Arthroscopic treatment of meniscal cysts.

Historically meniscal cysts have been treated with either an open total menisectomy, isolated cyst excision, or a combination of the two procedures. The advent of arthroscopic techniques has led to innovative treatment options for meniscal cyst management. A review of meniscal cysts and the results of arthroscopic treatment form the basis of this study. From 1986 to 1991, 18 patients with meniscal cysts were treated by arthroscopic cyst decompression. Thirteen men and five women comprised the study group and had an average age of 28 years. The follow-up period ranged from 6 to 60 months (average 26). Eight of the cysts were medial and 10 were lateral. A horizontal cleavage tear was noted in all cases, and 15 partial and three subtotal menisectomies were performed in conjunction with an intraarticular cyst decompression. There have been no recurrences to date, and all patients returned to their previous level of activity. Parameniscal cysts may result from synovial fluid tracking through a horizontal cleavage tear. Successful treatment of the meniscal cyst must include appropriate management of the torn meniscus, which can be entirely arthroscopic, consisting of a partial or subtotal meniscectomy, identification of the cyst opening, and cyst decompression.

Running and the older athlete.

The beneficial effects of regular, aerobic exercise are well documented. Regular running fulfills the criteria for such a program. Because of the stresses incurred secondary to its impact loading, however, injuries are common. The biological changes that accompany aging can lead to a whole gamut of overuse injuries. To reduce these stresses, proper preparation, clothing, running shoes, training surfaces, and training techniques are recommended.

The role of subtalar motion and ankle contact pressure changes from angular deformities of the tibia.

It is a well known entity that fractures of the tibia heal with some component of angular deformity. Ankle and subtalar joints may compensate for small degrees of angular deformities, but the exact amount of malunion that can be accepted without development of late sequalae has yet to be determined. Two recent studies from this institution have concluded that contact changes at the tibiotalar joint tend to be greater with distal third tibial fracture deformities compared to proximal and middle with the ankle in neutral, 5 degrees dorsiflexion, and 20 degrees of plantar flexion. Anterior and posterior bow deformities produced a greater change in contact area of the tibiotalar joint than with valgus or varus deformities. This phenomena may be possibly explained by the subtalar motion in the horizontal plane which averages 23 degrees. Thus, it was the primary purpose of this paper to determine the exact role, if any, in subtalar motion on tibiotalar contact in angular deformities of the tibia. To achieve this objective the subtalar joint was transfixed thereby eliminating its perceived compensatory movement. Six cadaveric lower extremities were disarticulated at the knee joint and stripped of soft tissue preserving capsular and ligamentous structures. A custom universal joint was used to create various angulatory deformities at proximal, middle, and distal third levels of the tibia.(ABSTRACT TRUNCATED AT 250 WORDS)