• Journal of Korean Medicine Rehabilitation
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• v.28 no.4
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• pp.71-79
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• 2018

Objectives The aim of this study is to observe the effectiveness of complex Korean medicine treatment applied to the patients with degenerative meniscal tear and the correlation among clinical effectiveness, body mass index (BMI) and Kellgren-Lawrence grade (KL-grade). Methods The study participants were 38 patients who had been diagnosed with degenerative meniscal tear. Participants were classified by BMI, KL-grade and treated with acupuncture, electroacupuncture and pharmacopuncture. Clinical outcomes were assessed using Numeric Rating Scale (NRS), Western Ontario and McMaster Universities Arthritis Index (WOMAC Index) and EuroQol-5 Dimension Index (EQ-5D Index). Results Both NRS and WOMAC scores were significantly reduced after treatment (p<0.001). The EQ-5D for assessing quality of life showed further improvement (p<0.05). A statistically significant correlation was observed between the BMI and NRS, EQ-5D. KL-grade was correlated with WOMAC. Conclusions These results show that complex Korean medicine treatment to the patient with degenerative meniscal tear may be effective as a conservative therapy. Further research is required to confirm the effectiveness of Korean medicine treatment.

• Korean Journal of Ophthalmology
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• v.32 no.6
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• pp.445-450
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• 2018

Purpose: To compare the tear film lipid layer thickness (LLT) between patients with incomplete nasolacrimal duct obstruction (NLDO) and normal controls and to analyze the changes in tear film LLT and blinking pattern after silicone tube intubation in NLDO patients. Methods: We reviewed the medical records of 68 eyes in 52 incomplete NLDO patients who underwent silicone tube intubation from January 2017 to July 2017. The LLT, blinking pattern, and Meibomian gland image were measured with the LipiView II ocular surface interferometer. The Meibomian gland drop-out ratio was measured using the polygon selection tool in the Image J program. Tear meniscus height, which is the other lacrimal indicator, was assessed with spectral-domain optical coherence tomography. Results: Tear meniscus height was significantly decreased after silicone tube intubation (p < 0.01). Preoperative minimum, maximum, and average LLT values were $62.4{\pm}24.0$, $86.7{\pm}17.9$, and $71.7{\pm}23.3nm$, respectively. Significant changes in the minimum, maximum, and average LLT ($74.8{\pm}23.6$, $98.8{\pm}11.0$, and $91.6{\pm}16.1nm$, respectively) were observed after silicone tube intubation (p < 0.001, p = 0.001, and p < 0.001). The partial blinking/total blinking ratio in 20 seconds and the Meibomian gland drop-out ratio showed no significant change after silicone tube intubation. Conclusions: Overall, the LLT was increased after silicone tube intubation. Silicone tube intubation may be helpful in maintaining LLT with a normalized of amount of tears.

• 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.

• Journal of the Korean Arthroscopy Society
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• v.13 no.2
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• pp.165-169
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• 2009

The lateral meniscus is morphologically more variable than the medial meniscus. An abnormal lateral meniscus also varies with respect to its size, shape and stability, and such variations can occur in any patient of any age. The most common variant is a discoid lateral meniscus. We recently encountered a patient with a discoid lateral meniscus for which the anterior horn of the meniscus was anomalously inserted into the anterior ACL. The patient was forty five years old women who had persistent pain for three to four years without any specific trauma history. She was preoperatively diagnosed as having discoid lateral meniscus by MRI, and was confirmed the presence of the complex tear and anomalous insertion of the anterior horn of the discoid lateral meniscus into the anterior ACL by arthroscopic examination. Arthroscopic subtotal meniscectomy was performed and the symptoms were improved after surgery.

• Journal of the Korean Arthroscopy Society
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• v.14 no.1
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• pp.1-6
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• 2010

This study was undertaken to document the clinical results and technical aspects of arthroscopic repair including popliteus tendon as a post for the treatment of complex lateral meniscus in young people indicated as total meniscectomy. From June 2004 to May 2006, we prospectively studied arthroscopic repairs on 32 young people knees with symptomatic complex lateral meniscus that was treated by all inside repair technique using Popliteus tendon as a post. Clinical results were evaluated using Lysholm knee scores preoperatively and at final follow-up. 2nd look arthroscopy or MRI was taken at final follow-up. 80% of patients carried out MRI or 2nd look arthroscopy under permission. Most patients who follow up were able to return to their previous life activities with little or no limitation, and no reoperation was required after an average follow-up of 42.8 months. Mean Lysholm knee scores improved from 65.4 (range, 55 to 75) preoperatively to 93.9 (range, 79 to 100) at the final follow-up (P<.001). 80% meniscus healing was found on arthroscopic or MRI follow up. Conclusively, arthroscopic repair using Popliteus tendon as a post is effective for treating young people with complex lateral meniscus tear as a salvage procedure.

