• Journal of the Korean Arthroscopy Society
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• v.4 no.1
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• pp.71-75
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• 2000

Purpose : To introduce arthroscopic partial meniscectomy fur bucket handle tear of medial meniscus using posteromedial portal, which is superior to arthroscopic partial meniscectomy using standard anterior portals commonly used. Method : After arthroscopic examination of the knee, we reduce the torn meniscus, advance the arthroscope into posteromedial compartment under arthroscopic visualization, we make posteromedial portal with reexamination of the compartment and perform arthroscopic partial meniscectomy. Conclusion : With the technique of arthroscopic partial meniscectomy using standard anterior portals, accurate partial meniscectomy can not be done because of inadequate visual field, associated meniscal injuries of posterior horn and cartilage lesion of posterior aspect of the medial femoral condyle can be missed, commonly posterior cruciate ligament can be injured and artificial damage to weight bearing surface of medial femoral condyle is possible. An arthroscopic partial meniscectomy using posteromedial portal is an excellent method fur bucket handle tear of medial meniscus.

• Journal of the Korean Arthroscopy Society
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• v.5 no.2
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• pp.92-98
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• 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
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• v.13 no.1
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• pp.22-27
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• 2009

Purpose: To identify the damage of the articular cartilage and analyze the clinical results of the partial medial meniscectomy. Materials and Methods: From January 2001 to December 2004, forty-eight patients in the degenerative arthritis and medial meniscal tear of knee who undertook arthroscopic partial meniscectomy and were able to keep pace with the times follow-up for more than 3 years were enrolled in this study. Six cases were men and 42 were women, and the mean age was 55.7 years (40~78 years). The patients were classified into two groups according to the Outerbridge grade. Grade I and II were classified into group 1 and grade III and IV into group 2. Group 1 included 30 cases and group 2 included 18 cases. The result were analyzed according to the Tapper & Hoover classification and Lysholm knee scoring scale. And we measured the distance of medial joint space in standing anteroposterior (AP) view of both sides at the pre-operative and the last follow-up. Results: According to the Tapper & Hoover classification, 28 cases were excellent, 7 cases good, 8 cases fair, and 5 cases poor. Among group 1, 25 cases were excellent, 2 cases good, 2 cases fair, 1 case poor. However, among group 2, 3 cases were excellent, 5 cases good, 6 cases fair, 4 cases poor. Average Lysholm knee score was improved from 62.4 preoperatively to 94 postoperatively in group 1, and from 58 preoperatively to 77.9 postoperatively in group 2. The joint space narrowing showed no statistically significant difference in both knees standing AP view. Conclusion: The arthroscopic partial meniscectomy for a patient with the degenerative articular cartilage was an effective treatment. However, we could not satisfy the results, in cases of Outerbridge grade III and IV. In grade III and IV, the partial meniscectomy was not aggravated the cartilage damage.

• Journal of Korean Orthopaedic Sports Medicine
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• v.5 no.2
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• pp.155-160
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• 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
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• v.3 no.2
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• pp.115-120
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• 1999

Purpose : After the total or partial meniscectomy of the lateral discoid meniscus, many patients complain the residual pain or the recurrent symptoms of the meniscus, and some of them need reoperation. We analyzed the causes of the reoperation after initial meniscectomy. Material & Method : Two hundred seventy three patients with the symptomatic lateral discoid meniscus were treated by arthroscopic meniscectomy between October, 1989 and September, 1998. Of the 273 patients, 69 patients were treated by total meniscectomy and 204 patients were treated by partial meniscectomy. The male to female sex ratio was 1:1.04, and the average of the age was 23.1 years old(from 4 to 59 years old). The reoperation was done in 8 patients, of which 1 was the case of total meniscectomy at the initial operation, and the rest 7 were the case of partial meniscectomy. Results : Of the 8 reoperations, 3 patients recurred the meniscal symptoms within the 3rd week after the initial operation, and 5 patients recurred beyond the 3rd week after the initial operation. Among the 3 patients of carly recurrence, 2 patients showed inadequate sizes of the remnant meniscus, and 1 patient showed posterolateral instability of the remained meniscus. Among the 5 patients of late recurrence, 3 patients showed rerupture of the meniscus, and 2 patients showed associated pathology of degenerative arthritis following osteochondritis dissecans. Conclusions : The reoperation rate after initial meniscectomy of the lateral discoid meniscus was higher in partial meniscectomy than total meniscectomy. During the operation of the lateral discoid meniscus, we must determine the adequate resectional margin, confirm the remnant meniscus by probing, and look for the associated pathologies.

