[Progress on study of factors influencing the prognosis and complications of surgery for discoid meniscus injury in children].

The discoid meniscus is a common congenital meniscal malformation that is prevalent mainly in Asians and often occurs in the lateral discoid meniscus. Patients with asymptomatic discoid meniscus are usually treated by conservative methods such as observation and injury avoidance, while patients with symptoms and tears need to be treated surgically. Arthroscopic saucerization combined with partial meniscectomy and meniscus repair is the most common surgical approach., and early to mid-term reports are good. The prognostic factors are the patient's age at surgery、follow-up time and type of surgery. Some patients experience complications such as prolonged postoperative knee pain, early osteoarthritis, retears and Osteochondritis dissecans. The incidence of prolonged postoperative knee pain was higher and the incidence of Osteochondritis dissecans was the lowest. Retears of the lateral meniscus is the main reason for reoperation.

[Application of percutaneous pie-crusting deep medial collateral ligament release for posterior horn surgery of medial meniscus].

OBJECTIVE: To explore clinical and radiographic effects of percutaneous pie-crusting deep medial collateral ligament release in patients with posterior horn tear of medial meniscus combined with tight medial compartment. METHODS: From January 2012 to December 2016, 35 patients with medial meniscus posterior horn injury were treated with percutaneous pie crusting deep medial collateral ligament release technique, including 21 males and 14 females, aged from 21 to 55 years old with an average of (39.1±6.5) years old. Degree of meniscus extrusion were recorded before and 24 months after operation. The knee valgus stress test was performed to evaluate stability of medial collateral ligament, and compared difference between healthy and affected side. Lysholm and IKDC functional scores were compared before and 24 months after operation. RESULTS: All patients were followed up from 27 to 60 months with an average of (36.7±6.8) months. All patients were underwent operation, the wound healed well without complications. Operative time ranged from 0.5 to 1.2 h with an average of (0.8±0.4) h. Nineteen patients were performed partial meniscectomy, 16 patients were performed repair suture. Convex of meniscus before operation was (1.5±0.7) mm, and (1.7±0.4) mm after operation;had no statistical difference(P>0.05). Lysholm score was improved from 53.4±8.8 before operation to 91.5±4.6 at 24 months after operation;IKDC score was increased from 50.7±9.2 before operation to 90.6±3.9 at 24 months after operation;there was statistically significant (P<0.05). Valgus stress test was performed on 0 ° and 30 ° position of knee flexion in affected side and compared with ipsilateral side, all patients showed negative. CONCLUSION: For patients with medial meniscus tear of posterior horn combined with tight medial compartment, percutaneous pie-crusting deep medial collateralligament release could improve medial compartment space, and Knee valgus instability and meniscus extrusion are not affected.

Ankle distraction arthroplasty for the treatment of severe ankle arthritis: Case report, technical note, and literature review.

RATIONALE: Widely applied in the treatment of severe ankle arthritis (AA), ankle distraction arthroplasty (ADA) can avoid not only the ankle range of motion loss but also ankle fusion. However, the clinical outcomes of ADA for severe AA are poorly understood. This study aims to present our clinical outcomes of severe AA treated by ADA. PATIENT CONCERNS: A 53-year-old man suffered right ankle sprain 10 years ago, endured right ankle pain and limited movement for 6 years. DIAGNOSIS: The patient was diagnosed as severe AA. INTERVENTIONS: He received ankle distraction arthroplasty. No adjuvant procedures were performed. The visual analog scale (VAS), the American Orthopaedic Foot and Ankle Society (AOFAS) score, the short-form (SF)-36 physical component summary (PCS) score and ankle activity score (AAS) were recorded to access the clinical outcomes pre- and postoperatively. Moreover, ankle joint space distance was evaluated on weight-bearing radiographs. OUTCOMES: The patient derived effective pain relief and restored a satisfactory range of movement. There was a 13-month follow-up period after frame removal. The AOFAS score improved from 56 preoperatively to 71 postoperatively. The VAS score decreased from 6 prior to surgery to 1 after surgery. The SF-36 PCS was 47.2 and 71.8 pre- and postoperative, respectively. The AAS scores were improved from 3.4 preoperatively to 7.3 postoperatively. LESSONS: ADA is reliable to achieve pain relief, functional recovery, and serve AA resolution. Besides, it is an alternative to ankle arthrodesis or total ankle arthroplasty in selected patients with severe AA.

[Arthroscopic pullout suture repair of posterior root tear of the medial meniscus via the double tibial tunnels].

OBJECTIVE: To evaluate the surgical technique and clinical effect of arthroscopic pullout suture repair of posterior root tear of the medial meniscus via the double tibial tunnels. METHODS: From May 2014 to May 2017, 22 patients with posterior root tear of medial meniscus were treated by pullout suture repair via the double tibial tunnels, including 8 males and 14 females, aged 34 to 53 years old, with a mean of averaged(45.7±4.7) years old. The patients were followed up for 12 to 24 months, with a mean of (16.4±5.2) months. RESULTS: The Lysholm score of knee joint before operation was 61.8±4.3, IKDC score before operation was 59.9±2.9, Lysholm score at the latest follow-up was 89.1±3.0, and IKDC score was 89.0±2.5. The difference was statistically significant. CONCLUSIONS: Arthroscopic pullout suture repair via the double tibial tunnelsis an effective treatment for symptomatic posterior root tear of medial meniscus, and it can significantly improve the knee functional outcome.