• Journal of Korean Medicine Rehabilitation
• /
• v.28 no.1
• /
• pp.175-184
• /
• 2018

The purpose of this study is to report the effectiveness of complex Korean Medicine treatment for anterior cruciate ligament (ACL) injuries with meniscus tear. Four patients were treated with complex Korean Medicine by acupuncture, pharmacopuncture and herbal medication. We evaluated the improvement of knee pain and function by Numeric Rating Scale (NRS), Western Ontario and McMaster Universities Arthritis Index (WOMAC Index), EuroQol-5 Dimension Index (EQ-5D Index). After treatment, we found that knee pain was reduced and joint function was improved by NRS and WOMAC index in all cases. In the evaluation of health-related quality of life through EQ-5D index, there was no significant difference in patients with degenerative knee osteoarthritis and severe meniscal injury. This results show that complex Korean Medicine may be an effective option for ACL injuries with meniscus tear. Further clinical studies are needed to clarify the effect of Korean Medicine therapy on ACL injuries with meniscus tear.

• Journal of the Korean Arthroscopy Society
• /
• v.6 no.2
• /
• pp.142-149
• /
• 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.

• Journal of the Korean Arthroscopy Society
• /
• v.15 no.1
• /
• pp.42-49
• /
• 2011

Recently, meniscal allograft transplantation has been regarded as a successful procedure in terms of pain relief and functional improvement for the symptomatic patients previously underwent subtotal or total meniscectomy. However, the likelihood of a successful outcome would be reduced by various complications including graft tear, shrinkage, extrusion, infection, progressive chondral injury, and granuloma due to nonabsorbable suture material. Therefore, knee surgeons need to be all aware of the complications and to make an effort to minimize them. The purpose of this article is to review the current literatures regarding clinical results and complications after meniscus allograft transplantation.

• Journal of Acupuncture Research
• /
• v.39 no.1
• /
• pp.59-63
• /
• 2022

Spontaneous osteonecrosis of the knee (SONK) is a common form of osteonecrosis of the knee and mainly affects the medial condyle due to localized vascular insufficiency. We report a case of SONK in a 65-year-old woman who had severe knee pain in her left knee whichimpeded her capacityto walk beyond 10 minutes. Bilateral knee X-rays revealed degenerative osteoarthritis of both knees and magnetic resonance imaging revealed R/O SONK in the lateral aspect of the medial femoral condyle, as well as a medial meniscal posterior horn root tear, and a Grade 1 medial collateral ligament injury. She was hospitalized at Jaseng Hospital of Korean Medicine for 21 days and receivedcombination therapy includingacupuncture, pharmacopuncture, and herbal medicine. Patient-reported scales indicated that her pain and physical functional limitations were alleviated. Combination therapy consisting of Korean traditional medicine may bean alternative nonoperative treatment approach for patients with SONK.

• Journal of Korean Orthopaedic Sports Medicine
• /
• v.9 no.1
• /
• pp.48-57
• /
• 2010

Purpose: To compare the incidence and risk factors for osteoarthritis after anterior cruciate ligament (ACL) reconstruction between two groups using bone-patellar tendon-bone (BPTB) and hamstring tendon (HT) autograft. Materials and Methods: 53 cases of ACL reconstruction using patellar tendon and 40 cases using hamstring tendon were followed up at least 8 years. Radiographic evaluation was done according to the Kellgren and Lawrence's classification. Clinical functional testing (Lysholm Knee Scores, the Tegner activity scores) and laxity testing (Lachman, pivot shift tests), and the instrumented laxity testing with $Telos^{(R)}$ were all examined in relation to the development of osteoarthritis. Results: Radiographic osteoarthritic changes were detected in 24 patients (45.3%) in BPTB group and 14 patients (35.0%) in HT group. Accompanying meniscal injury (BPTB p<0.001; HT p=0.091), intervals from the injury to reconstruction of > 12 months (BPTB p=0.037; HT p=0.021), and patient's age at reconstruction of > 25 years (BPTB p=0.003; HT p=0.048) were found to be significant independent predictors of osteoarthritis. However, no statistically significant correlations were found between the development of osteoarthritis and the clinical outcome or the radiographic stability in both groups. Conclusion: Although ACL reconstruction using BPTB or HT autograft had good clinical results at an average follow-up of 10 years, considerable incidence of radiographic osteoarthritic changes were noted. Various factors such as accompanying meniscal injury, protracted time from injury to reconstruction, more than 25 years old at the time of reconstruction were related to radiographic osteoarthritic changes.

