• Title/Summary/Keyword: Meniscus Repair

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Magnetic Resonance Imaging (MRI) of a Hypertrophy of Cartilage and Simultaneous Regeneration of a Damaged Meniscus after Autologous Bone Marrow Aspirates Concentrate (BMAC) Transplantation: a Case Report and Literature Review

  • Bae, Sung Hwan;Kim, Hyun-joo;Oh, Eunsun;Hwang, Jiyoung;Hong, Seong Sook;Hwang, Jung Hwa
    • Investigative Magnetic Resonance Imaging
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    • v.21 no.3
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    • pp.187-191
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    • 2017
  • Bone marrow aspirates concentrate (BMAC) transplantation is a well-known technique for cartilage regeneration with good clinical outcomes for symptoms in patients with osteoarthritis (OA). Magnetic resonance imaging (MRI) has an important role in evaluating the degree of cartilage repair in cartilage regeneration therapy instead of a second assessment via an arthroscopy. We experienced a case of hypertrophic regeneration of the cartilage and a presumed simultaneous regeneration of the posterior horn of the lateral meniscus after BMAC transplantation for a cartilage defect at the lateral tibial and femoral condyle. This report provides the details of a case of an unusual treatment response after a BMAC transplant. This report is the first of its kind to demonstrate a MR image that displays the simultaneous regeneration of the cartilage and meniscus with a differentiation ability of the mesenchymal stem cell to the desired cell lineage.

Arthroscopic Meniscal Repair with Rapid Loc Device (Rapid Loc 기기를 이용한 관절경적 반월상 연골판 봉합술)

  • Kwon, Duck-Joo;Lee, Kee-Byung;Joeng, Woong-Kyo;Lee, Byung-Taek;Park, Sang-Wook
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.2
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    • pp.180-185
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    • 2005
  • Purpose: To purpose of this study is to evaluate the clinical and radiological results of arthroscopic meniscus repair using Rapid Loc device. Materials and Methods: A retrospective study was performed on 44 cases which had been turned out longitudinal tear without degeneration. We repaired all cases with Rapid Loc device. Patients were evaluated using clinical examination, Orthopaedische Arbeitsgemeinschaft Knie (OAK) scheme, and MRI. We regarded patients with joint line tenderness, swelling or McMurray positive test as clinical failure. Results: A mean age was 33.3 years and follow-up period was average 15 months. Clinical results were excellent 15 cases(34.1%), good 20 cases(45.5%), fair 7 cases(15.9%), poor 2 cases(4.5%). MRI showed grade 115 cases(33.3%), grade II 22 cases(50%), grade III 7 cases(16.7%). Clinical failures were 8 cases and only one complication was developed. Conclusion: Rapid Loc device showed the excellent results in meniscus repair. We regard it has a lot of advantages in safety, softness, ease, ability to control tension at repair site.

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Meniscal Repair with Meniscal Arrows (반월상연골 화살을 이용한 반월상연골 봉합술)

  • Kim Jung-Man;Oh In-Soo
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.1 no.2
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    • pp.124-130
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    • 2002
  • Purpose: The results of meniscal repair of peripheral tear of meniscus with meniscal arrow was analysed. Materials and Methods: Peripheral tears of posterior 1/2 of menisci of 25 cases including 18medial, 6 lateral and 1 both menisci were repaired with meniscal arrows. One to six meniscal arrows were used for each meniscus according to the length of tears. Concurrent tears of ACL were noted in14 cases. The follow-up period was 3.4 years in average. The findings of physical examination and MRI which were taken once or twice in 1$\~$5 years after operation were evaluated. Results: Healing of the tear was achieved in all cases. However, a vertical longitudinal tear of body occurred in two medial menisci along the line of insertion of arrows. An arrow migrated subcuta-neously in two cases, respectively. Conclusions: The meniscal arrow was effective in the treatment of the peripheral tear of menicus. However, there was a chance of occurrence of longitudinal tear of the meniscus in case of insertion of arrows in a row. Migration of the arrow may occur.

