• Title/Summary/Keyword: Medial meniscus

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Tear Patterns in Traumatic and Atraumatic Meniscal Injuries of the Knee (외상과 비외상에 의한 슬관절 반월상 연골의 파열 형태)

  • Sohn, Jong-Min;Kim, Hyoung-Gwan;Jahng, Ju-Hae;Choi, Moon-Ku;Moon, Chan-Woong
    • Journal of the Korean Arthroscopy Society
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    • v.2 no.2
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    • pp.147-150
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    • 1998
  • We reviewed the charts and photos taken during arthroscpy of 218 knees of 214 patients(240 menisci) retrospectively. The male was 156 cases(73%) and the female 58 cases(27%). The mean age of the patients was 35 years(range, 7-68). The patients who had definite trauma history were classified as trauma group(Group 1), and the patients who had no or could not recall trauma history were as atrauma group(Group 2). The trauma group was subclassified into the the patients with sports injury, traffic accident, fall down, slip down, direct injury, and miscellaneous according to the causes of the trauma. The patterns of meniscal tear were classified into longitudinal, bucket-handle, horizontal, transverse, flap, complex, and degenerative tear on the basis of O'Connor's classification. The aim of this study was to compare the meniscal tear patterns between trauma group(Group 1) and atrauma group(Group 2) and between the patients before and after the age of 40. The results were as follows ; 1) The difference in the incidence of tear between medial and lateral meniscus was not significant statistically. 2) In Group 1, 60% of the cases showed the longitudinal and bucket-handle tear and 52% of the cases of Group 2 were horizontal tear. 3) In the patients before the age of 40, the longitudinal and bucket-handle tear were 52% of the cases and in the patients over 40, tear patterns which were thought to be related to degenerative change, horizontal and degenerative tear were more than half of the cases (51%).

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Patellar Inferior Pole: New Landmark for the Anteromedial Instrument Portal for Arthroscopic Surgery of the Medial Meniscus Posterior Horn (슬개골 하극: 내측 반월상 연골판 후각부에 대한 관절경 수술을 위한 전내측 기구 삽입구의 새로운 표식)

  • Kim, Young-Mo;Hwang, Deuk-Soo;Lee, June-Kyu;Shin, Hyun-Dae;Kang, Tae-Hwan;Kim, Dong-Kyu;Kim, Pil-Sung
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.7 no.2
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    • pp.128-134
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    • 2008
  • Purpose: We prospectively evaluated the clinical usefulness of the patellar inferior pole (PIP) as a landmark of the anteromedial (AM) portal for the arthroscopic surgery of the medial mensiscus posterior horn (MMPH). Materials and Methods: Group 1 (50 normal left knees of adults), Group 2 (10 normal knees under anesthesia), and Group 3 (50 consecutive knees undergoing elective arthroscopic surgery for relatively simple intraarticular pathologies, or diagnostic arthroscopy) were included. In Group 1 and 2, the true lateral (A) and valgus stress lateral radiographs (B) on $30^{\circ}$ flexion were obtained, and the lines (AM portal line) passing through the PIP and distal-most medial femoral condyle (MFC) were drawn under the condition without considering the thickness of articular cartilage of MFC (1, 2-A, B group), and considering it as 2.5mm on B (1, 2-C group). Then, we investigated the meeting point of the AM portal line with medial tibial plateau (C-D percentage), and measured the distance between the PIP and the anterior joint line (E-length), and medial tibial-femoral joint space (F-length). In Group 3, the AM portal was made at the PIP level and clinical usefulness of the approach to the MMPH and body of the lateral meniscus (LM) was analyzed. Results: The average C-D percentage came out as 85.8, 101.3, 69.1% for each Group 1-A, B, C, and 102.4, 144.6, 116.8% for each Group 2-A, B, C. Measured E-length was an average of 15.1 (Group 1-A), 15.5 (Group 1-B, C), 13.1 (Group 2-A), and 12.9 mm (Group 2-B, C) and the change by valgus stress had no statistical significance. The F-length increased about 1.2 (Group 1) and 3.6 mm (Group 2) when valgus stress was applied, which had statistical significance (p<0.001, p<0.001). In Group 3, 49, 48 knees were classified as good for the MMPH, and the body of LM in aspect of the clinical usefulness of AM portal made on the PIP level. Conclusion: We identified the clinical usefulness of the PIP as a skin landmark of AM portal for the arthroscopic surgery of the MMPH.

