• Title/Summary/Keyword: 반월상 연골판

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Arthroscopic Technique of Partial Meniscectomy for Bucket Handle Tear of Medial Meniscus using Posteromedial Portal (내측 반월상 연골판 양동이형 파열의 후내측 도달법을 이용한 관절경적 부분 절제술 - 수술 수기 -)

  • Ahn, Jin-Hwan;Lee, Jong-Yoon
    • Journal of the Korean Arthroscopy Society
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    • v.4 no.1
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    • pp.71-75
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    • 2000
  • Purpose : To introduce arthroscopic partial meniscectomy fur bucket handle tear of medial meniscus using posteromedial portal, which is superior to arthroscopic partial meniscectomy using standard anterior portals commonly used. Method : After arthroscopic examination of the knee, we reduce the torn meniscus, advance the arthroscope into posteromedial compartment under arthroscopic visualization, we make posteromedial portal with reexamination of the compartment and perform arthroscopic partial meniscectomy. Conclusion : With the technique of arthroscopic partial meniscectomy using standard anterior portals, accurate partial meniscectomy can not be done because of inadequate visual field, associated meniscal injuries of posterior horn and cartilage lesion of posterior aspect of the medial femoral condyle can be missed, commonly posterior cruciate ligament can be injured and artificial damage to weight bearing surface of medial femoral condyle is possible. An arthroscopic partial meniscectomy using posteromedial portal is an excellent method fur bucket handle tear of medial meniscus.

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Ultrasonographic Utility for Arthroscopic Examination of Knee (슬관절 관절경 검사 시 초음파 검사의 유용성)

  • Byun, Ki-Yong;Rhee, Kwang-Jin;Kim, Kyung-Cheon;Kim, Dong-Kyu;Kim, Bo-Kun
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.2 no.1
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    • pp.18-23
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    • 2009
  • Purpose: To evaluate the relationship between the real pathology & abnormal finding found by ultrasonography. Without an MRI test being done beforehand, an arthroscopy is done after an ultrasonography to show abnormal lesions during a knee abnormality. Materials and Methods: The subjects were 42 patients out of 49 cases, excluding those with rheumatoid arthritis, septic arthritis and patients suspected with a ligament tear, which were examined by ultrasonography alone before receiving a knee arthroscopy in our hospital from July 2007 to July 2008. In every case, a physical examination, simple X-ray and knee ultrasonography was done. An arthroscopy was performed when there was ultrasonographic abnormal finding. Before the procedure, a MRI test was not performed and when abnormal findings were found by an arthroscopy, an appropriate surgery was done. Results: During the ultrasonographic examination, there were various sized effusions in the suprapatellar pouch. Also, in addition there were eleven cases of medial meniscus abnormalities, sixteen cases of lateral meniscus abnormalities, and two cases of cystic lesions. Throughout the arthroscopic examination, there were 14 cases of medial meniscus abnormalities, 20 cases of lateral meniscus abnormalities, 15 cases of cartilage damages, 9 cases of medial pathologic plica, 2 cases of intra-articular loose bodies, 5 cases of chondromalacia, 2 cases of cyst, and 2 cases of synovitis. When an effusion abnormality was found by the ultrasonography in a suprapatellar pouch, there was a 100% probability of knee pathology. When a medial meniscus abnormality was found with an ultrasonography, there was a 90.9% probability of a real pathology. When a lateral meniscus abnormality was found there was 81.2% probability of a real pathology. Ultrasonography was 100% accurate when it came to cystic lesions. Conclusion: Knee ultrasonography performed before an arthroscopy seems to be a very useful examination method when suspecting intra-articular lesions.

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Indication and Pre-operative Planning of Meniscal Allograft Transplantation (연골판 이식술의 적응증과 수술 전 계획)

  • Kim, Tae-Hyung;Choi, Nam-Hong
    • Journal of the Korean Arthroscopy Society
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    • v.15 no.1
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    • pp.32-35
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    • 2011
  • Meniscal allograft transplantation is considered to restore important functions of the meniscus after total and subtotal meniscectomy. There are patients who need meniscal allograft transplantation have concomitant lesions; chronic anterior cruciate ligament tear, chondral defect, and malalignment of the knee. Therefore proper selection of the patients and thorough preparation of operative procedure are imperative to get satisfactory results.

