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Association between Varus Mechanical Alignment and Medial Meniscus Tears: A Retrospective Study
Zhiheng Lan1, Yuan An2, Juan Wang1
1Department of Arthrosis, the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
The Journal of Knee Surgery
|December 5, 2025
Summary
Varus knee alignment significantly increases the risk of medial meniscus tears (MMT). Even minor increases in varus alignment nearly double MMT odds, highlighting its importance in knee osteoarthritis management.
Area of Science:
- Orthopedics
- Radiology
- Biomechanical Engineering
Background:
- Varus mechanical alignment is a known risk factor for medial compartment osteoarthritis (OA).
- Medial meniscus tears (MMT) are frequently observed in patients with knee OA.
Purpose of the Study:
- To investigate the association between knee mechanical alignment and the presence of medial meniscus tears (MMT).
- To quantify the risk of MMT associated with varying degrees of varus alignment.
Main Methods:
- Retrospective analysis of 201 knee joints using whole-leg weight-bearing radiographs and MRI.
- Hip-Knee-Ankle Angle (HKAA) measured to quantify mechanical alignment.
- MMTs assessed via MRI; participants grouped into MMT and no-MMT cohorts.
Main Results:
- Patients with MMT exhibited significantly greater varus alignment (HKAA) compared to those without.
- Each degree increase in varus alignment nearly doubled the odds of MMT (adjusted OR=2.01).
- Varus alignment conferred over a 3-fold higher risk of MMT (OR=3.25).
Conclusions:
- A strong association exists between varus mechanical alignment and MMT.
- Incremental increases in varus alignment significantly elevate the likelihood of MMT.
- Mechanical alignment is crucial for the prevention, early detection, and management of MMT.