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Arthroscopic Treatment for Localized Pigmented Villonodular Synovitis of the Knee (슬관절의 국소적 색소 융모 결절성 활액막염에 대한 관절경적 치료)

  • Kim, Sung-Jae;Shin, Sang-Jin;Choi, Nam-Hong;Joo, Eui-Tak;Kim, Hyung-Chan
    • Journal of the Korean Arthroscopy Society
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    • v.3 no.2
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    • pp.121-126
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    • 1999
  • Diagnosis of localized pigmented villonodular synovitis (PVNS) is difficult because of its rarity and indistinctive symptoms. This study presented 11 cases of localized PVNS of the knees, which were diagnosed and treated by arthroscopic technique. There were 6 males and 5 females between the age of 15 and 59 years (mean 34.6 years). The interval from the onset of symptoms to treatment ranged from 2 months to 3 years (average 29.9 months). All patients complained knee pain and 7 patients complained palpable mass. Four of the 11 patients had trauma history. The most common involved site was anteromedial synovium near the anterior horn of medial meniscus (5 patients). The remaining cases were identified on anterior fat pad (2 cases), suprapatellar pouch, posteromedial compartment, medial gutter and the anterior horn of the lateral meniscus, respectively. Nine cases had 1 mass and the remaining cases each had 2 or 3 masses. There was no evidence of recurrence during the follow-up period (average 29.9 months). Arthroseopy is effective in the diagnosis of localized PVNS with minimal morbidity and in the definitive treatment for PVNS.

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Rapidly Destructive Arthrosis of Knee Following Treatment of Crizotinib in a Patient with Non-Small-Cell Lung Cancer (비소세포폐암 환자에서 크리조티닙 치료 후 발생한 급속 파괴형 슬관절증)

  • Hwang, Jin Tae;Choi, Jae-Hyeong;Park, Chul-Hyun;Yoon, Kyung Jae;Lee, Yong-Taek;Do, Jong Geol
    • Clinical Pain
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    • v.19 no.2
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    • pp.120-123
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    • 2020
  • Rapidly destructive arthrosis is a rare syndrome characterized by narrowing of the joint space and rapid joint destruction within 6~12 months. A 62-year-old woman with anaplastic lymphoma kinase rearranged non-small-cell lung cancer presented with both knee pain and varus deformity. She was treated with crizotinib 500 mg/day for more than 2 years, with partial tumor response. Initial plain radiography showed Kellgren and Lawrence (K-L) grade 1. After 10 months, varus deformity was worsened and plain radiography aggravated to K-L grade 4 despite conservative treatment including activity modification. Diffuse synovitis with massive joint effusion and destruction of anterior cruciate ligament, medial meniscus, medial collateral ligament, and lateral collateral ligament were shown in magnetic resonance imaging. The patient was diagnosed with rapidly destructive arthrosis of knee and underwent a both total knee arthroplasty.

Acute Subdural Hematoma after Accidental Dural Puncture During Epidural Anesthesia

  • Kim, Il-Sup;Lee, Sang-Won;Son, Byung-Chul;Hong, Jae-Taek
    • Journal of Korean Neurosurgical Society
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    • v.40 no.5
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    • pp.384-386
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    • 2006
  • Acute subdural hematoma is an exceptionally rare, but life-threatening complication of spinal anesthesia. The authors report here on a case of acute subdural hematoma in a 52-year-old male who underwent an arthroscopic knee joint operation under spinal epidural anesthesia due to tearing of the medial meniscus. He complained of headache after surgery. Computed tomography[CT] revealed acute subdural hematoma in the right fronto-tempo-parietal area. The headache progressed in spite of analgesics and bed rest; two weeks later, the CT showed subacute subdural hematoma with a mass effect. The patient improved after surgical decompression. The pathogenesis of subdural hematoma formation after dural puncture is discussed and we briefly review the relevant literature. Prolonged and severe postdural puncture headache[PDPH] should be viewed with suspicion and investigated promptly to rule out any intracranial complications. Immediate treatment of the PDPH with an epidural blood patch to prevent further CSF leakage should be considered.

