Arthroscopic Analysis of Lateral Meniscal Variants

PURPOSE: We classified lateral meniscal variants according to types and tear pattern, and compared MR images with arthroscopic findings. MATERIALS AND METHODS: We reviewed 164 consecutive cases (158 patients) of arthroscopic examination for lateral meniscal variants during last ten years. We classified lateral meniscal variants into four types of arthroscopic appearance by modified Watanabe 's classification, and into six tear patterns by modifying O 'Connor 's classification. RESULTS: Regarding four types, 131 cases were complete; 25, incomplete; 4, Wrisberg, and 4, ringshaped. Six tear patterns were as follows: 33 simple horizontal, 21 complicated horizontal, 37 longitudinal, 27 central, 14 complex, and 12 radial. Among 31 cases with central tear or ring-shaped meniscus, we reviewed 25 MR images. Fifteen (60%) MRI 's were interpreted as displaced meniscal tear(bucket handle tear), 7 (28%) as discoid meniscal tear, and other 3 (12%) as simple tear: misinterpretation rate was 72%. Twelve patients (13 cases, 7.9%) had osteochondritis dissecans of lateral femoral condyle: nine patients (10 cases) of them had central tear, two patients (2 cases) had simple horizontal tear, and one patient (1 case) had ring-shaped meniscus. CONCLUSION: MR findings of ring-shaped meniscus or central tear should be differentiated from displaced meniscal tear(bucket-handle tear) considering history of trauma.

Comparative Results of Arthroscopic Anterior Cruciate Ligament Reconstruction with Autologous Quadriceps Tendon-bone Versus Bone-patellar Tendon-bone

PURPOSES: We analyzed the comparative results of arthroscopic anterior cruciate ligament reconstruction using the autologous quadriceps tendon-bone versus the bone-patellar tendon-bone. MATERIALS AND METHODS: Thirty-three patients with ACL reconstruction using the autologous quadriceps tendon-patellar bone were evaluated (group 1). Control group were 33 patients underwent ACL reconstruction with autologous bone-patellar tendon-bone in similar period (group 2). The mean age was 29.7 years in group 1 and 23.5 years in group 2. The mean follow-up period was 20.8 months in group 1, and 21.8 months in group 2. We selected the patient with the similar age, conditions and operation methods. But group 1 with bone-to-tendon graft healing at one side was delayed rehabilitation program than group 2 (bone-to-bone healing). The final evaluation were range of motion, anterior knee pain, Lachman test, KT-2000 arthrometer, Lysholm score, IKDC evaluation, one-leg hop muscle function test. Student ttest was used for statistical analysis (p 0.05). According to the International Knee Documentation Committee (IKDC) rating system, normal were 30.3%, nearly normal 57.6%, abnormal 12.1% in group 1, and in group 2 normal was 24.3%, nearly normal was 63.6%, abnormal 12.1%. There were no statistical differences in normal and nearly normal rate between two groups (p> 0.05). Recovery of quadriceps strength by one-leg hop test was 78% of the normal knee in group 1, and 80% in group 2 (p> 0.05). CONCLUSION: There were no significant differences of clinical results in ACL reconstruction using between quadriceps tendon-bone and bone-patellar tendon-bone, but anterior knee pain. We consider that autologous quadriceps tendon-bone is a good alternative substitute in ACL reconstruction together with the bone-patellar tendon-bone.