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MRI Study of the Degenerative Radial Tear of Medial Meniscus (내측 반월상 연골판 후각부의 퇴행성 파열에서 MRI를 이용한 두께의 변화)

  • Kwak, Ji Hoon;Sim, Jae Ang;Kim, Nam Ki;Lee, Beom Koo
    • Journal of the Korean Arthroscopy Society
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    • v.15 no.2
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    • pp.108-112
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    • 2011
  • Purpose: To evaluate the thickness of the posterior horn of the medial meniscus accompanying with degenerative radial tear. Materials and Methods: We retrospectively reviewed 170 cases which show degenerative meniscal tear with variable degree of meniscal degeneration from February 2000 to February 2010. All cases were older than 40 years and 57 cases were men and 113 cases were women. Mean age were 55-year-old. We grouped the cases into 3 categories. Group A were composed with cases which showed horizontal and radial tear in posterior horn of medial meniscus. Group B showed horizontal tear only and group C showed intrasubstance degeneration without meniscal tear. Results: The mean thickness of medial meniscus posterior horn in group A, B, C were 7. 44 mm, 6.52 mm, 6.04 mm respectively. Group A showed significant increase of the thickness of medial meniscus posterior horn than group B, C. Group B also showed significant increase of thickness than group C. The degree of meniscal degeneration was highest in group A, which showed significant higher meniscal degeneration than group B and C, and, group B showed higher degeneration than group C, however, there was no statistically difference between group A and B regarding the degree of meniscal degeneration. Conclusion: The thickness of medial meniscus posterior horn was increased when accompanied with radial tear, which may elicit pain caused by meniscal impingement.

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Intrameniscal Gouty Tophus Originating from Medial and Lateral Meniscus (내측 및 외측 반월연골판에서 기시한 반월연골판 내 통풍 결절)

  • Park, Il-young;Kim, Young-mo;Joo, Yong-bum;Lee, Sang-bum
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.5
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    • pp.440-444
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    • 2021
  • In advanced gout, monosodium urate crystals are deposited in the joints and surrounding tissues, resulting in gouty tophi. A 45-year-old man was admitted to hospital due to pain and a limited range of motion in his right knee. Magnetic resonance imaging revealed a mass, and arthroscopic surgery and biopsy were then performed. Gouty tophi invading the anterior horns of the medial and lateral menisci were identified and surgically removed. To the best of the author's knowledge, there is no case report of intrameniscal gouty tophi invading both the medial and lateral menisci. This paper presents this case along with a review of the relevant literature.

The Outcome of Anterior Cruciate Ligament Reconstruction in Patients with Meniscal Injury (반월판 연골 손상이 동반된 환자에서 전방 십자 인대 재건술의 임상적 결과)

  • Lee Kwang Won;Park Jae Guk;Jung Yu Hun;Kim Byung Sung;Kim Ha Yong;Choy Won Sik
    • Journal of the Korean Arthroscopy Society
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    • v.7 no.2
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    • pp.160-168
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    • 2003
  • Purpose : To analyze the anterior stability and functional results after the arthroscopic ACL reconstruction and meniscectomy based on meniscus status at the time of surgery. Materials and Methods : From October 1997 to October 2002, 78 patients (male 64 female 14) were treated by arthroscopic ACL reconstruction and meniscectomy and followed more than 12 months (range, $12\~72$ months, average: 32 months). Average age was 32 years old (range, $18\~57$ years old). We divided the patients into 4 groups; Both menisci was intact (BMI, control group), lateral meniscus removed (LMR), medial meniscus removed (MMR) and both menisci removed (BMR). Anterior passive displacement (objective stability) was estimated using KT-2000 arthrometer under the loading of 15lb,20lb and 30lb and evaluated anterior drawer test, Lachman test, range of motion, thigh circumference. Functional evaluation system of IKDC, OAK and Lysholm knee score was used. Results : Average anterior displacement under the loading of 30lb were 2.47 mm, 2.96 mm, 2.96 mm and 3.57 mm in each group(BMI, LMR, MMR, BMR) and it was statistically significant difference (p<0.05). There is no statistically significant difference in average anterior displacement under the loading of 15lb and 20lb in each group but it has showed decreasing tendency in meniscal removed groups. The mean anterior displacement was within 3 mm in 21 cases, 15 cases, 24 cases and 12 cases (total 72 cases, $94\%$) under the loading of 15lb and 20 cases, 15 cases, 24 cases and 11 cases (total 70 cases, $91\%$) under the loading 20lb of in each group and postoperative knee joint stability has showed increasing tendency (p>0.05). The mean score was 94.5, 93.2, 92.2 and 90.4 points in each group and 71 cases $(91\%)$ were more than excellent or good with a OAK score and fair results were noted 4 cases in both meniscal removed group. There were 65 cases $(83\%)$ with a Lysholm knee score more than excellent or good, and IKDC grading were more than normal or nearly normal in 74 cases $(95\%)$ except 4 cases (2 cases in MMR group and 2 cases in BMR group). Conclusion : Long-term anterior stability and functional results of a successful ACL reconstruction affected by tile status of the menisci at the time of surgery and KT-2000 arthrometer was good for estimation of objective follow up.

