• Title/Summary/Keyword: Medial meniscus

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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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Spur-like Lesion on the Lateral Tibial Condyle - A Sign of Chronic ACL tear - (경골 외과의 골극 유사 병변 - 만성 전방 십자 인대 파열의 징후 -)

  • Cho Sung-Do;Ko Sang-Hun;Hwang Su-Yeon;Yang Jung-Hun
    • Journal of the Korean Arthroscopy Society
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    • v.7 no.2
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    • pp.201-205
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    • 2003
  • Purpose : Authors experienced cases of chronic ACL tear with spur-like lesion on the tibial condyle which is different from the lateral capsular sign and degenerative change and evaluated the significance of 'spur-like lesion' in relations with chronic ACL injury. Material and Method : We have 5 patients with spur-like lesion on the lateral tibial condyle in simple radiogram. The location, shape and size of the lesion were studied using radiogram and MRI. Cause of injury, associated injury and chronicity of the ACL tear were analyzed. All 5 patients were male, and mean age was 33.8 $(17\~46)$ years. Result : The spur-like lesion was located from 3.8 mm(avg.) below the articular surface of the lateral tibial condyle to the apex of the fibular head and protruded laterally or inferolaterally from just posterior to the Gerdy's tubercle with a round or sharp-end triangular shape. Average length was 6 mm and average width ortho base was 9.2 mm. The cause of injury were sports jnjury 4 cases and traffic accident in one. The chronicity of the ACL tear was average 10.7(8 months$\~$23 years) years and medial meniscus tear was shown in all cases and lateral meniscus tear in three. Conclusion : We suggest that a patient who has a history of trauma with spur-like lesion on the lateral tibial condyle of the knee is expected to have chronic ACL tear.

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The Interpretation of Joint Line Tenderness in Meniscal Injury (반원상 연골판 손상에서의 관절선 압통의 해석)

  • Lee, Yong-Seuk;Jung, Young-Bok;Choi, Sung-Woo;Hwang, Joon-Sung;Kim, Man-Kyung;Lee, Jong-Suk;Suh, Dong-Hyun
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.5 no.2
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    • pp.161-164
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    • 2006
  • Purpose: Meniscal injuries are very common sports problems and indications for knee surgery. We analyzed the effectiveness of joint line tenderness retrospectively. Materials and Methods: From May 2005 to June 2006, 76 knees which were diagnosed meniscal injury and performed arthroscopic surgery by same surgeon at military hospital were included. We analyzed sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of joint line tenderness in meniscal diagnosis. Results: The joint line tenderness gave such results (78.8%, 32.6%, 52.6%, 47.3%, 66.7% for sensitivity, specificity, accuracy, positive predictive value, negative predictive value respectively). We got similar results in analyses with medial meniscal lesion, lateral meniscal lesion, and combined instability patients. Conclusion: The joint line tenderness is a easy and comfortable maneuver but, it's effectiveness is low when it is used lonely The composite examinations including MRI and diagnostic arthroscopy for meniscal injuries of the knee perform much better than joint line tenderness alone.

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All-Inside Meniscal Repair Using FasT-Fix (FasT-Fix를 이용한 All-Inside 반월연골판 봉합술)

  • Jung, Yu-Hun;Choi, Nam-Hong;Kim, Byeong-Yeon
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.12 no.1
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    • pp.24-28
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    • 2013
  • Purpose: All-inside meniscal repair using FasT-Fix (Smith & Nephew Endoscopy, Andover, Massachusetts, USA) is a popular method for the meniscal tear. However, there was no report after all-inside repair using FasT-Fix for the meniscal tear in Korea. Therefore, the purpose of this retrospective study was to report clinical outcomes after all-inside meniscal repair using FasT-Fix. Materials and Methods: 25 consecutive patients underwent meniscal repairs using FasT-Fix for tears of the posterior horn of the medial or lateral menisci combined with hamstring anterior cruciate ligament (ACL) reconstructions. Postoperative evaluations included Lysholm knee score and Tegner activity scale. Using clinical criteria, a repaired meniscus was considered healed if there was no effusion or joint line tenderness, negative McMurray test, and no sense of giving way. Results: The average follow-up was 47.9 months (range, 40 to 61 months). At follow-up, the mean Lysholm score was 91.8 and the mean Tegner activity scale was 5.6. According to clinical criteria, 20 (80%) menisci was healed, and 5 (20%) failed. Conclusion: All-inside meniscal repair using FasT-Fix showed satisfactory results in patients with hamstring ACL reconstructions.

