• Journal of the Korean Arthroscopy Society
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• v.16 no.2
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• pp.153-159
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• 2012

Purpose: This study aims at evaluating our results with a 5-year follow up of arthroscopic pull-out suture repair of posterior root tear of the medial meniscus. Materials and Methods: This study enrolled 30 cases who underwent a arthroscopic pull-out suture repair to treat the posterior root tear of the medial meniscus from January 2001 to May 2005 and followed up at least 5 years. The average follow-up period was 76 months (range, 60-90 months). Clinical results by use of the Lysholm knee score and radiographic grade by use of the Kellgren-Lawrence classification were evaluated and second-look arthroscopy was done in all cases. The clinical results were compared with trauma history, obesity, varus deformity and time to operation. Results: At the last follow up, the Lysholm knee score improved from 55 points to 86 points. For the radiological results, 23 cases displayed maintenance or improvement of the medial joint space on the follow up X-ray, but 7 cases displayed decrease of the medial joint space, and 1 case was lately performed total knee replacement due to progressive osteoarthritic change. Conclusion: Arthroscopic pull-out suture repair has a good result at 27 cases (90%) in minimum 5 years follow-up. The clinical improvement was significantly reduced in more severe varus angle.

• Journal of the Korean Arthroscopy Society
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• v.13 no.2
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• pp.165-169
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• 2009

The lateral meniscus is morphologically more variable than the medial meniscus. An abnormal lateral meniscus also varies with respect to its size, shape and stability, and such variations can occur in any patient of any age. The most common variant is a discoid lateral meniscus. We recently encountered a patient with a discoid lateral meniscus for which the anterior horn of the meniscus was anomalously inserted into the anterior ACL. The patient was forty five years old women who had persistent pain for three to four years without any specific trauma history. She was preoperatively diagnosed as having discoid lateral meniscus by MRI, and was confirmed the presence of the complex tear and anomalous insertion of the anterior horn of the discoid lateral meniscus into the anterior ACL by arthroscopic examination. Arthroscopic subtotal meniscectomy was performed and the symptoms were improved after surgery.

• Journal of the Korean Arthroscopy Society
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• v.16 no.2
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• pp.114-120
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• 2012

Purpose: The purpose of the study was to evaluate the usefulness and the stability of the superficial medial collateral ligament (MCL) release in posterior medial meniscus root repair. Materials and Methods: We compared 20 patients who underwent posterior medial meniscus root repair with superficial MCL preserved (PM) and 32 patients who underwent posterior medial meniscus root repair combined with superficial MCL release (RM) from April 2006 to September 2010. We excluded the patients combined with other surgery. To evaluate the postoperative valgus instability in RM group, we examined direct tenderness on MCL insertion, the subjective feeling of instability and valgus stress test at 3 months and 1 year follow-up. We compared the tourniquet time between PM group and RM group, and the clinical results were assessed by Lysholm score and International Knee Documentation Committee (IKDC) for the usefulness. Results: All patients had no clinically significant complication related to the superficial MCL release. Three months and 1 year follow-up, there were no positive tenderness test, no subjective symptoms and no significant increase of valgus instability although 5 patients examined grade I valgus instability. The mean tourniquet time was $41.3{\pm}12.7$ minutes in RM group and $53.5{\pm}13.6$ minutes in PM group. There was a significant difference in the tourniquet time between the two groups (P<0.05). Average Lysholm score was $56.8{\pm}5.5$ (range, 44-70) preoperatively and $85.1{\pm}5.8$ (range, 77-94) postoperatively in PM group, and was $56.2{\pm}5.4$ (range, 45-67) preoperatively and $87.4{\pm}3.9$ (range, 82-95) postoperatively in RM group (P<0.001). No significant difference of Lysholm score was found in both groups (P<0.05). Average IKDC scores was $42.6{\pm}3.9$ (range, 30-53) preoperatively and $77.2{\pm}6.3$ (range, 68-92) postoperatively in PM group, and was $42.7{\pm}5.7$ (range, 30-53) preoperatively and $89.6{\pm}2.9$ (range, 84-95) postoperatively in RM group (P<0.05). There was also no significant difference of IKDC score in both groups (P<0.05). Conclusion: The superficial MCL release in posterior medial meniscus root repair is useful to gain a wide surgical field and reduces the tourniquet time and does not lead to postoperative valgus instability. It can be considered clinically useful and safe procedure in medial meniscus posterior root repair.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.15 no.2
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• pp.55-62
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• 2020

