• Title/Summary/Keyword: Medial meniscus

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Meniscal Repair with Meniscal Arrows (반월상연골 화살을 이용한 반월상연골 봉합술)

  • Kim Jung-Man;Oh In-Soo
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.1 no.2
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    • pp.124-130
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    • 2002
  • Purpose: The results of meniscal repair of peripheral tear of meniscus with meniscal arrow was analysed. Materials and Methods: Peripheral tears of posterior 1/2 of menisci of 25 cases including 18medial, 6 lateral and 1 both menisci were repaired with meniscal arrows. One to six meniscal arrows were used for each meniscus according to the length of tears. Concurrent tears of ACL were noted in14 cases. The follow-up period was 3.4 years in average. The findings of physical examination and MRI which were taken once or twice in 1$\~$5 years after operation were evaluated. Results: Healing of the tear was achieved in all cases. However, a vertical longitudinal tear of body occurred in two medial menisci along the line of insertion of arrows. An arrow migrated subcuta-neously in two cases, respectively. Conclusions: The meniscal arrow was effective in the treatment of the peripheral tear of menicus. However, there was a chance of occurrence of longitudinal tear of the meniscus in case of insertion of arrows in a row. Migration of the arrow may occur.

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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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The comparative study of arthroscopic meniscectomy with or without high tibial osteotomy in patients with degenerative medial meniscus posterior horn tear (내반 변형을 지닌 내측 반월상 연골판 후방 골 기시부 퇴행성 파열 환자에서 반월상 연골판 절제술 단독과 근위 경골 절골술 동반 수술의 결과 비교)

  • Moon, Jae-Young;Seon, Jong-Keun;Song, Eun-Kyoo;Kim, Hyung-Soon;Yim, Ji-Hyeon;Cho, Hyun-Jong
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.11 no.1
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    • pp.30-36
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    • 2012
  • Purpose: We compared the clinical and radiological results of meniscectomy with HTO or without HTO for degenerative medial meniscus posterior horn with varus deformity. Materials and Methods: Forty-two patients who had medial meniscus degenerative root tear with varus deformity more than 3 degrees were included for this study. Among them, 30 patients were performed meniscectomy combined with open wedge HTO and 12 patients were performed only meniscectomy without HTO. The mean follow-up period was 52.5 months. The clinical results were evaluated based on symptom improvement, patients' subjective satisfaction for surgery and HSS score. We also compared the osteoarthritic progression between the group on preoperative and at the final follow up radiographs. Results: Symptom improvement was achieved in 83.3% (25 cases) with HTO group and 66.7% (8 cases) without HTO group at final follow up with a significant difference. Patients' satisfaction was achieved in 83.3% (25 cases) with HTO group and 58.3% (7 cases) without HTO group which has a significant difference. The HSS score was improved in both group (90.8: with HTO group, 89.0: without HTO group) at the final follow up without significant difference. WOMAC score was improved in both groups at the final follow up without significant difference. There were no significant differences in the osteoarthritic progression between two groups. Conclusion: The good clinical result for treatment of patient who have medial meniscus degenerative root tear with varus deformity, proximal high tibial osteotomy is considered absolutely necessary. However, the progression of degenerative arthritis, its effect on long term follow up will be needed.

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The Clinical Results of Meniscus Allograft Transplantation - Comparison between medial, Lateral, Isolated and Combined Procedure Groups - (동종 반월상 연골 이식술의 임상적 결과 - 내측과 외측 및 동반 손상의 유무에 따른 비교 -)

  • Cho, Seung-Mok;Yoon, Kyoung-Ho;Lee, Jung-Hwan;Bae, Dae-Kyung;Song, Sang-Jun;Kang, Chang-Min
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.1
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    • pp.28-33
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    • 2009
  • Purpose: To compare the clinical outcomes after meniscus allograft transplantation between lateral and medial or isolated and combined procedure groups. Materials and Methods: Of the patients who had undergone arthroscopic meniscal allograft transplantation between Dec. 1997 and Jun. 2007, 52 patients were available for retrospective evaluation. Patients were grouped into lateral(33 cases) and medial(19 cases) transplant groups as well as those with isolated(18 cases) and combined(34 cases) procedure. The average age was 34.2 years and the mean follow-up period was 42.2 months. Postoperative range of motion (ROM), visual analog scale (VAS), International Knee Documentation Committee (IKDC) subjective score, Lysholm score, Tegner score, patient's subjective satisfaction, $2^{nd}$ look arthroscopy and MRI were evaluated retrospectively. Results: Mean postoperative ROM was $130.3^{\circ}$. The VAS showed an improvement from 5.96 to 3.05 at the last follow up. IKDC subjective score and Lysholm score also showed an improvement from 46.5 to 64.5 and from 61.9s to 79.58 respectively. Tegner score was improved from 2.9 to 3.6. Overall, 61.5% of patients reported they were completely or mostly satisfied with procedure. There were no significant differences noted between lateral and medial groups as well as isolated and combined groups. In 2nd look arthroscopy, 10 of 18 cases showed good pheripheal healing and there were 6 cases of partial and 2 of complex tear. We observed graft subluxation or extrusion in 12 of 16 cases who were evaluated with follow-up MRI. Conclusion: Meniscus allograft transplantation alone or in combination with other procedure showed an improvement in knee pain and clinical score. But there were no significant difference between lateral and medial groups or isolated and combined procedure groups.

