A Study on the Development of Degenerative Osteoarthritis after Arthroscopic Total Menisectomy / 대한정형외과학회잡지

PURPOSE: This study compared the clinical and radiological incidence of osteoarthritis after a total meniscectomy. MATERIALS AND METHODS: Seventy eight patients, who underwent a total meniscectomy, were evaluated after a minimum follow up of five years. The operations were a medial meniscectomy (group I) in 16 cases, a lateral meniscectomy (group II) in 17 cases, a discoid meniscus (group III) in 29 cases and medial meniscectomy with an anterior cruciate ligament reconstruction (group IV) in 16 cases. The development of degenerative osteoarthritis was analyzed using the Kaplan-Meyer survivorship. RESULTS: At postoperative 5 years and 7 years, degenerative osteoarthritis developed in 17% and 36% of patients, respectively. The incidence ofdegenerative osteoarthritis at postoperative 5 years and 7 years in groups I, II, III and IV was 9% and 18%, 14% and 29%, 25% and 46%, and 28% and 55%, respectively. The difference was statistically significant. CONCLUSION: The meniscus deficient knee joint which varies according to the patterns of a meniscal injury, had a higher incidence of degenerative osteoarthritis. Careful attention should be paid to the treatment of meniscal tears.

Short-term Follow up after Meniscus Allograft Transplantation with Clinical Results and MRI Findings

PURPOSE: We investigated the clinical results and MRI findings follow up after meniscal transplantation using fresh frozen meniscal allograft. MATERIAL AND METHODS: From Dec. 1999 to Dec. 2001, we evaluated 17 patients (12 cases: male, 5 cases: female) after meniscal transplantation using fresh frozen meniscal allograft. The patients performed the lateral meniscal transplantation were 12cases, the medial were 5cases. The average age was 32 years old (ranging from 19 to 50 years old), and was follow up period 18 months (ranging from 12 to 26 months). Among them we studied MRI findings in 16 patients and the postop-period was 16.9 months (ranging from 5 to 26 months). We analyzed the clinical data by applying KASS(knee assessment scoring system) & Lysholm knee score, and rehabilitation ability using of Tegner activity scale. It investigated the retrogressive changes of joint effusion, misfortune degree of meniscal location, intensity, tear and degenerative change which was made from the MRI. RESULTS: The follow up mean KASS score and Lysholm score were 84.3 (ranging from 61 to 94), and 81.1 (ranging from 63 to 90). Among the 17 patients, 15 patients showed good results. But painful swellings were 2 cases and intermitent locking symtom was 1 case. The MRI findings were 14 cases increasing signal intensity, 2 cases peripheral displacement, 2 cases partial meniscal tear and some degree effusions of 13 cases. CONCLUSION: The meniscal transplantation using fresh frozen allogrft came to be thought with the surgical method which improved the function of knee joint after operating it brought a successful result from the MRI.

A new method of arthroscopic total meniscectomy (a report of 169 cases) / 中国微创外科杂志

Objective To research for a new method of arthroscopic total meniscectomy with simple instru- ments. Methods One hundred and sixty nine cases were followed up for short period that had been operated on with a forward knife, a back cutting knife, a punch and a 30?scope from Nov. 1992. to Aug. 1998. Results The av- erage time of operation was 78 minutes. The operations had no injury to cartilage and ligament. It is necessary for only 7 .9 percent of patients to take analgesic intramuscularly after operation. Eight patients had a transient tourniquet paral- ysis. All of them could begin to work and exercise after postoperative 2 weeks. Conclusion As compared with the method introduced by David Sisk ,this method has the advantages of simple instruments, fewer ports and complications and minimal trauma Either lateral meniscus or medial meniscus can be cut off by the same method. This method is a safety and a better way to arthroscopic meniscectomy.

Comparison between Total and Partial Resection with Arthroscope in the Lateral Discoid Meniscus / 대한정형외과학회잡지

In the treatment of meniscal injury of the knee joint, it has been known that the result of partial meniscectomy to prevent degenerative change of the knee joint after meniscectomy. However the result of lateral discoid meniscectomy is controversial between partial and total meniscectomy. In the treatment of lateral discoid meniscal injury, Fujikawa and Dickhaut reported the better results with partial meniscectomy than total resection, but Ikeuchi and Kobayashi reported the better results with total meniscectomy. The purpose of this paper is to compare the results of arthroscopic partial and total meniscectomy. Five hundred ninety-five patients with meniscal injury was treated by meniscectomy between January, 1983 and December, 1994 at the department of orthopaedic surgery, Soonchunhyang Univ. Hospital. 119 patients of all were done lateral discoid meniscectomy had no other combined findings. Wr wrre able to follow up 42 patients(44 cases) of 84 patients with interview and/or questionnaire. WR analysed the 44 cases and summarized the results as follow: 1) A discoid lateral meniscus was presented in 20.0% of all meniscal resection. 2) Postoperative click sound was presented in 7 cases of 25 cases(28.0%) with partial meniscectomy and in 5 cases of 19 cases(26.3%) with total meniscectomy. Giving way was presented in 2 cases(8.0%), 1 case(5.3%) and Locking in 1 case(4.0%), 0case(0.0%) respectively. 3) In the post operative. Pain, no pain and mild pain were presented in 88.0% of partial meniscectomy and in 94.8% of total meniscectomy. 4) In the degree of activity level, “same before symptoms was developed(no symptom)”. was presented in 84.0% of partial meniscectomy and in 84.2% of total meniscectomy. 5) In the return to work, all patients returned to original job with/without limitation. 6) In the knee rating scale of Ikeuch, excellent or good was presented 72.0% of partial meniscectomy and in 89.5% of total meniscectomy. 7) Roentgenologic degenerative changes were more presented after total than partial meniscectomy. We concluded that the total meniscectomy is better than the partial meniscectomy in the symptom and functional results, but long term follow up secondary degenerative change must be followed.