연구 목적 이 연구는 내측 반월상 연골판 손상으로 인한 무릎 통증을 호소하는 5명의 환자에서 한의학적 치료, 특히 신바로 약침으로 인한 통증 개선이 있었기에 보고함이다. 연구 방법 무릎 통증으로 본원 입원치료를 받은 환자 중, MRI 영상 검사상 내측 반월상 연골 파열 진단을 받은 환자들의 차트를 분석하였다. 슬관절 통증 호전 및 기능 개선은 Numeric Rating Scale (NRS), Western Ontario and McMaster Universities Arthritis Index (WOMAC Index), 슬관절 Range Of Motion(ROM) 및 special tests 측정으로 판단하였다. 연구 결과 5증례에서 NRS는 평균 3.4의 호전, WOMAC Index는 평균 64.4%의 호전을 보였다. 슬관절 ROM 측정에서 환자 모두 입원시보다 증가되었으나, 무릎에 손상에 사용되는 보편적 검사인 Stress valgus, Stress varus, Drawer test, Apley compression test, Mcmurray's test 상 전후비교에서 4명의 환자는 호전되었고, 1명 환자에서는 변화가 없었다. 결과 이 연구는 내측 반월상 연골판 손상에 대한 신바로 약침을 포함한 한의학적 치료 후 단기간 내 통증 및 기능 향상을 보여주었다.

• IMMUNE NETWORK
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• v.24 no.2
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• pp.17.1-17.16
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• 2024

We have reported that anterior cruciate ligament (ACL) injury leads to the differential dysregulation of the complement system in the synovium as compared to meniscus tear (MT) and proposed this as a mechanism for a greater post-injury prevalence of post traumatic osteoarthritis (PTOA). To explore additional roles of complement proteins and regulators, we determined the presence of decay-accelerating factor (DAF), C5b, and membrane attack complexes (MACs, C5b-9) in discarded surgical synovial tissue (DSST) collected during arthroscopic ACL reconstructive surgery, MT-related meniscectomy, osteoarthritis (OA)-related knee replacement surgery and normal controls. Multiplexed immunohistochemistry was used to detect and quantify complement proteins. To explore the involvement of body mass index (BMI), after these 2 injuries, we examined correlations among DAF, C5b, MAC and BMI. Using these approaches, we found that synovial cells after ACL injury expressed a significantly lower level of DAF as compared to MT (p<0.049). In contrast, C5b staining synovial cells were significantly higher after ACL injury (p<0.0009) and in OA DSST (p<0.039) compared to MT. Interestingly, there were significantly positive correlations between DAF & C5b (r=0.75, p<0.018) and DAF & C5b (r=0.64 p<0.022) after ACL injury and MT, respectively. The data support that DAF, which should normally dampen C5b deposition due to its regulatory activities on C3/C5 convertases, does not appear to exhibit that function in inflamed synovia following either ACL injury or MT. Ineffective DAF regulation may be an additional mechanism by which relatively uncontrolled complement activation damages tissue in these injury states.

