• Title/Summary/Keyword: Arthroscopic meniscectomy

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Clinical Results of the Radial Tear of Posterior Root of Medial Meniscus (내측 반월상 연골 후각부 방사형 파열의 임상적 결과)

  • Nha, Kyung-Wook;Jo, Jin-Ho;Lee, Dong-Bong
    • Journal of the Korean Arthroscopy Society
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    • v.11 no.2
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    • pp.128-133
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    • 2007
  • Purpose: To examine the clinical results after arthroscopic meniscectomy of radial tear of medial meniscus. Materials and Methods: We studied 45 cases with the radial tear of medial meniscus which follow up more than 2 years(range 2 to 7 years). Arthroscopic surgery was performed to the patients with grade 0-2 according to the Kellgren and Lawrence classification. Evaluation of cartilage damage was performed on surgical photos according to Outerbridge classification. Evaluation of clinical result was used the modified Lysholm score. Results: The mean pre-operation Lysholm score was 79.1, 71.2, 68.5, 67.9, 67.2, 61.5 and post-operation Lysholm score was 86.3, 75.1, 73.0, 73.1, 73.2, 66.2 and 61.5%, 62.5%, 60.0%, 50.0%, 50.0%, 25.0% improved knee pain and 69.2%, 75.5%, 70.0%, 66.6%, 75.0%, 75.0% were satisfied knee surgery and 30.7%, 20.5%, 20.0%, 50.0%, 25.0%, 50.0% required further surgery in patients respectively. According to Kellgren and Lawrence classification, 7 cases(15.5%) progress grade 3 osteoarthritis. Conclusions: The radial tear of medial meniscus showed the poor results with arthroscopic meniscectomy even if the grade 0-2 osteoarthritis. For the improvement of the clinical results, consider the technique to restore the hoop stresses or use the high tibia osteotomy for preventing the osteoarthritis.

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Arthroscopic Meniscectomy in Patients Aged Over 50 - More than 3 Years Follow-Up Result - (50세 이상 환자에서의 반월상 연골 절제술 - 최소 3년 이상 추시 결과 -)

  • Cho, Sung-Do;Youm, Yoon-Seok;Go, Sang-Hun;Jung, Kwang-Hwan;Cha, Jae-Ryong;Lee, Chae-Chil;Jeong, Ji-Young;Seo, Dong-Kyo
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.2
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    • pp.107-111
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    • 2008
  • Purpose: To evaluate the clinical and radiographical results of arthroscopic meniscectomy in patients aged over 50 with minimum 3-year follow-up. Materials and Methods: Of the patients who had undergone arthroscopic meniscectomies between Dec. 1997 and Dec. 2003, 36 patients(36 knees) were available for retrospective evaluation. The average age at the time of surgery was 56.4 years and the mean follow-up period was 63 months. According to the Kellgren-Lawrence classification, grade I change were noted in 16 patients, II in 12, III in 6 and IV in 2. According to Outerbridge classification, grade I articular lesions were noted in 16 patients, II in 10, III in 7 and IV in 3. Postoperative Lysholm score, patient s subjective satisfaction and radiographic changes were evaluated retrospectively. Results: Twenty-four patients(66.7%) were good or excellent for the Lysholm score and 26 patients(72.2%) were satisfied at final follow-up. Tibiofemoral angle was changes from mean valgus 3.9 degrees to mean valgus 2.6 degrees and 22 patients(61.1%) showed the progression of osteoarthritic changes. Conclusion: The satisfactory results could be obtained in 72.2% of patients aged over 50 with a minimal follow-up of 3 years after arthroscopic meniscectomy. The results tended to be worse in patients with moderate or severe tibiofemoral osteoarthritic changes or with articular cartilage lesions.

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The Results of Partial Meniscectomy according to the Grade of the Articular Cartilage Injury (관절 연골 손상 정도에 따른 반월상 연골 부분절제술의 결과)

  • Choi, Nam-Yong;Yang, Young-Jun;Nah, Ki-Ho;Yang, Hyuk-Jae;Song, Hyun-Seok
    • 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.

