High Tibia Osteotomy for a Posterior Root Tear of the Medial Meniscus / 대한정형외과학회잡지

Posterior root tear of the medial meniscus which is frequently unrecognized is a common injury of meniscus that often results in serious consequences in a knee joint. After medial meniscus posterior root tear (MMPR), there is a significant increase in tibio-femoral contact pressure concomitant with altered knee joint kinematics. This injury frequently leads to meniscal extrusion, and thus the transmission of circumferential hoop stresses would be impaired, which condition is biomechanically similar to that of total meniscectomy. For these reasons, several methods (conservative treatment, meniscectomy, repair, or unicompartmental knee arthroplasty) have been developed for treatment of MMPR, many of which have shown good clinical results. However, the methods of MMPR treatment are still debatable. This article presents a review of the current strategies for treatment of common injuries to these MMPR and clinical results of high tibia osteotomy for MMPR after failed conservative treatment.

Second-Look Arthroscopic Results after Repair of Medial Meniscus Root Tears / 대한정형외과학회잡지

PURPOSE: The purpose of this study is to evaluate the healing rate of medial meniscus root repair according to the duration of symptom and to determine the association between healing status and the clinical result after medial meniscus root repair. MATERIALS AND METHODS: Eighty-four patients who underwent arthroscopic meniscal root repair and second-look arthroscopy were included. Second-look arthroscopy evaluation of meniscal healing status was performed by dividing medial meniscal posterior root into the anterior half and posterior half and classifying by contact degree on the surface of the tibia and continuity. Clinical results were analyzed according to International Knee Documentation Committee (IKDC) subjective scores and Lysholm scores. In addition, after dividing cases according to acute group and chronic group by six-month symptomatic period, differences were evaluated. RESULTS: Significant differences in post-operative clinical results were observed between the acute group and chronic group. A significant difference in meniscal healing status was observed between the two groups (p<0.001). A higher postoperative IKDC score and Lysholm score was observed for the completely healed group, as confirmed by second-look arthroscopy, than for the other groups. CONCLUSION: In the aspect of improving the clinical result, arthroscopic medial meniscal posterior root repair is a good treatment modality. Early repair of medial meniscal posterior root may lead to improvements in the clinical result such as meniscal healing status.

Symptomatic Posterior Cruciate Ganglion Cyst Causing Impingement between Posterior Root of the Medial Meniscus and Anterior to the Posterior Cruciate Ligament

There are several reports of symptomatic ganglion cysts near the posterior cruciate ligament (PCL), but no reports of a symptomatic ganglion originating from the anterior aspect of the PCL in the deep recess between the posterior root of the medial meniscus and the PCL, bulging into the posteromedial joint space. In this report, we present the clinical features of a patient with a symptomatic ganglion cyst treated successfully by arthroscopic excision.

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.

Minimum 1 Year Results of Arthroscopic Pull-out Repair for Posterior Root Tear of Medial Meniscus / 대한스포츠의학회지

This study is to evaluate clinical and arthroscopic second-look results of arthroscopic repairs of posterior root tears of medial meniscus which may cause loss of circumferential hoop tension and extrusion of meniscus. From October 2006 to May 2009, fifty-eight patients (59 knees) underwent arthroscopic pull-out repairs. Clinical results were evaluated using Hospital for Special Surgery (HSS) score and International Knee Documentation Committee (IKDC) score for 12-month follow-up. Second-look arthroscopy was done to evaluate meniscal healing in 21 cases. Magnetic resonance imaging (MRI) was performed to assess status of repaired meniscus and tibial tunnel position in 9 patients. Average preoperative HSS score and IKDC score of 59 cases were 69.5 and 36.0, respectively. Average postoperative HSS score and IKDC score of 59 cases had been changed into 90.3 (p<0.001) and 66.8 (p<0.001), respectively. Second-look arthroscopies revealed complete or incomplete healing except one case. Two patients showed increased one grade according to the Kellgren-Lawrence radiologic classification system and others showed no change. Of 9 patients who performed MRI, six patients showed complete healing. The average position of tibial tunnel was 4.8 mm anterior and 5.7 mm medial to center of posterior cruciate ligament. Arthroscopic pull-out repair technique using transtibial tunnel seems to be simple and effective procedure for posterior root tear of medial meniscus. Further evaluation of arthroscopic repair of posterior root tear of medial meniscus should be needed to prove the effectiveness on the prevention of osteoarthritis of knee.

Change of glucose in plasma in selective posterior rhizotomy at lumbar and sacral regions on cerebral palsy children / 中国康复理论与实践

@#Objective To investigate the carbohydrate metabolism during selective posterior rhizotomy (PCR) at lumbar and sacral regions on cerebral palsy children (CPC).Methods62 CPC who received SPR at lumbar and sacral regions under combined intravenous and inhalation anesthesia were tested with the level of glucose (Glu) in plasma at different time during the operation.Results and ConclusionThere is no significant difference of Glu at different time during the operation, however, the Glu level shows an elevating trend at 3 and 10 minutes after posterior root electric stimulation.