• Journal of the Korean Arthroscopy Society
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• v.10 no.1
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• pp.77-82
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• 2006

Purpose: The purpose of this study was to analyze the clinical results of symptomatic lateral discoid meniscus found in adults over 40 years old. Materials & Methods: From March 1994 to March 2004, 53 cases treated for lateral discoid meniscus in 48 patients aged over 40 years with the mean age $48.4(40{\sim}62)$ who were followed up more than 1 year, were analyzed by physical findings, simple X-ray, MRI and arthroscopic exam. Results: Most of the cases (42 cases, 79.2%) had symptoms for less than 1 year duration. 26 cases(49.1 %) out of 53 had trauma history. Simple radiologic evaluation showed that lateral condylar abnormality such as the flattening of lateral femoral condyle, marginal osteophytes, and subchondral sclerosis was seen in 37cases(69.8%). Also medial condyle showed degenerative changes in 16 cases (30.2%). Tear of discoid meniscus in 45 cases(84.9%) were examined by arthroscope and tear was not detected in 8 cases(15.1%). Type of tear was complex(18 cases), longitudinal(12 cases), horizontal(11 cases) and transverse(4 cases). Concomitant medial meniscal rupture was found in 7 cases(13.2%). The simple procedure done was reshaping(46 cases), subtotal resection(5 cases), total resection(1 case) and meniscal repair after reshaping in 6 cases, and arthroplasty was performed after arthroscopic examination in 1 case. Conclusion: Onset of symptom in adult lateral discoid meniscus is usually traumatic in origin. Most cases showed radiologic abnormality such as degenerative change in lateral condyles as well as medial condyles and the results of preservative surgical treatment was the most preferred option in most patients.

• Journal of the Korean Arthroscopy Society
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• v.6 no.1
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• pp.14-20
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• 2002

Purpose : To analyze the clinical result of the arthroscopic decompression of meniscal cyst and meniscus resection or repair of meniscus tear. Materials and Methods : From April 1994 and October 2001, 19 patients with diagnosis of meniscal cyst associated with tears of the meniscus were treated by arthroscopic meniscal resection or repair with decompression of the cyst. The mean age was 39.8 years(range, 22-58years). The follow-up period ranged from 3 months to 36 months with an average of 18 months. Seven of 19 patients had tenderness over the joint line with palpable mass. Treatment consists of arthroscopic resection or repair of meniscal tear with decompression of the cyst through transmeniscal approach. Open excision of cyst was performed in one case. Clinical evaluation was performed using Lysholm knee score and Tegner activity. All cases were executed proper treatment using arthroscopy. Results : Twelve cysts involved the lateral meniscus$(64\%)$ and seven cysts were on medial cyst$(36\%)$. Most of lateral meniscal cysts were located in anterior one-third and medial meniscal cyst were on posterior one-third. Meniscal tear were observed in seventeen cases$(89.5\%)$ and most tears were horizontal$(79\%)$. Preoperative symptom disappeared and no cyst recurrences were observed at last follow-up(mean follow-up: 18 months). Conclusion : Meniscal cysts involved lateral side in $64\%$ and most of them were associated with meniscus tear$(89.5\%)$ which consists of mainly horizontal component$(79\%)$.

• 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.

• Journal of the Korean Arthroscopy Society
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• v.6 no.2
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• pp.150-155
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• 2002

Purpose : The purpose of this study was to evaluate the clinical results of meniscal repair using the bioabsorbable devices. Materials and Methods : From 1998, 21 meniscal repairs were underwent using the bioabsorbable devices and followed more than 1 year. The Meniscus $Arrow^{\circledR}$(Bionx) and the Meniscal $Fastener^{\circledR}$(Mitek) had been applied. The indication for meniscus refixation was an unstable longitudinal tear in the posterior horn of the medial or lateral meniscus. Concurrent ACL reconstruction with meniscal repair was performed on 9 knees. The clinical result was evaluated using Lysholm knee score. Result : The average Lysholm knee scores for all patients improved from 56 preoperatively, to 89 postoperatively. The type of the device were not significantly related to clinical outcome or Lysholm knee score. But the concurrent ACL reconstruction group and the patients treated within 8 weeks had better clinical result than the others. Conclusion : The all-inside meniscal repair technique using bioabsorbable devices can be considered to be an useful method in the well selected patients and concurrent ACL reconstruction surgery.

• 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.