• Journal of the Korean Arthroscopy Society
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• v.14 no.1
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• pp.7-12
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• 2010

Purpose: To evaluate the effects of total or subtotal meniscectomy on anterior cruciate ligament reconstruction. Materials and Methods: We reviewed the 455 cases of arthroscopic ACLR (anterior cruciate ligament reconstruction) from February, 2003 to February, 2007 and followed-up more than 1 year. The 93 cases were enrolled. The 45 cases who underwent only ACLR were included and the 48 cases who underwent ACLR with total or subtotal meniscectomy were included in this study except grade 3 or 4 chondral lesion, partial meniscetomy or meniscal repair. We divided the patient into 4 groups which were isolated ACLR group (group I, 45cases), ACLR with lateral meniscectomy group (group II, 10cases), ACLR with medial meniscectomy group (group III, 28cases) and ACLR with both medial and lateral meniscectomy group (group IV, 10cases). The clinical evaluation was done by range of motion (ROM), IKDC subjective score, Lysholm score, anterior drawer test, Lachman test, Pivot shift test and KT-1000 arthrometer. Results: At final follow up, group IV was inferior than group I in IKDC subjective score and Lysholm score, and inferior than group II in IKDC subjective score. In KT-1000 arhtometric test, group I had better results than group III and group IV. Also in anterior drawer test and Lachman test, group 1 had better result than group III and group IV. In pivot shift test, there was no significant difference among four groups. Conclusion: Medial or both medial and lateral meniscectomy had greater laxity in anterior drawer test, Lachman test and KT-1000 arthrometric test and both medial and lateral meniscectomy had a lower subjective score than both meniscus intact group.

• 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.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$(79\%)$.

• Journal of the Korean Arthroscopy Society
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• v.15 no.1
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• pp.7-12
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• 2011

Purpose: We purposed to evaluate clinical results after undergoing arthrocopic surgery of lateral discoid meniscus in children. Materials and Methods: Retrospective evaluation was executed for the 21 cases which showed abnormal findings of knee joint due to lateral discoid meniscus, from Janunary 1 1999 to December 30 2007. Average observation period was 38.4 months (14months~60 months), and average age was 9.5 years old (7~12 years old). The major clinical findings for knee joint extension limitations were the most common with 11 cases, and there were 8 cases of knee joint pain, 6 cases of snapping, and 10 cases of gait abnormality. The forms of lateral discoid meniscus were 14 cases of complete type, 5 cases of incomplete type, and 2 cases of Wrisberg type. All patient had arthroscopic partial menisectomy and some patient who had meniscus tear had arthroscopic meniscus repair. The clinical results were evaluated using Ikeuchi grading system, and the change of knee joint was observed through routine radiography. Results: The peripheral hypermobility of lateral disciform meniscus was observed in 7 cases. The peripheral tear was observed in 4 cases, where partial menisectomy was along with suture at the same time. The final clinical results were 5 cases of Excellent, 12 cases of Good, 4 cases of Fair. Radiologically, there were 5 cases of subchondral sclerosis and narrowness of hardness at the lateral knee joint, and osteochondritis occurred at the joint facet of external femur in 1 case. In clinical result, meanwhile, there were 20 cases of normal or almost normal and only 1 case of abnormal in IKDC score. Conclusion: Knee joint arthroscopic partial menisectomy for treatment of lateral discoid meniscus is useful, and when accompanied by peripheral disruption, suture is thought to be necessary.

• Journal of Korean Orthopaedic Sports Medicine
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• v.9 no.2
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• pp.79-84
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• 2010

Purpose: In patients with meniscal tear with degenerative arthritis, controversy remains as to whether arthroscopic menisectomy is worthwhile or not. The purpose of this study was to evaluate the effect of arthroscopic medial meniscectomy in degenerative arthritis of the knee with meniscal tear. We also intended to identify pertinent indications and risk factors. Materials and Methods: 287 patients underwent arthroscopic medial meniscectomy from 2006 to 2008; 103 patients who had Kellgren-Lawrence grade II, III arthritis of the knee, were over 50 years old, and had minimum 1 year follow-up, were analyzed in this study. Clinical assessment was performed retrospectively using the arthroscopic surgery database, medical records, questionnires and interviews. Assessment included visual analogue scale (VAS) scores and Lysholm scores. Results: The mean Lysholm score increased from 69 to 85 after surgery. The mean VAS score improved from 7 to 3.1 after surgery. Kellgren-Lawrence grade II group and group with trauma history showed significant improvement of pain and function compared with grade III and group without trauma history. Outerbridge grade I showed significantly more improvement of pain than grade III and IV. Multiple regression analysis showed that trauma history and Outerbridge grade affect the improvement of Lysholm score. Conclusion: In one year follow-up, arthroscopic medial menisectomy can improve pain and function of patients in Kellgren-Lawrence grade II, III degenerative arthritis of the knee. We could expect good results especially in group with low Kellgren-Lawrence grade, trauma history, and mild articular cartilage lesion.