• 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.

• Journal of the Korean Arthroscopy Society
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• v.3 no.2
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• pp.109-114
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• 1999

Purpose : The importance of meniscal repair is well recognized. But transeciton of the posterior horn of the medial meniscus at the posterior tibial attachment is rarely documented and known irreparable. We experienced 9 cases of transection, and present clinical features and pull out suture technique. Methods and Materials : There were 9cases of transection of the posterior horn of medial meniscus from September 1998 to July 1999 in our hospital. Age was 59.3 years in average and ranged from 38 to 70years. Clinical features and MRI made diagnosis in all cases. We confirmed the diagnosis with arthroscopy and repaired the transection with pullout suture technique. Clinical features : Transection of the posterior horn of the medial meniscus at the posterior tibia attachment occurred frequently in middle aged people. They complained posterior knee pain, but they have no history of definitive trauma. Characteristically they had difficulty in full flexion of the knee and in having a squatting position. MRI is very important in diagnosis of transection, especially in coronal view, there is separation of the posterior horn of the meniscus from the posterior tibial attachment. Surgical technique : Pullout suture technique includes debridement of fibrous or scar tissue, exposure of the subchondral bone of the posterior tibial attachment site, suture the transected end of the meniscus with PDS suture, bone tunnel formation from the anteromedial aspect of the proximal tibia, insertion of wire loop through the tibia tunnel, pull the PDS suture through the tibia tunnel out of the joint and stabilize the PDS with post-tie technique to the proximal tibia. Conclusion : Transection of the posterior horn of the medial meniscus at the posterior tibial attachment is not common clinically and rarely documented. Clinical features and MRI are very important in diagnosis of this type tear. Arthroscopic pullout sutures is useful for treatment of this type tear of the meniscus.

• 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.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.5 no.2
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• pp.85-91
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• 2001

Purpose : The purpose of this study was to determine the clinical outcome of meniscal repairs according to tern location and combined injury. Materials and Methods : From 1994, 73 meniscal repairs were underwent by arthroscopy and followed more than 1 year. The locations of torn meniscus were 29 red-red Bone, 36 red-white zone, 8 white-white zone. Twenty-six patients also had combined lesion including ACL injury 17 cases and treated simultaneously. Clinical result was evaluated by OAK system. Result : Healing rates(above good) were $94\%$ in isolated injury and $88\%$ in combined injury, especially $94\%$ in ACL injury. The result according to tern location were $90\%$ in red-red zone, $91\%$ in red-white zone, all in white-white zone. Conclusion : Meniscus tear with ACL injury should be repaired by arthroscopy, simultaneously. The meniscal tear of white-white zone could be healed by arthroscopic meniscal suture.

• Journal of the Korean Arthroscopy Society
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• v.14 no.1
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• pp.25-28
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• 2010

Most of bucket handle meniscal tears are associated with anterior cruciate ligament (ACL) deficiency. Lateral meniscus lesions are more common with acute ACL deficiency, where medial meniscus lesions are more associated with chronic ACL deficiency. We reported an ACL deficient knee with bucket handle tears of medial and lateral meniscus of the same knee. The report suggests the need for increased awareness of the possible presence of this. Additionally, we discuss injury mechanism, clinical symptoms, specific signs on Magnetic Resonance Imaging (MRI), and treatment options.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.4 no.2
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• pp.72-76
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• 2011

Purpose: To verify the sinificance of the hyperechoic cluster formation in medial meniscal tear on the sonography. Materials and Methods: The formation of hyperechoic cluster of the medial meniscus on the sonography were compared with the MRI and arthroscopic findings in 28 knees. Results: The cluster formation area coincided with the overlapped torn fragment of the meniscus in all cases. Conclusion: The hyperechoic cluster on the sonography reveals the position of the overlapped torn fragment.

• Journal of the Korean Arthroscopy Society
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• v.13 no.3
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• pp.280-284
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• 2009

Purpose: The authors introduce a new technique of arthroscopic reduction of subluxed medial meniscus using suture anchor for the restoration of hoop stress. Operative Technique: Anterolateral, anteromedial, and medial midpatellar arthroscopic portal are used. Arthroscope was inserted through anterolateral portal. Through the scope, we confirmed subluxation of medial meniscus. Transection of menisci including radial and root tear were excluded. We released the anterior horn of medial meniscus through anteromedial and burred the future insertion site of suture anchor. After inserting suture anchor through medial midpatellar portal, we used 90 degree suture hook and no.2 Nylon to retrieve the suture of inserted anchor. We tied the suture by sliding knot-tying method. Weight bearing was limited for 6 weeks postoperatively. Conclusion: Arthroscopic retightening of medial meniscus is less invasive, conserving and progressed method for subluxed meniscus.

• 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.

• 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.