• Title/Summary/Keyword: 반월상 연골 부분절제술

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A Simple Arthroscopic Resection Technique for Inferior Leaf of the Deep Horizontal Tear in the Anterior Meniscal Horn - Technical Note - (반월상 연골 전각의 깊은 수평 파열에서의 간단한 관절경 하부 연골편 절제술 - 수술술기 -)

  • Lee, Kee-Byoung;Lee, Seok-Beom;Chang, Ho-Guen;Moon, Young-Wan;Kang, Ki-Hoon;Kim, Kye-Won
    • Journal of the Korean Arthroscopy Society
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    • v.3 no.1
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    • pp.62-65
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    • 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.

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Long-Term Outcome Of Arthroscopic Meniscectomy In Traumatic Patients (외상성 반월상 연골 파열의 관절경적 절제술 후 장기 추시 결과)

  • Seo, Jae-Seong;Min, Hak-Jin;Yoon, Ui-Seong;Kim, Hee-Seon;Kim, Yoon-Jong;Kim, Yoo-Mih
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.2
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    • pp.174-179
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    • 2005
  • Purpose: To study the long-term outcome of arthroscopic meniscectomy with regard to clinical symptoms and radiographic signs of osteoarthritic change. Materials and Methods: The materials for the investigation consisted of 79 individuals among 144 patients who underwent knee arthroscopy due to an isolated meniscal tear from October 1990 to September 1992 in our hospital. Those 79 individuals were followed up for $10{\sim}15$ years after the knee arthroscopy and were took clinical examination through the review of knee radiographies obtained with weight bearing. 52 of the 79 patients were men, and the mean age of the total materials was 34.6 years old (in the range $17{\sim}48$). Results: At follow-up, radiographic changes including Fairbank changes and joint space narrowing were seen from 45 of the 79 patients (56.2%). In other calculation, radiographic changes were seen in 23 out of 54 patients (42.6%) who had a partial meniscectomy, but were presented in 22 out of 25 patients (88.0%) who had a total meniscectomy. As a result, more radiographic changes were seen after total meniscectomy (p=0.03). In clinical results, 39 out of 54 patients (72.2%) after partial meniscectomy were satisfactory, and 14 out of 25 patients (56.0%) after total meniscectomy were satisfactory, therefore, more percentage of patients were satisfactory in partial meniscectomy group than in total meniscectomy group, but the statistical differences were absent (p=0.24). Conclusion: The frequency of radiographic changes in $10{\sim}15$ years after meniscectomy was related to the quantity of the meniscus removed, but the differences of these changes were low and had little influence on activity and knee function.

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Patterns of Meniscus Injury with Acute Anterior Cruciate Ligament Tears (급성 전방 십자 인대 파열과 동반된 반월상 연골 손상의 양상)

  • Cho Sung-Do;Ko Sang-Hoon;Hwang Soo-Yeon;Kim Moon-Chan
    • Journal of the Korean Arthroscopy Society
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    • v.7 no.1
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    • pp.58-62
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    • 2003
  • Purpose : The purpose of this study was to investigate the incidence, location, type and treatment of meniscal injury associated with acute anterior cruciate ligament (ACL) tears Material and Methods: From Mar. 1997 to Feb. 2002, we reviewed 73 cases of acute ACL tear. There were 66 males and 7 females. The average age at the time of surgery was 33 year old (range, 16-62 years). The common causes of meniscal injury were sports injuries (45 cases) and traffic accidents (19 cases). In 45 sports injuries, thirty four cases were soccer injuries. All patients had undergone arthroscopic evaluation. We analyzed incidence, type, location, and treatment of meniscal injuries, especially those of soccer injuries. Results : Foully eight (57 sites) out of 73 had meniscal tears : Of these injuries, tears of lateral meniscus (26 cases, $54.2\%$) were more common than medial meniscus. Posterior horn of the meniscus was the most common location (52 cases, $91.2\%$) and radial tears were the most common type (15 cases, $26.3\%$). Thirty eight cases $(66.7\%)$ were treated by partial menisectomy. In soccer injuries, twenty eight (33 sites) out of 34 had meniscal tears. and tears of lateral meniscus (17 cases, $60.7\%$) were more common. Posterior horn of the meniscus was the most common location (30 cases, $90.9\%$) and radial tears were the most common type (9 cases, $27.3\%$). Twenty two cases $(66.7\%)$ were treated by partial menisectomy. Conclusions : Lateral meniscal tears in the setting of an acute ACL insufficiency are more common than medial meniscal tears. The findings in the this study would be helpful in clinical diagnosis and subsequent treatment decisions in patients with an acute ACL tears.

