RESUMEN
Our study aims to determine the association between obesity and meniscal tears involving the posterior third of the medial meniscus and meniscal root tears. We conducted a 3-year retrospective review of isolated operatively treated meniscal injuries in adult patients performed by a single surgeon. Cases with concomitant pathology were excluded. Patient demographics, height, weight, and body mass index (BMI) were recorded and compared against location of meniscus tear noted via magnetic resonance imaging and arthroscopic imaging. Eighty-nine patients met the inclusion criteria, of which 65.2% were obese (BMI > 30) and 10.1% were morbidly obese (BMI > 40). Average BMI across all patients was 32.6 ± 6.7. Forty-four patients had a tear involving the posterior horn of the medial meniscus, including 20 involving the meniscal root. The average BMI of patients with tears involving the meniscal root was 35.7 ± 6. There was a statistically significant association between type of meniscus tear and BMI as well as height. Obese patients were more likely to have a posterior horn of the medial meniscus tear (odds ratio [OR]: 1.59) and meniscal root tear (OR: 124.67), as were morbidly obese patients (OR: 2.21 and 5.41, respectively). Elevated BMI is associated with posterior horn of the medial meniscus tear. Obesity and morbid obesity are strongly associated with meniscal root tears and tears included in the posterior third of the medial meniscus.
RESUMEN
OBJECTIVE: To test whether a novel visuospatial testing platform improves trainee ability to convert two-dimensional to three-dimensional (3D) space. METHODS: Medical students were recruited from Baylor College of Medicine and McGovern Medical School (Houston, TX). We 3D reconstructed 3 partial nephrectomy cases using a novel, rapid, and highly accurate edge-detection algorithm. Patient-specific reconstructions were imported into the dV-Trainer (Mimics Technologies, Seattle, WA) as well as used to generate custom 3D printed physical models. Tumor location was altered digitally to generate 9 physical models for each case, 1 with the correct tumor location and 8 with sham locations. Subjects were randomized 1:1 into the dV-Trainer (intervention) and No-dV-Trainer (control) groups. Each subject completed the following steps: (1) visualization of computed-tomographic images, (2) visualization of the reconstructed kidney and tumor in the dV-Trainer (intervention group only), and (3) selection of the correct tumor location on the 3D printed models (primary outcome). Normalized distances from the correct tumor location were quantified and compared between groups. RESULTS: A total of 100 subjects were randomized for this study. dV-Trainer use significantly improved subjects ability to localize tumor position (tumor localization score: 0.24 vs 0.38, P < .001). However, subjects in the No-dV-Trainer group more accurately assigned R.E.N.A.L. scores. CONCLUSION: Even brief exposure to interactive patient-specific renal tumor models improves a novice's ability to localize tumor location. Virtual reality simulation prior to surgery could benefit trainees learning to localize renal masses for minimally invasive partial nephrectomy.
