Correlation of Second-look Arthroscopy and MR Findings of Anterior Cruciate Ligament Graft

PURPOSE: To evaluate the postoperative MR findings of the healthy anterior cruciate ligament (ACL) grafts which were confirmed by the second-look arthroscopic examination. MATERIALS AND METHODS: Among 419 cases who underwent the arthroscopic ACL reconstruction by one operator between June 1996 and January 2001, we evaluated 33 MR scans of 29 patients who underwent the postoperative MR scan and the second-look arthroscopic examination (4 patients underwent postoperative MRI twice). There were 18 male and 11 female patients, and the patient 's age ranges from 16 to 59 years-old (mean 29.7). There were 15 cases of autogeneous bone-patellar tendon-bone (BPTB) grafts, 13 cases of autogeneous double-loop hamstring grafts, and 1 case of allogeneous BPTB graft. Thirty-three MRIs were divided into 3 groups according to the time interval between operation and postoperative MR examination: less than 6 months, 7 to 12 months, and more than 13 months. The MR findings of ACL grafts - signal intensity, morphology, continuity, orientation, diameter - were analyzed. RESULTS: The increased signal intensity was found in 29 ACL grafts (87.7%) among 33 MR images. The most common pattern of the graft morphology was a longitudinal streak increased signal band (27 cases, 81.8%). The partial rupture was seen in 9 cases (27.3%), and the lax orientation in 4 cases (12.1%). According to Howell 's scoring system, the signal intensity score of the graft tended to decrease with time after operation, and the sagittal diameter of the graft tended to increase with time after operation. CONCLUSION: The main MR finding of the healthy ACL graft was longitudinal streak increased signal band. The graft signal intensity seemed to decrease, and the sagittal diameter of the graft seemed to increase, as time passes after operation.

Bone tunnel enlargement after anterior cruciate ligament reconstruction / 대한정형외과학회잡지

PURPOSE: To evaluate the bone tunnel enlargement after an anterior cruciate ligament reconstruction (ACLR), We compared the results between a group that had a bone-patellar tendon-bone (BPTB) autograft (group 1) that included the nubbin and one that had a hamstring double looped autograft (group 2). MATERIALS AND METHODS: We evaluated 120 knees over a one year follow-up period. In group 1, the tibial tunnel was completely filled with nubbin. The clinical results were evaluated using the IKDC knee rating system and a KT-2000 arthrometer. Changes in the bone tunnel width on ordinary radiographs were measured periodically. RESULTS: Clinically, there was no significant difference between the two groups. In group 2, more tunnel enlargement occured (p<0.05). ACLR that included the nubbin in the BPTB autograft showed better results in the tunnel enlargement than the others. CONCLUSION: ACLR using the nubbin at the BPTB autograft is one of the solutions available for prevention of bone tunnel enlargement after ACLR.

Classification and Treatment of the Tear of Lateral Discoid Meniscus

PURPOSE: It is widely accepted that partial meniscectomy has done in case of the discoid meniscus. Authors classify the type of the discoid meniscus and report the results of different treatment according to type of tear. MATERIALS AND METHODS: We analyze the 68 patients, 70 knees. After classifying the type of tear according to the arthroscopic findings, we compare the findings of physical examination and X-ray each other, predict arthroscopic findings by MRI findings and report the results of different treatment according to type of tear. RESULTS: There are type 1(no tear) 8 knees(l 1.4%), type 2(longitudinal tear) 4 knees(5.7%), type 3(horizontal tear) 19 knees(27.1%), type 4(central hole) 9 knees(12.9%), type 5(peripheral tear) 10 knees(14.2%), type 6(transverse tear) 8 knees(11.4%) and type 7(complex tear) 12 knees(17.1%). We has performed partial meniscectomy after meniscal repair of tear site in some cases of type 5,6,7 and got the good results at the follow up period. There is no progressive arthritic changes. CONCLUSION: It is necessary to diagnose the exact type of tear and to treat according to it.

Arthroscopic Diagnosis and Treatment

No abstract available.

Treatment of torn discoid meniscus in children / 대한정형외과학회잡지

In children, snapping knee syndrome and joint pain with the loss of physiological hyperextension strongly suggests a diagnosis of a torn discoid meniscus. We performed arthroscopic meniscectomy to treat torn discoid lateral meniscus on 19 knees and open meniscectomy on 9 knees of 26 children(average age: 10.9 yrs) from September, 1983 to October, 1993 at Guro hospital. According to Ikeuchi's grading system', excellent results were obtained in 14, good in 11, fair in 2 knees and poor in 1 knee which was associated with osteochondritis dissecans. The knees treated by partial meniscectomy showed less Fairbank's radiologic changes than those by total meniscectomy during the average follow-up 4.2 years(minimum 1 year, maximum 7 year 11 months).