ABSTRACT
Background: Menisci play a pivotal role in functioning of knee joint. It contributes to the smooth movements ofthe joint by improving congruence, weight distribution and proprioception. The injuries of the menisci candisable as they lead to degenerative changes. Meniscal transplantation is latest of the adopted procedures inorthopedic surgeries. Therefore a thorough anatomical knowledge of the meniscal parameters is an essentialneed.Objectives: The aim of the research was to study the variation in distance between anterior horn and posteriorhorn of menisci and to find out relation between area of the menisci and area of corresponding tibial plate.Materials and Methods: The study was conducted on 60 Menisci (30 Lower Limbs) from donated dead bodies toDepartment of Anatomy, Medical college, Baroda. Data was analyzed statistically using student’s t- test. P value< 0.05 is considered significant. Data is presented as mean + SD and analyzed with the help of Microsoft Excel.Result: In the study it was observed that on the medial side the distance between anterior and posterior horns is28.87 + 1.06 mm whereas on the lateral side, is 12.60 + 0.35mm. The ratio between the areas of the menisci to thetibial plate was observed as 58% for medial and 54% for lateral menisci.Conclusion: The anatomical knowledge of the dimensions of the menisci would prove to be helpful in guidingmeniscal transplantation with allografts. It will be useful to various orthopedic surgeons, radiologists, forensicexperts, anatomists and physiotherapists alike.
ABSTRACT
A evolução do conhecimento acerca das funções dos meniscos e do tratamento das suas lesões, impulsionada pelo advento da cirurgia artroscópica, consagrou e popularizou a meniscectomia por esta via, por ser uma técnica menos invasiva, com menor morbidade e menores custos hospitalares, a ponto de torná-la, atualmente, a cirurgia ortopédica mais frequentemente realizada no mundo. Embora a maior parte dos pacientes submetidos a esta intervenção cirúrgica tenha resultados favoráveis e resolução rápida dos sintomas, percebe-se que parte considerável dos pacientes, especialmente os mais idosos, não apresenta uma evolução póscirúrgica satisfatória, apresentando piora dos sintomas e, eventualmente, necessitando de nova cirurgia. Partindo da hipótese que em determinados pacientes a meniscectomia, em vez de tratar, precipita e acentua um desequilíbrio biomecânico do joelho, o autor realizou estudo observacional prospectivo não-controlado com 86 pacientes de ambos os gêneros, com idade superior a 50 anos (média de 60,2 ± 7,1 anos), submetidos à meniscectomia artroscópica para tratamento de lesão do menisco medial de natureza degenerativa, com o objetivo de determinar variáveis demográficas, clínicas, anatômicas e cirúrgicas relacionadas aos resultados desfavoráveis. As avaliações funcionais pré e pós-operatórias foram realizadas utilizandose o Índice do KOOS (Knee Injury and Osteoarthritis Outcome Score), aplicado a todos os pacientes antes da cirurgia e 60 meses depois. Após análise estatística dos resultados obtidos, o autor verificou que 10 fatores podem ser considerados preditivos das meniscectomias mediais artroscópicas neste grupo etário, sendo quatro fatores fortemente associados aos resultados desfavoráveis: lesão da raiz posterior do menisco medial, dor pré-operatória intensa, claudicação antes da cirurgia e tempo decorrido entre o início dos sintomas e a cirurgia; dois fatores foram considerados moderadamente associados aos resultados...
The evolution of knowledge concerning meniscal functions and the treatment of their injuries, boosted by the development of arthroscopic surgery, has established and popularized arthroscopic meniscectomy due to its less invasiveness, less post-operative morbidity and lower hospital costs, to the point it has become, nowadays, the most frequently performed orthopedic procedure in the world. Although the majority of patients undergoing this operation is quite pleased with the outcomes and with the prompt resolution of their symptoms, it is noticeable that a considerable amount of patients with meniscal injuries, mainly the older, does not have a satisfactory postoperative outcome, with worsening of symptoms after being operated on and occasionally requiring another surgery. Based on observations of his medical practice and on the assumption that meniscectomy, rather than treat, can hasten and accentuate a biomechanical imbalance of the knee in those patients, the author conducted an observational prospective uncontrolled study with 86 patients of both genders, aged over 50 years old (average 60.2 ± 7.1 years), who underwent arthroscopic meniscectomy for the treatment of degenerative medial meniscal lesions, aiming to determine demographic, anatomical, clinical and surgical variables related to poor outcomes. The functional pre and post-operative evaluations were performed using the KOOS index (Knee Injury and Osteoarthritis Outcome Score) applied to all patients before surgery and 60 months later. After statistical analysis of the results, the author found that 10 factors can be considered predictors of arthroscopic medial meniscectomy in this age group: four factors were strongly associated with unfavorable results - posterior root lesion of the medial meniscus, intense pre-operative pain, claudication before surgery and time elapsed between onset of symptoms and surgery; two factors were moderately associated with unfavorable results - bone marrow...
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Arthroscopes , Arthroplasty, Replacement, Knee/rehabilitation , Arthroscopy/instrumentation , Damage Prediction , Menisci, Tibial/surgery , Menisci, Tibial/injuries , Risk Factors , Chronic Disease/rehabilitation , Epidemiologic Factors , Prospective StudiesABSTRACT
A discoid medial meniscus is a relatively rare pathology of the knee joint, and bilateral cases are extremely rare. We present one case of bilateral symptomatic discoid medial menisci. Arthroscopy revealed a complete type of discoid medial meniscus in one knee and an incomplete type in the other knee. Ours is a very rare case of bilateral discoid medial menisci with associated osseous changes in the tibia, and it is perhaps the first such reported case in the world. The patient was successfully treated by partial meniscectomy using routine arthroscopic procedures.