Pseudoradial Tear of the Medial Meniscus: A Relatively Common Potential Pitfall (내측반월상 연골의 가성방사파열: 비교적 흔한 진단상 함정)

  • You, Woo Young;Choi, Jung-Ah;Oh, Kyoung Jin;Min, Seon Jeong;Choi, Jae Jeong;Chang, Suk Ki;Hwang, Dae Hyun;Kang, Ik Won
    • Investigative Magnetic Resonance Imaging
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    • v.18 no.3
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    • pp.219-224
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    • 2014
  • Purpose : To determine the incidence of truncated triangle appearance of anterior horn (AH) to body of medial meniscus (MM) and determine its clinical significance. Materials and Methods: IRB approval was obtained, and informed consent waived for this study. The criteria of "pseudoradial tear" was truncated triangle appearance of the tip of AH to body of MM on one or more coronal images with adjacent fluid signal intensity at the blunted tip. Two musculoskeletal radiologists retrospectively evaluated 485 knee MR images independently for the presence and number of sections with "pseudoradial tear" of AH to body of MM using proton density-weighted coronal MR images. Inter-and intraobserver agreement was calculated using kappa coefficients. Medical records were reviewed for arthroscopic correlation. Results: A pseudoradial tear in the AH to body of MM was present in 381 (78.6%) patients. Locations were 112 in AH (29.4%), 143 in AH to body (37.5%), and 126 in body (33.1%). Number of consecutive sections of pseudoradial tear were 1 in 100 (26.2%), 2 in 164 (43.0%), 3 in 94 (24.7%), 4 in 21 (5.5%), and 5 in 2 (0.5%). Interobserver agreement was 0.99 for presence and 0.43 for number of sections of pseudoradial tear. Arthroscopies were performed in 96 patients and none of the pseudoradial tears were proven as true radial tears on arthroscopy. Conclusion: Pseudoradial tears are frequently seen in AH to body of MM on coronal MR images and may be another pitfall that a radiologist needs to be aware of and be able to differentiate from true radial tear.

Operative Treatment of the Displaced Bucket Handle Tear of the Medial Meniscus (내측 반월상 연골의 전위된 양동이 손잡이형 파열의 수술적 치료)

  • Hahn Sung-Ho;Yang Bo-Kyu;Yi Seung-Rim;Chung Shun-Wook;Lee Dong-Ho;Kim Min-Seok
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.2
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    • pp.142-149
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    • 2002
  • Purpose : The purpose of this study is to compare with result of repair and resection in displaced bucket handle medial meniscal tear. Materials and Methods : From Sep. 1998 to Dec. 2001, we experienced 46 cases, 45 patients. We classified them into repair group (group I, 23 cases) and resection group (group II, 23 cases). We analyzed the time interval between injury and operation, zone of tear, the status of reduction and quality of displaced fragment of all cases. Average follow-up period is 29, 28 months, respectively. We evaluated the final results of both groups as Lysholm knee score, radiologic changes and 2nd look arthroscopy. Results : Mean age was 25 years old in both group, respectively. Mean interval between injury and surgical treatment was 12 and 17 weeks. respectively. In group I, 6 of 7 cases were evaluated as clinical success in red-red zone, 12 of 15 cases were assessed as clinical success in red-white zonal tear, stable reduction. Another case which is evaluated as clinical failure showed red-white zonal tear, unstable reduction and poor quality meniscal fragment. 5 cases showed variant degrees of tibio-femoral compartment symptom. In group II, red-white zone (9 cases) and white-white zone (14 cases) were treated as resection and got good results. Conclusion : Considering zone of tear, reducibility and quality of meniscal fragment before treatment will improve the success rate of meniscal repair.

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The Effect of Meniscectomy on Clinical Result After ACL Reconstruction (전방십자인대 재건술에서 반월상 연골 절제술의 영향)

  • Cho, Hyung-Jun;Lee, Jung-Hwan;Bae, Dae-Kyung;Song, Sang-Jun;Yoon, Kyoung-Ho
    • Journal of the Korean Arthroscopy Society
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    • v.14 no.1
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    • pp.7-12
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    • 2010
  • Purpose: To evaluate the effects of total or subtotal meniscectomy on anterior cruciate ligament reconstruction. Materials and Methods: We reviewed the 455 cases of arthroscopic ACLR (anterior cruciate ligament reconstruction) from February, 2003 to February, 2007 and followed-up more than 1 year. The 93 cases were enrolled. The 45 cases who underwent only ACLR were included and the 48 cases who underwent ACLR with total or subtotal meniscectomy were included in this study except grade 3 or 4 chondral lesion, partial meniscetomy or meniscal repair. We divided the patient into 4 groups which were isolated ACLR group (group I, 45cases), ACLR with lateral meniscectomy group (group II, 10cases), ACLR with medial meniscectomy group (group III, 28cases) and ACLR with both medial and lateral meniscectomy group (group IV, 10cases). The clinical evaluation was done by range of motion (ROM), IKDC subjective score, Lysholm score, anterior drawer test, Lachman test, Pivot shift test and KT-1000 arthrometer. Results: At final follow up, group IV was inferior than group I in IKDC subjective score and Lysholm score, and inferior than group II in IKDC subjective score. In KT-1000 arhtometric test, group I had better results than group III and group IV. Also in anterior drawer test and Lachman test, group 1 had better result than group III and group IV. In pivot shift test, there was no significant difference among four groups. Conclusion: Medial or both medial and lateral meniscectomy had greater laxity in anterior drawer test, Lachman test and KT-1000 arthrometric test and both medial and lateral meniscectomy had a lower subjective score than both meniscus intact group.

