{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:16:07Z","timestamp":1782346567739,"version":"3.54.5"},"reference-count":50,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,3,22]],"date-time":"2026-03-22T00:00:00Z","timestamp":1774137600000},"content-version":"vor","delay-in-days":49,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2026,3,22]],"date-time":"2026-03-22T00:00:00Z","timestamp":1774137600000},"content-version":"vor","delay-in-days":49,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["arthroscopyjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To investigate whether concurrent arthroscopic meniscus centralization with all\u2010inside side\u2010to\u2010side root repair during open\u2010wedge high tibial osteotomy (OWHTO) provides superior clinical, radiological, and second\u2010look arthroscopic outcomes compared with isolated OWHTO in patients with medial meniscus posterior root tears (MMPRTs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Between January 2020 and December 2021, 82 patients with symptomatic medial meniscus posterior root tears meeting prespecified criteria were prospectively enrolled and randomized into two groups: isolated OWHTO (Group A, n\u2009=\u200944) or OWHTO combined with arthroscopic meniscus centralization and all\u2010inside side\u2010to\u2010side root repair (Group B, n\u2009=\u200938). Inclusion criteria included age 50\u201075 years, mild\u2010to\u2010moderate varus alignment, medial meniscus extrusion (MME) &gt;\u20093\u2009mm, flexion contracture &lt; 10\u00b0, and intact lateral meniscus and cartilage. Demographic characteristics and second\u2010look arthroscopic findings were compared between groups. Clinical outcomes (including range of motion and change in knee flexion [\u0394flexion]) and radiographic parameters\u2014such as hip\u2010knee\u2010ankle angle, medial proximal tibial angle, and MME\u2014underwent analysis for both intragroup pre\u2010 to postoperative changes and intergroup comparisons at preoperative and postoperative timepoints. Furthermore, the minimal clinically important difference (MCID) values were calculated for Lysholm scores and \u0394flexion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At a mean follow\u2010up of 32.9 months (range, 26\u201041 months), with comparable duration between groups (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.153), no significant differences were found between the two groups in terms of final Lysholm (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.102) or Hospital for Special Surgery scores (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.547). \u0394flexion was significantly greater in Group A than in Group B (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.036). However, Group B exhibited significantly higher postoperative knee flexion loss than Group A (36.8% vs 13.6%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001). This loss was more pronounced in Group B patients with preoperative flexion &gt;130\u00b0, with the incidence of 66.7%. Regarding clinically relevant values, the cohort\u2010specific MCID was calculated as 4.0 points for Lysholm score and 2.5\u00b0 for \u0394flexion. All patients (100%) met the MCID threshold for Lysholm score, while 58.5% (48\/82) achieved it for \u0394flexion. Notably, Group B had a higher proportion of patients failing to reach \u0394flexion MCID compared with Group A (44.7% vs 38.6%). Group B showed significantly decreased MME at final follow\u2010up compared with Group A (0.8\u2009mm vs 4.2\u2009mm,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001) but no differences in other radiologic variables (including hip\u2010knee\u2010ankle angle and medial proximal tibial angle). Second\u2010look arthroscopy revealed a significantly higher meniscal healing rate in Group B (28.9% vs 13.6%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001). Nevertheless, no significant differences in postoperative Lysholm or Hospital for Special Surgery scores were observed between healed and nonhealed patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Compared with isolated OWHTO, concurrent meniscus centralization with all\u2010inside root repair resulted in reduced MME and improved meniscal healing, but did not confer superior clinical outcomes and was associated with a greater loss of knee flexion, particularly in patients with preoperative hyperflexion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level II, lesser\u2010quality randomized controlled trial.<\/jats:p>\n                  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