[Meniscal injury in the plastic reconstruction of the anterior cruciate ligament. Meniscal suture or abstention]. / La lésion méniscale dans le cadre de la ligamentoplastie de substitution du ligament croisé antérieur: suture méniscale ou abstention.

The purpose of this study was to observe the change of the meniscal lesions, which are conservable by suture or simply by leaving-in-place within the frame of operated anterior instability. Forty-six knees which had been operated by the free transplant of bone-patellar tendon-bone, presented the associated lesions of conservable meniscus. These lesions were treated by suture of the meniscus in 15 cases and left in place in 31 cases. The programme of rehabilitation was the same in the two groups. All the patients have been followed-up for 26 months in average (12-40 months). In the group of meniscal suture, only one secondary meniscectomy was carried out. 8 patients presented moderate pain on the corresponding femorotibial joint line and 5/13 of the sportive patients recovered to the same level of activity. In the group of leaving-in-place, no meniscectomy has been carried out. Only 4 patients complained of pain and 23/27 recovered to the same activity level. The arthrographic and arthroscopic observations have been carried out in 23 cases. They confirmed the cicatrization of the sutured meniscus but also showed the possibility of total or partial cicatrization of the lesions left in place (12 on 13). The authors conclude that the peripheral meniscal lesions associated with the operation of the chronic anterior instability do not always require suture. The abstention on the meniscal lesion is possible if it is limited on the posterior segment: Then the functional results seem better.

[Arthroscopy of the shoulder with the patient in beach-chair position]. / L'arthroscopie de l'épaule en position assise.

The authors describe a technique of arthroscopy in the "beach chair" position, that they have exclusively used since 1989. The classical setting in lateral decubitus takes a long time and can be the cause of complications especially neurological due to the traction. In the chair position, the vision of the intraarticular structures is identical to the lateral position, and the absence of traction avoid the neurological complication. Another advantage is the quick and easy setting; the locoregional anesthesia is easy to use, it is possible to practice an open surgery without changing the setting. All these advantages lead the authors to propose this position for all arthroscopy of the shoulder whether diagnostic or therapeutic.