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The Effect of Meniscectomy on Clinical Result After ACL Reconstruction (전방십자인대 재건술에서 반월상 연골 절제술의 영향)

  • Cho, Hyung-Jun;Lee, Jung-Hwan;Bae, Dae-Kyung;Song, Sang-Jun;Yoon, Kyoung-Ho
    • 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.

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Discoid Medial Meniscus in the Knee - A case report - (슬관절 내측 원판형 연골 - 1례 보고 -)

  • Kyung, Hee-Soo;Kim, Kyung-Hoon;Oh, Chang-Wug
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.1
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    • pp.58-62
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    • 2009
  • A discoid medial meniscus is a relatively rare pathology of the knee joint, and we recently encountered a patient with discoid medial meniscus, and this report is a case of therapeutic experience in this patient. The patient was twenty years old man who had a persistent dull pain for several years without specific trauma history. He was presumptively diagnosed as discoid medial meniscus by MRI, and arthroscopic examination confirmed the presence of the complete type of discoid medial meniscus with horizontal tear. We performed arthroscopic partial meniscectomy, and the patient could get free from symptom.

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The comparative study of arthroscopic meniscectomy with or without high tibial osteotomy in patients with degenerative medial meniscus posterior horn tear (내반 변형을 지닌 내측 반월상 연골판 후방 골 기시부 퇴행성 파열 환자에서 반월상 연골판 절제술 단독과 근위 경골 절골술 동반 수술의 결과 비교)

  • Moon, Jae-Young;Seon, Jong-Keun;Song, Eun-Kyoo;Kim, Hyung-Soon;Yim, Ji-Hyeon;Cho, Hyun-Jong
    • 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.

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Treatment of Lateral Meniscus Injury (외측 반월상 연골손상의 치료)

  • Bae, Dae-Kyung;Kwon, Oh-Soo;Lim, Chan-Teak
    • 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.

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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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The Patients' Satisfaction Degree to Arthroscopic ACL Reconstruction (관절경하 전방십자인대 재건술에 대한 환자의 만족도)

  • Chung, Hyun Kee;Choi, Choong Hyeok;Kim, Jong Heon;Song, Sang Jun
    • Journal of the Korean Arthroscopy Society
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    • v.2 no.2
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    • pp.129-134
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    • 1998
  • The arthroscopic ACL reconstruction using the bone-patellar tendon-bone has been considered as the gold standard in the treatment of the ACL insufficiency. There are many reports about the good functional outcome and the restored stability of the knee joint. But there are a few reports showing whether this surgery has good results in the patients' satisfaction. The purpose of this study is to evaluate the patients' satisfaction in this surgery. Authors analysed 32 cases who had taken the ACL reconstruction from Jannuary, 1989 to June, 1997. The average follow-up was 40 months. At the last follow-up, 32 patients reported the patients' satisfaction degrees(four degrees; very satisfied, generally satisfied, improved, no change or aggravated), KT-1000 arthrometer test, Vastus atrophy(thigh circumference), and three kinds of the knee scores(Lysholm, HSS, IKDC). Among the 32 cases, 12 cases (37.5%) were very satisfied, 17 cases(53.1%) were generally satisfied and 3 cases(9.4%) were improved. No case showed no change or aggravated. The satisfaction degree in this surgery had little relation with the age, operation time, follow-up period, combination of meniscectomy, but had significant relations with anteroposterior stability evaluated by KT-1000, thigh circumference measurements and the functional scoring of the knee(Lysholm, HSS, IKDC scores).

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Case Report on Medial Discoid Meniscus (내측 원판형 연골의 증례 보고 -1예 보고-)

  • An, Hyug-Su;Cho, Young-Ho;Kim, Dong-Young;Yun, Hee-Min;Park, Ho-Won
    • Journal of the Korean Arthroscopy Society
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    • v.11 no.1
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    • pp.50-53
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    • 2007
  • Although the lateral discoid meniscus of the knee has been observed frequently, the medial discoid meniscus has very rarely been reported in the literature. A 22-year-old female patient was diagnosed as having a medial discoid meniscus with horizontal tear by means of magnetic resonance image and arthroscopy. The patient was treated by arthroscopic partial meniscectomy.

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