Editorial Commentary : Repairing the Crack and Rebuilding the Foundation? Rethinking Success After High Tibial Osteotomy and Medial Meniscus Root Repair

Abstract

Medial meniscus posterior root tears in the varus knee present a challenge of balancing biological repair with biomechanical correction. Recent studies show that combining high tibial osteotomy with root repair improves arthroscopic healing rates compared with osteotomy alone; however, this does not consistently reduce meniscal extrusion or prevent osteoarthritis progression. There is a clinical disconnect between structural healing and functional outcomes, as patient‐reported improvement may occur despite ongoing degeneration. We emphasize the importance of patient selection and prompt reconsideration of what defines success in knee preservation surgery.