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Treatment of Osteochondroma of the Mandibular Condyle with Inferior Adhesion of Meniscus: A Case Report (관절원판의 유착을 동반한 하악과두의 골연골종의 치료: 증례보고)

  • Seol, Dong-Ju;Choi, Byung-Joon;Kim, Yeo-Gab;Lee, Baek-Soo;Ohe, Joo-Young;Lim, Ji-Min
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.35 no.3
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    • pp.189-194
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    • 2013
  • Osteochondroma is a benign neoplasm, osseous projection surrounded with cartilage, 35.8% of benign osseous tumor, 8.5% of whole osseous tumor and usually arises from the skeletal bone. Osteochondroma is a cartilaginous derivation and relatively uncommon in the craniofacial bone. Osteochondroma of the mandible has slow growth rates which mainly affect women around forty years of age and it can appear through the coronoid process and mandibular condyle, especially in the medial half. Clinical finding associated with osteochondroma of condyle are primarily a palpable, painless temporomandibular area mass with facial asymmetry, malocclusion and midline deviations. Sometimes pain and dysfunction like trismus often accompany the anatomic derangement. Other features include malocclusion with open-bite on the affected side and cross-bite on the contralateral side. In this study, a 45-years old female patient exhibits pain on the left temporo-mandibular joint area and malocclusion due to loss of the molar region with osteochondroma on the top left of her mandibular condyle head. The patient is able to recover gradually from the symptom through treatments on manipulation, stabilization splint, arthroscopic lavage and surgical excision, thus, this is reported as a clinical case.

Avenanthramide C as a novel candidate to alleviate osteoarthritic pathogenesis

  • Tran, Thanh-Tam;Song, Won-Hyun;Lee, Gyuseok;Kim, Hyung Seok;Park, Daeho;Huh, Yun Hyun;Ryu, Je-Hwang
    • BMB Reports
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    • v.54 no.10
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    • pp.528-533
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    • 2021
  • Osteoarthritis (OA) is a degenerative disorder that can result in the loss of articular cartilage. No effective treatment against OA is currently available. Thus, interest in natural health products to relieve OA symptoms is increasing. However, their qualities such as efficacy, toxicity, and mechanism are poorly understood. In this study, we determined the efficacy of avenanthramide (Avn)-C extracted from oats as a promising candidate to prevent OA progression and its mechanism of action to prevent the expression of matrix-metalloproteinases (MMPs) in OA pathogenesis. Interleukin-1 beta (IL-1β), a proinflammatory cytokine as a main causing factor of cartilage destruction, was used to induce OA-like condition of chondrocytes in vitro. Avn-C restrained IL-1β-mediated expression and activity of MMPs, such as MMP-3, -12, and -13 in mouse articular chondrocytes. Moreover, Avn-C alleviated cartilage destruction in experimental OA mouse model induced by destabilization of the medial meniscus (DMM) surgery. However, Avn-C did not affect the expression of inflammatory mediators (Ptgs2 and Nos) or anabolic factors (Col2a1, Aggrecan, and Sox9), although expression levels of these genes were upregulated or downregulated by IL-1β, respectively. The inhibition of MMP expression by Avn-C in articular chondrocytes was mediated by p38 kinase and c-Jun N-terminal kinase (JNK) signaling, but not by ERK or NF-κB. Interestingly, Avn-C added with SB203580 and SP600125 as specific inhibitors of p38 kinase and JNK, respectively, enhanced its inhibitory effect on the expression of MMPs in IL-1β treated chondrocytes. Taken together, these results suggest that Avn-C is an effective candidate to prevent OA progression and a natural health product to relieve OA pathogenesis.