Impact of Preoperative Medial Meniscus Extrusion and Subchondral Bone Marrow Edema on Postoperative Outcomes Following Medial Opening Wedge High Tibial Osteotomy
Bibliographic record
Abstract
Objective: Currently, limited evidence exists regarding the impact of preoperative medial meniscus extrusion (MME) and subchondral bone marrow edema (BME) on clinical outcomes following medial opening wedge high tibial osteotomy (MOWHTO). This study aimed to evaluate how preoperative MME and BME affect short-term postoperative outcomes in patients undergoing MOWHTO. Methods: A total of 43 patients who underwent MOWHTO between January 2022 and January 2023 were included in this retrospective analysis, with a mean follow-up duration of 1.8 years. Patients were grouped based on MME, classified as pathologic if ≥ 3 mm. Subchondral BME was graded into four categories using lesion volume criteria from the MRI Osteoarthritis Knee Score (MOAKS). Clinical outcomes were assessed using the Hospital for Special Surgery (HSS) score, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the Knee Society Score (KSS). Results: The average preoperative MME across all participants was 3.6 ± 1.9 mm. Pathologic MME was observed in 29 patients (67.4%). A positive correlation was found between the severity of BME and the degree of MME. Patients with pathologic MME exhibited significantly poorer clinical outcomes based on WOMAC and KSSpain and function subscales, as well as HSS scores at both 1 and 2 years postoperatively (all p < 0.05).Subchondral BME was present in 35 patients (81.4%).Based on MOAKS grading, the distribution was as follows: 8 patients (18.6%) with grade 0, 17 (39.5%)with grade 1, 11 (25.6%) with grade 2, and 7 (16.3%)with grade 3. Preoperative clinical scores varied significantly across BME grades (p < 0.001), but these differences did not persist at 1 or 2 years post-surgery (p > 0.05).In both univariate and multivariate analyses, only MME showed a consistent association with worse clinical outcomes (p < 0.001).Conclusions: Preoperative MME ≥ 3 mm is associated with poorer shortterm functional and pain-related outcomes following MOWHTO.In contrast, the severity of subchondral BME prior to surgery did not significantly impact postoperative recovery.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".