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A Case Report of Intra-articular Bee Venom Pharmacopuncture combining with oriental medical treatment for Acute Traumatic Partial Tear of Meniscus (급성기 외상성 슬관절 반월상 연골판 손상 환자에 대한 기존 한방치료에 관절강내 봉약침 시술을 추가 시행한 치험 1례)

  • Lee, Jae-Hoon;Kim, Jun-Soo;Jeong, Young-Hoon;Jeong, Byul;Lee, Cha-Ro
    • Journal of Pharmacopuncture
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    • v.13 no.4
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    • pp.129-137
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    • 2010
  • This case was report of intra-articular bee venom pharmacopuncture injection on the patient with Acute Traumatic Partial tear of meniscus. We used intra-articular bee venom pharmacopuncture injection to Acute Traumatic Partial tear of meniscus diagnosed by symptoms and MR imaging. Be under treatment if necessary we prescribed herbal medication and physiotherapy. The state of patient was measured by Visual Analog Scale(VAS) and Walking time and Western Ontario and McMaster Universities(WOMAC) Index score. After several times of treatments, noticeable reduction of pain was measured and increased time of walking on floor and decreased WOMAC score. This results suggest that intra-articular bee venom pharmacopuncture injection are effective to treatments of Acute Traumatic Partial tear of meniscus.

Clinical and Arthroscopic Findings of Medial Meniscus Posterior Horn Insertion Tear (내측 반월상 연골판 후각 기시부 파열의 특징 및 관절경 소견)

  • Lee, Jun-Young;Kim, Dong-Hui;Ha, Sang-Ho;Lee, Sang-Hong;Gang, Joung-Hun
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.8 no.1
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    • pp.33-38
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    • 2009
  • Purpose: We wanted to report the clinical characteristics and arthroscopic findings of radial tear in medial meniscus posterior horn insertion, commonly occurs in patient over middle age with documentary review. Materials and Methods: Retrograde study using hospital records was done to 40 cases in 40 patients who visited our hospital and had been performed knee arthroscopic surgery due to medial meniscus posterior horn insertion tear between January, 2005 to April, 2007. Seven cases were male and 33 cases were female with the mean age of 61 (range, 47-80). Trauma history, stage of arthritis, period between pain and operation, MRI findings, clinical symptoms and operation methods were evaluated. Results : Six cases had trauma history while 34 cases didn't. In simple x-ray, using Kellgren-Lawrence classification, 31 cases were between stage 0 and II while 9 cases were stage III. In arthroscopic exam, there were 17 cases of Outerbridge grade IV, 4 cases of grade III, 9 cases of grade II, 9 cases of grade I. The mean duration of pain was 5.3 months. In MRI, at least one finding of cleft in axial or coronal view or ghost sign in sagittal view was found in all cases. The shape of meniscus tears were blunt in 18 cases, transverse in 12 and degenerative tear in 10. Subtotal meniscectomy was performed in 16 cases, partial meniscectomy in 10 cases and meniscal repair in 14 cases. Conclusion : Medial meniscus posterior horn insertion tear occurs in patients over middle age is rarely related to trauma history but causes painful mechanical symptom and usually accompany arthritis. Meniscectomy can be done for the treatment but repair can be considered is some cases. Further study on the treatment result will be needed.

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The Role of Meniscal Arrow in the Treatment of the Meniscal Tear (반월상 연골 파열의 치료에서 meniscal arrow의 역할)

  • Bae, Dae Kyung;Yim, Chang Moo;Jeong, Ki Woong
    • Journal of the Korean Arthroscopy Society
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    • v.3 no.1
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    • pp.24-29
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    • 1999
  • Purpose : The purpose of this paper is to analyze the clinical results after meniscal repair using meniscal arrow. Materials and Methods : Between May 1997 and Aug 1998, we repaired 22 tom menisci in 22 patients using meniscal arrows. There were nineteen males and three females with an average age of 27 years. There were longitudinal tear in 14 cases, Bucket-handle tear were 7 cases and horizontal tear was in 1 case. In 22 meniscus tears, 16 cases were associated with anterior cruciate ligament tear. Average number of meniscal arrow that was used were 2.5(ranged 1 to 4). Average follow-up period was 14.7 months(ranged 6 to 22 months). We evaluated the clinical results by the Tapper and Hoover's grading system. Results : There were excellent in 16 cases, good in 4 cases and fair in 2 cases on the clinical results. At the last follow up, the range of the motion of the knee joint were average 135 degrees(ranged 125 to 140 degrees). Mean time elapsed for meniscal repair were 25 minutes(ranged 15 to 40 minutes). Conclusion : Meniscal arrow has many advantages such as short operative time, easy fixation technique, and less neurovascular injury. We think that arthroscopic meniscal repair using meniscal arrow is effective treatment method in selected patient who have longitudinal, bucket-handle tear at the posterior hom associated with anterior cruciate ligament tear.

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