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Chondroprotective Effects of Cinnamomum cassia Blume in a Rat Model of Osteoarthritis (골관절염 랫드 모델에서 계피의 연골보호 효과)

  • Kim, Myoung Hwan;Kang, Seong Soo;Kim, Gonhyung;Choi, Seok Hwa
    • Journal of Veterinary Clinics
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    • v.30 no.3
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    • pp.159-165
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    • 2013
  • The present study was conducted to evaluate the efficacy of Cinnamomum cassia Blume (CC) extract on the repair of damaged cartilage in a rat model of osteoarthritis (OA) by anterior cruciate ligament transection (ACLT) and medial meniscus resection (MMx). Forty-eight rats were assigned to six groups (n = 8 per group): sham as negative control (NC), positive control (PC), diclofenac sodium (DS, 2 mg/kg), CC 25 mg/kg, CC 50 mg/kg and CC 100 mg/kg groups. Treatments were 12 weeks from 7 days after ACLT + MMx. Loss of cartilage and joint instability were significantly reduced in response to treatment with CC or DS compared to the PC (p < 0.05). CC significantly ameliorated cartilage degradation in a dose-dependent manner as assessed by histological findings (p < 0.01). A reduction in the severity of structural changes and a dose-dependent increase in Safranin-O staining intensity were observed in CC treatments, indicating that cartilage degradation was inhibited. Although DS did not affect the increase in active caspase-3 and cleaved poly(ADP-ribose) polymerase-induced apoptosis during the progression of OA, cells reactive to these apoptotic markers were decreased significantly by CC (p < 0.05). However, treatments with CC or DS did not influence the uptake of 5-bromo-2'-deoxyuridine. The findings suggest that CC can exert a chondroprotective action on OA through anti-inflammatory and anti-apoptotic properties.

Anterior Cruciate Ligament Reconstruction with a Four-Strand Single Semitendinosus Tendon Autograft (반건양건 단일 4가닥을 이용한 전방십자인대 재건술)

  • Kyung, Hee-Soo;Kim, Tae-Gong;Oh, Chang-Wug;Yoon, Sang-Hyup
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.2
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    • pp.138-142
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    • 2009
  • Purpose: The purpose of this study was to evaluate the result of anterior cruciate ligament (ACL) reconstruction using a fourstrand single semitendinous tendon to decrease the donor site morbidity due to harvest both semitendinosus and gracilis tendon. Materials and Methods: Thirty seven consecutive patients who had underwent ACL reconstruction using four-strand single semitendinosus tendon were evaluated. Mean age was 28.6 years old. Male was 34, female 3 patients. Time from injury to surgery was 5.4 months. Combined injuries were 10 meniscus injuries, 3 medial collateral ligament injuries and 1 osteochondral injury. Mean follow-up period was 16 months(12~18 months). Clinical evaluation was done using range of motion, Lachman test, pivot-shift test, Lysholm score & KT-2000 arthrometer. Results: All patients showed the normal range of motion of mean 150..at follow-up. Lachman test and pivot-shift test was negative in 35 cases. Lysholm score was improve from 84 to 92. Two cases had residual laxity due to poor compliance. Mean anterior translation compared to contralateral side by KT-2000 arthrometer improved from 6.7 mm preoperatively to 2.1 mm at follow-up. Conclusion: Reconstruction of the anterior cruciate ligament with use of a four-strand single semitendinosus tendon autograft showed good clinical results.

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Arthroscopic Reduction and Internal Fixation of Intra-articular Fractures of Lateral Tibial Plateau (관절면을 침범한 경골 외과 골절의 관절경적 정복 및 내고정술)

  • Lee, Kwang-Won;Lee, Hang-Ho;Yang, Dong-Hyun;Choy, Won-Sik
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.1
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    • pp.53-60
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    • 2006
  • Purpose: This study is to analyze the clinical and radiological results after arthroscopic reduction and internal fixation of intra-articular fractures of lateral tibial plateau. Materials and Methods: The subject of the study are the 13 cases of the patients visited orthopedics surgery during March year 2000 to August year 2004 because of intra-articular fractures of lateral tibial plateau and were treated with arthroscopic reduction and internal fixation. X-rays and CT or MRI were both carried out to identify the precise pattern of fracture and the degree of depression which showed out to be all type 2 by Schatzker fracture classification. And in 9 of the cases, autogenous and allogenous bone grafts were given as bone loss were severe. The average age was 48, age group between 31 and 66, and average follow up period of about 38 months ($13{\sim}65months$). Radiological ratings were given by comparing the X-rays of degree of joint congruency before and after the operation, functional ratings by analyzing IKDC score and Lysholm score. Combined injuries observed after arthroscopy were posterior cruciate ligament injury in 1 case, meniscus injury in 4 cases and medial collateral ligament in 2 cases. Results: During follow up, X-rays showed well-maintained reduction of articular surface in all cases and no complications such as joint depression, fracture reduction loss, angular deformity or malunion were found. Average Lysholm score at last follow up was 87 points ranging from 65 to 97, in 8 of the cases excellent, 3 good, 1 fair and 1 poor according to Lynsholm classification. Average IKDC score was 92 (from 82 to 99). Conclusion: Not only does arthroscopic reduction of lateral tibial plateau fracture bring exact reduction of articular surface, but also, is considered to be a good way of operation to diagnose and treat combined injuries of knee joint using arthroscopy.

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