Prevalence of bilateral Discoid Lateral Menisci (DLM) in patients operated for symptomatic DLM with a follow-up study on their asymptomatic contralateral knees: a Magnetic Resonance Imaging (MRI) assessment.

BACKGROUND: The purpose was to investigate prevalence of bilateral discoid lateral menisci (DLM) in Han Chinese patients who received surgery for symptomatic DLM, as well as a follow-up study of their asymptomatic contralateral knees using magnetic resonance imaging (MRI). METHODS: A total of 110 patients [50 males and 60 females; average age: 21.95 ± 12.77 years (range: 6 to 67 years)] admitted to our hospital with symptomatic DLM were treated with arthroscopic surgery. The contralateral asymptomatic knees were evaluated for DLM by MRI. Postoperative clinical evaluation was performed using the Lysholm knee scoring scale and International Knee Documentation Committee subjective knee evaluation. RESULTS: Eighty (72.73%) of 110 symptomatic DLM patients had bilateral DLM, of which 68 (85%) were of homotype (same type). Fourteen of 80 bilateral DLM patients were symptomatic and received operations in both knees. Twelve of remaining 66 bilateral DLM patients with asymptomatic one knee underwent a second arthroscopic surgery as their asymptomatic knees became symptomatic over the five-year interim. Of these 12 cases, seven exhibited no shift and five showed posterocentral meniscal shift. Furthermore, at least two cases showed progression from asymptomatic grade II to symptomatic grade III over the interim. All patients showed significant improvement after surgery. CONCLUSIONS: The bilateral DLM rate of Han Chinese patients with symptomatic DLM was relatively high at 72.7 %, and 85 % of those were of homotype.

[Arthroscopic treatment of acute greater tuberosity fractures of the humerus].

OBJECTIVE: To study the outcome in the arthroscopic treatment of acute greater tuberosity fractures. METHODS: Twelve cases with acute great tuberosity fractures received reduction with arthroscopic treatment from August 2006 to December 2007. There were 7 males and 5 females. Eight cases were on left side and 4 on right side. The patients were operated at a mean age of 38 years old (range: 2745). The fractured fragments in displacements were greater than 5 mm. X-ray film and Constant score were used to evaluate the post-operative outcome. RESULTS: Three hollowed threaded screws with a washer were used to fix the big fractured fragments. The post-operative follow-up was a mean of 18 months (range: 14-33). The fracture fixations were excellent and bone union occurred. The patients received a mean Constant score of 92 (86-100) at the last follow-up. CONCLUSION: Arthroscopic treatment of acute greater tuberosity fractures is quite efficacious.

Arthroscopic reduction and fixation for isolated greater tuberosity fractures.

BACKGROUND: Traditionally, displaced greater tuberosity fractures are treated with open reduction and internal fixation. Arthroscopic treatment and outcome of greater tuberosity fractures is far from comprehensive. The objective of the current study was to assess the surgical procedure and outcome of an arthroscopic method in the treatment of isolated greater tuberosity fractures. METHODS: From January 2006 to December 2009, 23 patients with isolated greater tuberosity fractures were treated with an arthroscopic procedure using three cannulated screws combined with washers. During follow-up, radiographs and the constant shoulder score (CSS) were used to evaluate the outcome. RESULTS: Three cannulated screws with washers were used to fix the fractured fragment of the greater tuberosity under an arthroscope. All incisions healed at primary intention without infection. The mean duration of follow-up was 20 months (range 18 - 36 months). Fracture fixation was excellent, and fractures healed 2 - 6 months (mean 3.8 months) after surgery. At final follow-up, the CSS was 92 (range 86 - 100). CONCLUSIONS: The described arthroscopic procedure provides anatomical reduction and firm fixation for isolated greater tuberosity fractures. It is a successful and minimally invasive procedure with satisfying therapeutic effects as well as excellent functional recovery.