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Osteochondral allograft transplantation for treating medial femoral condyle subchondral bone cyst in a 14-year-old standardbred horse: a case report

  • Zsofia Pal;Gabor Bodo
    • Journal of Veterinary Science
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    • v.24 no.3
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    • pp.31.1-31.6
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    • 2023
  • Allograft arthroplasty is a promising cartilage-resurfacing technique. A 14-year-old horse was diagnosed with a medial femoral condyle subchondral bone cyst. Allografts were harvested from a young donor animal and implanted to fill the cyst cavity. A visual assessment of the surgical site was possible during follow-up arthroscopy. In addition to a desirable gliding surface and a good adaptation of the grafts, fibrillation of the cranial ligament of the medial meniscus was noted and debrided. The recipient horse became sound four months after follow-up surgery with a high level of owner satisfaction. In conclusion allograft transplantation is a promising technique for treating subchondral bone cysts.

Femoral Condyle Cut-off Sign - New Indirect Sign of Radiologic Finding in Knee with Discoid Lateral Meniscus - (대퇴 외과 절삭 징후(cut-off sign) - 원판형 외측 반월상 연골 예에서 나타나는 새로운 단순 방사선 소견 -)

  • Ha Chul-Won;Sung Ki-Sun;Park Jae-Chul
    • Journal of the Korean Arthroscopy Society
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    • v.7 no.2
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    • pp.215-219
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    • 2003
  • Purpose : To report the 'condylar cut-off sign', a new radiographic sign in knees with discoid lateral meniscus and to report the sensitivity, specificity, positive predictive value and negative predictive value of the sign to elucidate the diagnostic significance of the sign for discoid meniscus. Materials and Methods : Fifty knees with complete discoid lateral meniscus and fifty normal knees formed the basis of this study. All of them were arthroscopically confirmed fer the discoid or normal lateral meniscus. The authors developed a method to measure the length of the medial and lateral condylar were compare and analyzed. Results : Tile average ratio was 0.716 in the discoid meniscus group, and 0.902 in the normal group. The stastistical analysis by the T-test revealed the t-value -11.13(p<0.0001). Stastistical analysis by chi-square test using cut point 0.8, also showed significant difference between the two groups, with $76\%$ sensitivity, $100\%$ specificity, $100\%$ positive predictive predictive value and $81\%$ negative predictive value. The 'condylar cut-off sign' was readily detectable in all cases of discoid lateral meniscus, suggesting that the cut off sign could serve as a simple and reliable radiographic sign fur the diagnosis of discoid meniscus. Conclusion : The condylar cut-off sign on the Tunnel view of simple radiography of the knee can serve as a good sign for the diagnosis of discoid lateral meniscus, with $100\%$ positive predictive value.

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Tibial Plateau Leveling Osteotomy Combined with Tibial Tuberosity Transposition in a Dog with Medial Patellar Luxation and Cranial Cruciate Ligament Rupture

  • Kim, Ji-hye;Park, Jiyoung;Jeong, Seong Mok;Lee, Haebeom
    • Journal of Veterinary Clinics
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    • v.34 no.5
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    • pp.366-369
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    • 2017
  • A 30 kg, 6-year-old spayed female Samoyed dog was referred with a history of intermittent weight-bearing lameness in her right hindlimb for 3 weeks. The patient hadsurgery to correct a medial patellar luxation in the same limb 3 years prior. Based on the physical examination and radiographic findings, MPL and CCLR of the right hindlimb were diagnosed. Pre-surgical arthroscopy examination was performed, revealing a complete rupture of the cranial cruciate ligament, medial caudal meniscal tears and fibrotic cartilagechanges on the trochlear groove. An arthroscopy-assisted partial meniscectomy was used to repair themedial caudal meniscus. To correct the tibial plateau angle and medial patellar luxation, a tibial plateau leveling osteotomy (TPLO) was performed. A tibial tuberosity transposition (TTT) was performed to realignthe quadriceps mechanism with the trochlear block recession followed by soft tissue reconstruction. The post-surgical recovery was uneventful, and the patient was weight-bearing with normal ambulation on the repaired limb. There were no complications, and the implants were well positioned at the last follow-up. The clinical outcome of the caseindicates that combining TPLO with TTTis a good surgical option for treatingconcurrent CCLR and MPL.