• Journal of the Korean Arthroscopy Society
• /
• v.5 no.2
• /
• pp.92-98
• /
• 2001

Purpose : To analyze the clinical results of isolated lateral meniscus injury according to discoid versus non-discoid, athletes versus non-athletes and repaired cases versus cases treated with meniscectomy. Materials and Methods : Between January 1997 and June 2000, arthroscopic lateral meniscus surgery was performed in 329 cases. We reviewed 80 cases of isolated lateral meniscus injury without associated ligament injury or other pathologic condition retrospectively. The study population was composed of 54 males and 26 females with average age of 30.2 years(range, $17\~40$ years). Average follow up period was 15 months(range, $12\~39$ months). Eighty cases were classified into three categories; discoid group versus non-discoid group, athletes versus non-athletes, repaired cases versus cases treated with meniscectomy. Clinical evaluation was performed using Lysholm knee score and Tegner activity. Results : Non-discoid group had higher incidence of longitudinal tear than discoid group. Athletes group had higher incidence of repaired cases than non-athletes group. The repaired group had better clinical result than patient treated with meniscectomy group. Conclusion : Although lateral meniscus has some special features including anatomic mobility which can cause instability after meniscectomy and technical difficulties in repairing, it is recommended repairing meniscus tear not only longitudinal but also horizontal and complex tear to obtain better clinical results.

• Journal of the Korean Arthroscopy Society
• /
• v.3 no.1
• /
• pp.62-65
• /
• 1999

A new method for arthroscopic resection of the inferior leaf for the horizontal tear in the anterior horn of the meniscus extending deep toward the capsule was developed. Resection of this tear is difficult-perhaps more so than any other meniscal tear. At arthroscopy, a small incision on the meniscotibial ligament of the anterior horn was made after the deep horizontal tear was carefully debrided. A retrograde punch was introduced through the incision and underneath the inferior leaf of the anterior meniscus. The inferior leaf of the anterior horn was resected by the punch without difficulty. This simple technique minimizes the risk of superior leaf injury and can be used for a horizontal tear in the anterior horn as well as the mid horn with sweeping motion of the retrograde punch.

• Journal of Korean Orthopaedic Sports Medicine
• /
• v.5 no.2
• /
• pp.155-160
• /
• 2006

Purpose: To evaluate the results of meniscal repair and partial meniscectomy of lateral meniscus injury associated with tibial plateau fracture. Materials and Methods: Between February 1993 and August 2004, 24 cases (23 patients) of lateral meniscus tear with tibial plateau fracture were evaluated retrospectively. The most frequent type of tear was the longitudinal tear of the meniscocapsular junction (14 cases, 66.7%). All fractures were reduced under the control of arthroscopic and image intensifier. Arthroscopic repair of the longitudinal tear of the lateral meniscus or arthroscopic partial meniscectomy was performed. The final results were evaluated with the Ikeuchi criteria and Lysholm score. Results: At the final follow-up, the outcome was excellent in 12 cases (85.7%), good in 1 case (7.1%) and fair in 1 case (7.1%) among 14 cases of meniscal repair, and the excellent in 4 cases (66.7%) and good in 2 cases (33.3%) among 6 cases of partial meniscectomy according to the Ikeuchi criteria, There was a significant improvement of Lysholm score after surgery, 92.3 postoperatively compared with 56.6 preoperatively (p<0.0001, paired t-test). Conclusion: The fracture of the lateral tibial plateau did not seem to affect on the healing of the meniscus repair and partial meniscectomy.

• Journal of the Korean Arthroscopy Society
• /
• v.7 no.2
• /
• pp.160-168
• /
• 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.

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