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Effect of Accelerated Rehabilitation with Anti-Gravity Treadmill Program : Isokinetic Myofuction and Functional Score of Knee Joint, ROM, and VAS Score in Meniscus Repair Patients (Anti-Gravity Treadmill Program을 적용한 가속재활의 효과 : 반월상연골 봉합술 환자의 슬관절 등속성 근기능 및 기능점수와 관절의 가동범위, 통증지수)

  • Cho, Han-Su;Oh, Du-Hwan;Lee, Jin-Wook;Zang, Seok-Am;Lee, Jang-Kyu
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.8
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    • pp.46-54
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    • 2016
  • This study was conducted to investigate the effects of participation in the accelerated rehabilitation with an anti-gravity treadmill program for 16 weeks on isokinetic myofunction and functional score of knee joint, ROM, and VAS score in meniscus repair patients. A total of 10 male adult patients who underwent meniscus repair by the same doctor were investigated in this study. Both extension and flexion peak torque at $60^{\circ}/sec$ and $180^{\circ}/sec$ significantly increased (p<0.001, p<0.01), while under muscle deficit, extension and flexion peak torque at $60^{\circ}/sec$ and extension peak torque at $180^{\circ}/sec$ significantly decreased (p<0.01, p<0.05). ROM in extension significantly decreased (p<0.05), whereas ROM in flexion significantly increased (p<0.01) in response to the program. VAS score significantly decreased (p<0.001) and lysholm scores significantly increased after completion of the program (p<0.001). These results suggest that 16 weeks of the anti-gravity treadmill accelerated rehabilitation program improves isokinetic muscle strength and functional score of knee joint, ROM, and VAS score in meniscus repair patients. Therefore, the anti-gravity treadmill accelerated rehabilitation program, which is a more scientific and effective method than conventional rehabilitation, leads to faster recovery of paly ground and normal daily activities.

Usefulness of Ultrasonographic Follow Up Study After Repair of Peripheral Lateral Meniscal Tear (외측 반월상 연골 변연부 파열 봉합 후 초음파 추적 검사의 유용성)

  • Kim, Jung-Man;Im, Dong-Sun;Kim, Tae-Hyung;Shin, Eun-Su;Moon, Young-Suk
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.4 no.1
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    • pp.15-19
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    • 2011
  • Purpose: The purpose of this study was to evaluate usefulness of ultrasonography for the follow up of the repair of peripheral lateral meniscal tear compared to MRI. Materials and Methods: Fourteen patients who underwent repair of peripheral lateral meniscus tear were followed for at least 1 year (1 to 2.5 years). Ten cases were male, four cases were women, and average age was 36.1 years (19~53 years). After surgery ultrasonography and physical were performed at 6 weeks, 3 months, 6 months and 1 year. Results: Three cases had joint line tenderness or swelling on physical examination until 3 months, but after then, it disappeared. There is no re-tear in ultrasonograhic examination. Conclusion: The ultrasonography was useful for the follow-up study of the peripheral lateral meniscus tear.

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Transection of the posterior horn of the medial meniscus at the posterior tibial attachment - Clinical features and A new repair technique (Pullout suture) - (내측 반월상 연골 후각의 후방 경골 부착부위의 절단 파열 - 임상 양상 및 새로운 봉합 수기(pullout suture) -)

  • Ahn, Jin-Hwan;Ha, Chul-Won;Kim, Ho;Kim, Sung-Min
    • 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.

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Clinical results of arthroscopic meniscal repair according to joint stability (반월상 연골의 관절경적 봉합시 관절안정성에 따른 결과)

  • Kyung Hee-Soo;Ihn Joo-Chul;Baek Seung-Hoon
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.1
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    • pp.37-42
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    • 2002
  • Purpose : The purpose of this study was to evaluate the results of arthroscopic meniscal repair according to joint stability. Materials and Methods : Twenty cases were reviewed, which had underwent arthroscopic meniscal repair. The mean age was 32.3 years old. The mean follow-up period was 59.7 months. Menisci that had underwent complete repair of associated ligament injuries (8cases, Sa) and menisci that had no associated ligament injury (9 cases, Sb) were classified as stable group (S), and the others (3 cases) as unstable group (U). Also stable group was divided into acute and chronic group. The result was evaluated with Lysholm score and IKDC method. The statistical analysis was done using Wilcoxon rank sum test and Fisher's exact test (p<0.05). Results : Group Sa had $87.5\%$ satisfactory and Lysholm score was 90.9. Group U had $66.7\%$ satisfactory, and Lysholm score was 77.7. Group Sb had $89.9\%$, satisfactory and Lysholm store was 91.4. In acute group $91.7\%$ was satisfactory, Lysholm score 92.5, in chronic group $80\%$ was satisfactory, Lysholm score 88.6. Conclusion : Joint stability was important factor for the outcome of meniscal repairs. So, it is desirable to repair meniscus injury early and the repair of associated ligament injuries should be performed together.

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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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Arthroscopic Repair of Meniscus Tears - Comparison of torn location and combined injury - (파열된 반월상 연골판의 관절경적 봉합술 - 파열 위치와 동반 손상 여부에 따른 비교 -)

  • Jung, Young-Bok;Tae, Suk-Kee;Jin, Whui-Jae;Chung, Jai-Won;Park, Cheol-Kyoung
    • 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.

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