Characteristics of Radial Tears in the Posterior Horn of the Medial Meniscus Compared to Horizontal Tears

BACKGROUND: The clinical and radiologic features of radial tears of the medial meniscus posterior horn were compared with those of horizontal tears. METHODS: From January 2007 to December 2008, 387 consecutive cases of medial meniscal tears were treated arthroscopically. Among these, 91 were radial tears in the medial meniscus posterior horn, and 95 were horizontal tears in the posterior segment of the medial meniscus. The patients' data (age, gender, duration of symptom, body mass index, and injury history), radiographic findings (Kellgren and Lawrence score, posterior tibial slope, and femorotibial angle), and chondral lesions were recorded. RESULTS: The patient factors of age, gender, and body mass index were related to radial tears of the medial meniscus posterior horn. Radial tears were significantly correlated with Kellgren and Lawrence score, varus alignment, posterior tibial slope, and severity of the chondral lesion. CONCLUSIONS: Radial tears of the medial meniscus posterior horn are a unique clinical entity that are associated with older age, females and obesity, and are strongly associated with an increased incidence and severity of cartilage degeneration compared to horizontal tears.

Arthroscopic Direct Repair for a Complete Radial Tear of the Posterior Root of the Medial Meniscus

We report here on a new arthroscopic direct repair technique for a radial tear of the posterior root of the medial meniscus (PRMM) using a posterior trans-septal portal. Radial tears of the PRMM are commonly observed in the elderly population of Korea and Japan, and the life style of these people requires squatting and kneeling down in daily life. A radial tear of the PRMM results in the loss of hoop tension and this accelerates degenerative changes in the knee joint and causes early osteoarthritis. Several reports in the medical literature have focused on various repair techniques for these tears by using pull out sutures. These techniques result in nonanatomic fixation of the meniscus, which may lead to disturbed meniscal excursion and failure to restore hoop tension. Arthroscopic direct repair may contribute to restoring hoop tension and preventing accelerated degenerative changes in the knee joint of these patients.

Meniscus Repair with Fibrin Clot in Complete Radial Tear of Lateral Meniscus / 대한정형외과학회잡지

Meniscus tear is one of the most common knee injuries. The increasing recognition of the importance of the meniscal function has led to a range of new treatments for meniscal tears. A complete radial tear disrupts the circumferential hoop tension of the meniscus. Therefore, restoring its natural architecture is of utmost importance. However, it is difficult to achieve meniscal healing of a complete radial tear due to its structural characteristics. We report five cases of a complete radial tear of the lateral meniscus treated successfully using a fibrin clot that showed good meniscal healing and excellent clinical outcomes.

MR findings of the Radial Tear of Medial Meniscus

PURPOSE: To assess 1) the characteristics and the ability of MRI to detect, 2) incidence and 3) association with preexisting lesions in the radial tears of medial meniscus MATERIALS AND METHODS: 260 consecutive arthroscopic meniscectomy was performed. Of the 260 cases, 226 cases performed knee MR images preoperatively. Two radiologic signs were used to detect: 1)Cleft sign and 2) increased signal or absence of posterior meniscus (ghost meniscus). RESULTS: Forty-seven cases cases with radial tears of medial meniscus were identified(18.0%, mean age 60.5years) by arthroscopy. All of them were located in the posterior root and were full thickness tears except three cases. Thirty-four cases(72.3%) had preexisting cartilage degeneration(Outerbridge 1-4) and osteonecrosis. The sensitivity and specificity of the cleft sign and ghost sign were 72.9%, 98.8% and 93.7%, 98.8%, respectively. When combined these two criteria, accuracy was 97.7%. CONCLUSION: Radial tears located in the posterior root of the medial meniscus are common type in korea. They were frequently developed in elderly patients with preexisting cartilage damage or osteonecrosis. We can accurately diagnose the radial tear with the cleft sign and ghost sign

Decentration and Tilt of Posterior Chamber Lens According to Anterior Capsulotomy

To evaluate the abnormal positions of intraocular lens after cataract extraction and intraocular lens implantation, the study used the image analysis technique. Tilting and decent ration of posterior chamber intraocular lens(PCL) were studied according to the anterior capsulotomy. 103 patients(120 eyes) were randomized into 6 groups(20 eyes each) according to posterior chamber lens style and anterior capsulotomy type, and measured the degrees of tilting and decent ration of PCL by Scheimpflug camera. Three piece PCL implantation group showed significant less tilting than one piece PCL implantation group at postoperative 1 week. In one radial tear of anterior capsulotomy group, three piece PCL showed less tilting than one piece PCL. At postoperative 2 months, continuous curvilinear capsulorhexis without radial tear group showed significant less decent ration and tilting than one radial tear group. At postoperative 1 week and 2 months tilting of the continuous curvilinear capsulorhexis group was less than two or more radial tears group. As time passes from 1 week to 2 months tilting decreased significantly, but decentration did not showed significant decrease.