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Knee Arthroscopy in the Obese: A Case Report (비만환자에서 시행한 슬관절 관절경술 - 증례 보고 -)

  • Baek, Seung-Hoon;Kim, Shin-Keun
    • Journal of the Korean Arthroscopy Society
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    • v.14 no.1
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    • pp.29-32
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    • 2010
  • Several reports have described the increased perioperative risks as well as surgical techniques for performing various procedures in obese patients. However, few reports have addressed the effects of obesity on routine arthroscopic procedures known to be common and safe. Describing the case of a partial meniscectomy performed in a 17-year-old male with a body weight of 120 kg, we review literatures published to the present and provide technical problems and possible complications that can occur when performing routine knee arthroscopy in bariatric patients.

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Analysis of Lateral Meniscus Injury - Non-discoid versus Discoid - (외측 반월상 연골 손상의 분석 - 비원판형과 원판형의 비교 -)

  • Cho, Sung-Do;Go, Sang-Hun;Jung, Kwang-Hwan;Cha, Jae-Ryong;Lee, Chae-Chil;Youm, Yoon-Seok;Seo, Dong-Kyo
    • Journal of the Korean Arthroscopy Society
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    • v.11 no.2
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    • pp.122-127
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    • 2007
  • Purpose: To know about the clinical characteristics such as causes, types, associated injuries and treatment of the lateral meniscus injuries. Materials and Methods: Retrospective analysis was performed for 129 lateral meniscus tears which were divided into 2 groups, Non-discoid and Discoid. Analysis included age and sex distribution, causes of injury, types and location of tear, associated injuries, and methods of treatment. Results: Both Non-discoid and Discoid were prevalent in man and Discoid group was equally distributed through 2nd to 5th decades and Non-discoid group was more prevalent in 4th to 5th decades. Sports injury was the most common cause in both groups and the Nondiscoid group tended to sustain minor injuries compared to Discoid group. Complex tear and body was most common type and site of tear in both groups. Associated injuries were common in Non-discoid group and isolated injuries were common in Discoid group. Partial meniscectomy was commonly done in Non-discoid group and subtotal meniscectomy in Discoid group based on the types of tear. Conclusion: Non-discoid and Discoid lateral meniscus injuries are similar in types and sites of injuries but different in causes of injury, associated injuries and methods of treatment. Therefore, proper diagnosis and treatment would be necessary according to the characteristics.

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Discoid Meniscal Cyst -Report of 3 Cases- (원판형 연골 낭포 - 3예 보고 -)

  • Cho Sung-Do;Ko Sang-Hun;Hwang Soo-Yeon;Lee Ju-Yong
    • Journal of the Korean Arthroscopy Society
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    • v.7 no.2
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    • pp.220-225
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    • 2003
  • The meniscal cyst of knee joint is a rare disease, and the discoid meniscal cyst has not been reported in Korea. We report 3 cases of the discoid meniscal cyst confirmed by MRI and arthroscopy. In physical examination, all cases have tenderness of the knee joint. One has palpable mass of knee joint and the other one has limitation of knee motion with knee flexion contracture of 10 degrees and positive McMurray test at external rotation of the knee. All cases are complete discoid meniscus, which are, one medial discoid meniscus and two lateral discoid meniscus through MRI. We confirmed horizontal tear of meniscus in all cases and the location of meniscal cysts are anterior hem of meniscus in one and body of meniscus in two. We could get excellent results in all 3 cases that return to normal knee range of motion.

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Pull-out repair for root tear of medial meniscus (내측 반월상 연골 후방 골 기시부 파열의 수술적 봉합술)

  • Kim, Deok-Weon;Moon, Jeong-Seok;Kim, Min-Gun;Kim, Jin-Goo
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.1
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    • pp.40-45
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    • 2005
  • Purpose: This study is to evaluate the clinical findings of media] meniscus root tear, pull-out repair technique and it's short term results. Materials and Methods: From September 2003 to August 2004, 23 cases of total 27 medial meniscus root tears were treated by pull-out repair technique. Mean age was 60.2 years old. The pull-out technique was divided into 2 groups In group 1(14/23 cases), anterolateral portal was used and in group 2(9/23 cases), anterolateral and posteromedial portals were used for bed preparation. Concomitant cartilage lesions were documented as ICRS mapping system. The clinical outcomes were evaluated according to Lysholm Knee Score. Results: The postoperative Lysholm Knee Score was 77.1(range; $58{\sim}97$) in group 1 and 81.4(range; $72{\sim}94$) (p>0.05). The failure rate was 3 of 14 cases(21.4%) in group 1 and 1 of 9 cases(11.1%) in group 2. Twenty of 22 cases(90.9%) showed cartilage lesions in weight bearing portion of medial femoral condyle which were 8 grade III and 5 grade IV according to the Outerbridge classification. Conclusion: Pull-out repair seems to be a useful treatment of the medial meniscus root tear for preservation of circumferential hoop tension of meniscus.