Mid to Long - Term Results of Meniscal Allograft Transplantation (동종 반월상 연골 이식술 후 중장기 추시 결과)

  • Chun, Churl-Hong;Kweon, Seok-Hyun
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.8 no.1
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    • pp.19-25
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    • 2009
  • Purpose: We report mid to long - term results of meniscal transplantation and evaluate the important factors for successful outcomes. Materials and Methods: Between December 1999 and September 2002, 25 meniscal transplantations were performed using fresh frozen allograft. The lateral meniscus was transplanted in 19 cases and medial meniscus in 6 cases. The mean age was 34 years (range, 17~50 years) and the mean follow up was 54.8 months (range, 6~85 months). Preoperative measurements were made using a ruler graded in millimeters. Lateral meniscus was fixed by keyhole technique and medial meniscus was fixed by double bone plug technique with suturing the periphery of the meniscal transplant. All patients were evaluated with Knee Assessment Scoring System (KASS), Lysholm knee score, and Tegner activity scale for daily activity. Results: Symptoms improved in all cases. The average KASS score increased from 61.7 preoperatively to 83.8 postoperatively. The average Lysholm knee score increased from 77.7 preoperatively to 87.7 postoperatively (excellent in 3 cases, good in 17 cases, fair 4 cases, poor 1 case). But painful swellings were 3 cases, numbness in 1 case, and granuloma due to non-absorbable suture material in 1 case. Peroneal nerve palsy in 1 case was recovered after 6 weeks postoperatively. Conclusion: Meniscal allograft transplantation after subtotal or total menisectomy can significantly relieve pain and improve function of the knee joint. The exact preoperative sizing and secure fixation are essential for successful outcomes.

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Arthroscopic Findings of the Canine Stifle Joint (정상견 무릎의 관절경 검사소견)

  • 정순욱;정월순
    • Journal of Veterinary Clinics
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    • v.16 no.2
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    • pp.300-308
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    • 1999
  • Arthroscopy is a valuable diagnostic and operative tool in equine and human orthopedics. The arthroscope is a difficult instrument to use and requires patience, practice, and persistence in order to obtain good results. This technique was found to be less traumatic than arthrotomy, invasiveness, rapid recovery and the feasibility of surgically correcting many arthropathies. The use of the arthroscope in the dog provides a new dimension in the study and diagnosis of joint derangements. The purpose of this report is to introduce the use of the arthroscope in the dog-more specifically, in the stifle of the dog. A diameter 2.7 mm fore-oblique viewing arthroscope, cold light source, video and video printer are used. With the fore-oblique viewing type it is possible to view directly as well as slightly to the side and the range of viewing can be increased by rotating the arthroscope around the object The scope is connected with a cold light source by means of a fiber-optic light guide. The stifle joint was flexed to 20~30$^{\circ}$. The joint were lavaged with lactated Ringer's solution during arthroscopic examination. Arthroscopy of the stifle was performed prior to arthrotomy in 1 dead dog and 4 healthy dogs, and other 3 dogs was performed only arthroscopic examination. In this study only the conventional approaches were used and in most cases it was possible to view all the intra-articular structures via the lateral infrapatellar approach. In the stifle joint, endoscopic observation was performed to find lateral femoral condyle, patella, medial femoral condyle, trochlear groove, tibia, fat, cranial cruciate ligament, caudal cruciate ligament lateral meniscus, tendon of long digital extensor muscle, medial meniscus, and medial collateral ligament Post-arthroscopic examination, the lameness had disappeared within 12~24 hours. Pain and swelling in the stifle joint had disappeared within 24~36 hours. Post-arthroscopic secondary infection was never encountered in the dogs. In conclusion, arthroscopic insertion technique in canine stifle joint using a diameter 2.7 mm 30$^{\circ}$ arthroscope was established and arthroscopical views of all anatomical structures in the normal stilfe joint were obtained through lateral infrapatellar portal.

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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.