Classification and Treatment of the Tear of Lateral Discoid Meniscus

PURPOSE: It is widely accepted that partial meniscectomy has done in case of the discoid meniscus. Authors classify the type of the discoid meniscus and report the results of different treatment according to type of tear. MATERIALS AND METHODS: We analyze the 68 patients, 70 knees. After classifying the type of tear according to the arthroscopic findings, we compare the findings of physical examination and X-ray each other, predict arthroscopic findings by MRI findings and report the results of different treatment according to type of tear. RESULTS: There are type 1(no tear) 8 knees(l 1.4%), type 2(longitudinal tear) 4 knees(5.7%), type 3(horizontal tear) 19 knees(27.1%), type 4(central hole) 9 knees(12.9%), type 5(peripheral tear) 10 knees(14.2%), type 6(transverse tear) 8 knees(11.4%) and type 7(complex tear) 12 knees(17.1%). We has performed partial meniscectomy after meniscal repair of tear site in some cases of type 5,6,7 and got the good results at the follow up period. There is no progressive arthritic changes. CONCLUSION: It is necessary to diagnose the exact type of tear and to treat according to it.

Relationship between Popliteal Cyst and the Intra-articular Knee Disorders

PURPOSE: To evaluate the clinical symptoms and the associated intra-articular disorders of the polpliteal cyst. MATERIALS AND METHODS: We studied 56 patients, 60 cases of the popliteal cysts which. Had been treated with excision of the cyst after arthroscopy between May 1991 and February 2000. Arthroscopic findings and clinical results of the patients who had popliteal cyst were evaluated. RESULTS: Forty nine patients of the sixty patients of who had popliteal cyst showed intra-articular disorders. Tear of the meniscus and patello-femoral arthrosis with cartilage lesions were the most frequent intra-articular lesions. In 4 cases, recurrence of the popliteal cyst was noted. Two patients had tear of the meniscus and two had no intra-articular disorders. CONCLUSION: This study revealed that popliteal cysts frequently combined with intra-articular disorders. Arthroscopy of the knee joint seems worthwhile method for the patients who had popliteal cyst

Revision Total Hip Arthroplasty Using Cementless Acetabular Cup / 대한정형외과학회잡지

PURPOSE: To evaluate the clinical and radiological results of revision total hip arthroplasty using cemetless acetabular cup and several kinds of morseled bone grafts. MATERIALS AND METHODS: We performed 20 cases of revision total hip arthroplasties between July 1993 and June 1996. Acetabular bone deficiency was classified as type I in 4 hips, type II in 13 hips, type III in 2 hips and type IV in one hip by AAOS classification. Autogenous bone graft was used in 10 cases, heterograft in 5 cases, allograft in 2 cases and a mixture with autografts and allografts in 2 cases. The average contact rate between cup and host bone was 33.5% in type I acetabular deficiency, 65.1% in type II, 50% in type III and 39% in type IV. RESULTS: The mean Harris hip score was 82.9 points at the last follow-up. Osseous union between host bone and graft bone occurred within 6 months in 14 cases. Radiological failure was noted in 8 cases at the last follow-up. Three cases were revised during the follow-up period. Five cases out of 7 cases in which the contact rate between acetabular cup and host bone was less than 50% were determined to be a radiologic failure. Only 2 cases of the 10 cases in which autogenous bone graft had failed grafts. The rate of complication was 7cases (35%). CONCLUSIONS: The usage of the hemispherical cementless acetabular cup with autogenous bone graft and increasing the contact rate between the acetabular cup and host bone could be a safe management method in revision total hip arthroplasty. We recomrnend avoiding the use of heterograft in cementless cup revision arthroplasty.

Intravertebral Vacuum Phenomenon / 대한정형외과학회잡지

There are several reports on the intervertebral vacuum phenomenon since Maldague s report in 1978. This disease is, however, considered as uncommon and miscellaneous entity. We performed retrospective review of 27 collapsed vertebral bodies of 21 osteoporotic patients to define the clinical, radiological and pathological characteristics of intravertebral vacuum phenomenon. Simple radiographs and MRIs were reviewed and the pathological findings from 6 specimens were matched with MRI. Intravertebral air shadows were shown in all cases either on A-P or lateral view, more definite on extension lateral views. Basically, it was considered as a burst fracture with loss of anterior and middle column height. The extent of collapse could be classified as complete or incomplete and the shape of spinal canal intrusion as bulging or local beak type. 12 cases of MRI findings were classified in to three types by T1, T2 and gadolinium enhancement patterns. The extent of spinal canal intrusion was less then 50% in all cases but neurolgic deficits were examined in 10 cases. Pathologically, necrotic trabeculae with fibrous granulation tissue was mixed with reactive new bone and callus formation in some area. This phenomenon is considered not so uncommon, which can be noticed easily in lateral flexion/extension view. Basically, this is a burst fracture with nonunion from ischemic necrosis and neurologic status should be carefully obserued.