Smoking Has No Influence on Outcomes after Repair of the Medial Meniscus in the Hypo and Avascular Zones-A Pilot Study.

Complete loss of the meniscus inevitably leads to knee joint degeneration. Smoking is an important factor predicting poor outcome in orthopedics; however, data about its role in meniscus surgery are inconclusive. Smoking could be an important negative factor in isolated meniscus repair. The aim of this paper was to determine the influence of smoking on functional outcomes after isolated all-inside medial meniscus repair. This study included 50 consecutive patients with isolated, traumatic tear of the medial meniscus who underwent knee joint arthroscopy between 2016 and 2019. All-inside arthroscopic repair of the medial meniscus was performed in each case. All patients followed a uniform, postoperative rehabilitation protocol for 8 weeks. The follow-up examination was based on the functional scores at 3 and 6 months postoperatively. According to smoking status there were 17 smokers and 33 non-smokers. The mean number of cigarettes smoked per day was 11, for a mean of 7.4 years, and the mean pack-years index value was 4.9. There was no correlation between smoking years, number of cigarettes smoked per day, pack-years index, and functional outcomes. The arthroscopic inspection of the knee joints revealed cartilage lesions (≤IIº) in eight subjects, suggesting the secondary pathology to the meniscus tear. In this study, we found no evidence of an association between smoking indices and functional outcomes after all-inside repair of chronic medial meniscus tear. The nature of the chronic meniscal tear could be smoking-resistant owing to the poor blood supply to the sites in which these specific lesions occur.

Avascular Necrosis of Femoral Condyles in a Patient Treated Due to Lymphoma. A Case Study.

Periarticular avascular osteonecrosis is one of the most severe joint diseases and may result in complete joint destruction. It may affect patients after chemotherapy involving regimens including steroids. The paper describes the case of a female patient who was just under 18 years old when she underwent surgery due to bilateral osteonecrosis of the femoral condyles that developed in the course of treatment of a haematological malignancy. The aim of the paper is to present clinical and imaging-based assessment of the outcome of surgical treatment by reconstruction of osteochondral joint defects with a collagen membrane and bone grafts. In this patient, radiographic and clinical improvement of the joints treated was noted in a 24-month follow-up period. The available literature indicates that this is the first example of using this technique in the treatment of articular lesions associated with osteonecrosis caused by aggressive chemotherapy. The so-called "sandwich" technique is useful in these cases and may be recommended by the present authors.