for ROM, mechanical alignment, meniscal extrusion, joint space width, or osteoarthritis progression. Overall, these findings suggest that adding meniscal root repair to HTO may provide superior functional outcomes while maintaining similar radiographic outcomes compared with HTO alone.