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Clinical outcome in relation to stability of longitudinal meniscal tear associated with anterior cruciate ligament rupture (전방 십자인대 파열에 동반된 반월상 연골판 종파열의 파열부위 안정성에 따른 치료 결과)

  • Seo, Seung-Suk;Kim, Chang-Wan;Kim, Jin-Seok;Kim, Jeon-Gyo
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.9 no.2
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    • pp.91-97
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    • 2010
  • Purpose: The purpose of this study was to evaluate the results of treatment for longitudinal meniscal tear in ACL rupture patients by clinical evaluation and $2^{nd}$ look arthroscopy. Materials and Methods: Among the patients who underwent surgery due to ACL rupture and longitudinal meniscal tear between 2002~2009, 32 patients were selected for the study. The patients were devided into three groups; group 1 had repair, group 2 had partial menisectomy due to impossible to repair, group 3 had conservative treatment due to stable meniscus. Comparative retrospective analysis was applied with KT 1000 arthrometer, Lysolm' score, Tegner activity score, IKDC subjective score, and $2^{nd}$ look arthroscopy. Results: Lysolm' score, Tegner activity score, IKDC subjective score showed no statistical difference in all three groups. KT-1000 side to side difference improved from 6.2, 6.15, 6.38 before surgery to 2.56, 2.49, 2.58 after surgery in group 1, 2, and 3, respectively. In group 1, second-look arthroscopy revealed complete healing in 12 patients, incomplete healing without any clinical symptoms in 2, and healing failure in 1. In group 2, second-look arthroscopy showed partial regeneration on margin of meniscectomy. In group 3, second-look arthroscopy revealed complete healing in 2 patients, while 4 showed incomplete healing so that have repaired. Conclusion: In the study, the outcome was better when the stable longitudinal meniscal tear on posterior horn with ACL rupture had active treatment.

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Clinical and Arthroscopic Findings of Medial Meniscus Posterior Horn Insertion Tear (내측 반월상 연골판 후각 기시부 파열의 특징 및 관절경 소견)

  • Lee, Jun-Young;Kim, Dong-Hui;Ha, Sang-Ho;Lee, Sang-Hong;Gang, Joung-Hun
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.8 no.1
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    • pp.33-38
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    • 2009
  • Purpose: We wanted to report the clinical characteristics and arthroscopic findings of radial tear in medial meniscus posterior horn insertion, commonly occurs in patient over middle age with documentary review. Materials and Methods: Retrograde study using hospital records was done to 40 cases in 40 patients who visited our hospital and had been performed knee arthroscopic surgery due to medial meniscus posterior horn insertion tear between January, 2005 to April, 2007. Seven cases were male and 33 cases were female with the mean age of 61 (range, 47-80). Trauma history, stage of arthritis, period between pain and operation, MRI findings, clinical symptoms and operation methods were evaluated. Results : Six cases had trauma history while 34 cases didn't. In simple x-ray, using Kellgren-Lawrence classification, 31 cases were between stage 0 and II while 9 cases were stage III. In arthroscopic exam, there were 17 cases of Outerbridge grade IV, 4 cases of grade III, 9 cases of grade II, 9 cases of grade I. The mean duration of pain was 5.3 months. In MRI, at least one finding of cleft in axial or coronal view or ghost sign in sagittal view was found in all cases. The shape of meniscus tears were blunt in 18 cases, transverse in 12 and degenerative tear in 10. Subtotal meniscectomy was performed in 16 cases, partial meniscectomy in 10 cases and meniscal repair in 14 cases. Conclusion : Medial meniscus posterior horn insertion tear occurs in patients over middle age is rarely related to trauma history but causes painful mechanical symptom and usually accompany arthritis. Meniscectomy can be done for the treatment but repair can be considered is some cases. Further study on the treatment result will be needed.

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Irrigation Solutions in the Knee Arthroscopy - Comparison with Normal Saline and Lactated Ringer's Solution (슬관절 관절경 수술시 세척액 - 생리 식염수와 Lactated Ringer 용액의 비교)

  • Lee, Woo-Suk;Bae, In-Tak;Hur, Yun-Moo;Park, Won-Ki;Oh, Byung-Hak;Chung, Whan-Yong
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.2
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    • pp.125-128
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    • 2008
  • Purpose: The object of this study is to compare the clinical results of noraml saline and Lactated Ringer's solution in the arthroscopic meniscus surgery on the knee. Materials and Methods: The study group included 64 patients who had an medial meniscus tear and received arthroscopic partial medial meniscectomy. The group I was normal saline group, which was used as an irrigation solution during operation. The group II was Lactated Ringer's solution group. We measured the visual analogue scale, painless active knee flexion angle, and the ratio of the knee swelling at postoperative one day for all patients. Results: The visual analogue scale and the painless active knee flexion angle were no significant differences in comparing with normal saline and Lactated Ringer's solution group. The ratio of the knee swelling in Lactated Ringer's solution group was significantly less than those of noraml saline group. Conclusion: Lactated Ringer's solution has an advantage of decreasing the knee swelling in the arthroscopic meniscus surgery on the knee.

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