• Journal of the Korean Arthroscopy Society
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• v.16 no.1
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• pp.9-16
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• 2012

Purpose: Tibial plateau fractures cause a variety of problems in the knee joint. The purpose of this study was to investigate the characteristics of the meniscus injuries in tibial plateau fracture arthroscopically. Materials and Methods: Thirty-three out of 39 consecutive patients diagnosed with tibial plateau fractures underwent arthroscopy between March 2007 and March 2010. According to Schatzker classification, there were 1 type I (3.3%), 19 type II (53.3%), 4 type III (13.3%), 2 type IV (6.6%), 2 type V (6.6%) and 5 type VI (20%) fracture patterns in 33 patients. Results: Twenty-five cases (75.8%) had lateral meniscus tears. There were 18 meniscal tears in 19 cases of Schatzker type II fractures (94.7%), 3 meniscal tears out of 4 cases of Schatzker type III fractures (75%) and 4 meniscal tears out of 5 cases of Schatzker type VI fractures (80%). The most commonly affected site (22/25) was the anterior horn of the lateral meniscus. Of the 25 documented meniscal tears, all but one were vertical longitudinal tear at meniscocapsular junction so most cases are amenable to arthroscopic repair. Conclusion: Arthroscopy for the meniscal injuries in tibial plateau fractures is a valuable diagnostic and treatment tool, we recommend arthroscopy in tibial plateau fracture.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.1 no.1
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• pp.14-17
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• 2008

Meniscal extrusion is defined as a distance of 3 mm or more between the peripheral border of the meniscus and the edge of the tibial plateau on the coronal plane, associated with degeneration or tear of meniscus, effusion, osteophyte, osteoarthritis. There are many advantages of ultrasonography, including cost, dynamic real-time assessment. We evaluated a patient with anteromedial mass of the knee by ultrasonography, which was proved to be the extrusion of medial meniscus. We report a case of extrusion of medial meniscus evaluated by ultrasonography with review of the related literatures.

• Journal of Korean Orthopaedic Sports Medicine
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• v.1 no.2
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• pp.118-123
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• 2002

Purpose: To report modified technique of inside-out suture in repair of tear of postero medial corner of medial meniscus. Operative technique: Arthroscope is placed through anterolateral portal. Suture hook is delivered through anteromedial portal. By rotating the suture hook, it penetrates the inner portion of the torn meniscus from femoral surface to tibial surface of the meniscus for vertically oriented suture. A PDS suture is delivered through the lumen of suture hook, and the suture hook is withdrawn. The both ends of the suture are retrieved through anteromedial portal by a retriever, either grasper or crochet hook.A Zone-specific cannula is positioned below the inferior surface of the meniscus through anterolateral portal. The Looped Needle designed by the authors is delivered through the lumen of the Zone-specific cannula. The suture end of the tibial surface is placed in the loop of the Looped Needle and pulled out to the surface of posteromedial joint line. The suture end of the femoral surface is pulled out in same manner. A transverse skin incision of 1cm size is made adjacent to pulled out suture and the suture is tied. Discussion: Even though modified inside-out suture technique requires longer operation time than conventional inside-out technique, it provides vertically oriented suture and good tissue coaptation. The authors recommend this modified inside-out suture technique to be good alternative in repairing tear of the posteromedial corner of medial meniscus.

• Journal of the Korean Arthroscopy Society
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• v.2 no.2
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• pp.151-154
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• 1998

In the diagnosis of the meniscal tear of the knee, the high accuracy of the MRI diagnosis is well-known, but the accuracy of the MRI in the diagnosis of the very pattern of the tear of menisci is not well-established. The purpose of this study is to give some informations to consider in the diagnosis and therapeutic planning of torn menisci. The authors performed a retrospective study comparing the MRI and arthroscopic findings of 141 knees which had undergone arthroscopic surgery from Mar. 1997 to Mar. 1998. The results are as follows. In the diagnosis of tear of the menisci, MRI had sensitivity of 91%, specificity of 96%, accuracy of 95%. The mismatch of the tear patterns of the menisci between MRI and arthroscopic findings was identified in 59%, especially high in flap tear(100%), complex tear(84%), peripheral tear(55%). In conclusion, MRI is very accurate in the diagnosis of the tear of menisci, but the tear patterns of the menisci cannot be accurately determined by MRI. In the cases of flap tears, complex tears and peripheral tears, it is more difficult to determine the tear patterns of the menisci by MRI. False-negative rate of MRI was especially high(44%) in the peripheral tear type. So, other clinical correlations should be made in determination of the presence of the tear in the diagnosis of peripheral tear of the menisci.

• 대한관절경학회:학술대회논문집
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• 2007.10a
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• pp.101-102
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• 2007