Correlation of degenerative meniscus injury with lower limb alignment:a clinical report of 90 cases / 陆军军医大学学报

Objective To compare the differences in lower limb force line between degenerative medial meniscus injuries and lateral meniscus injuries and investigate their correlation.Methods A total of 90 patients who underwent arthroscopic treatment for meniscal injuries between March 2019 and March 2022 were enrolled in the study.They were 45 males and 45 females,at a median age of 52 years(ranging from 40 to 59 years).Of these patients,47 had medial meniscus injuries,while 43 had lateral meniscus injuries.The hip-knee-ankle(HKA)angle was measured on full-length films,and the differences were compared between the 2 groups.Results There were no significant differences in terms of gender,age,lower limb laterality,body mass index,site of injury,and type of injury between the medial meniscus injury group and the lateral meniscus injury group.Statistical difference was observed in the mean HKA angle,with a value of(177.20±2.46)° in the medial meniscus injury group and of(181.05±3.13)° in the lateral meniscus injury group(P＜0.01).Conclusion There is a significant difference in HKA angle between medial meniscus injury group and the lateral meniscus injury group.A correlation is found between lower limb alignment and degenerative meniscus injury.

Stepwise treatment strategy for spontaneous osteonecrosis of the medial femoral condyle of the knee joint / 中国组织工程研究

BACKGROUND:Currently,there have been a variety of conservative and surgical treatment plans for spontaneous osteonecrosis of the knee,achieving excellent results.However,a broad consensus on indication and guide of surgical treatment has not been announced.In clinical practice,there is still a misunderstanding that unicondylar replacement or total knee arthroplasty should be performed upon the discovery of spontaneous osteonecrosis of the knee,while an urgent need for universal access to the concept of stepwise therapy. OBJECTIVE:To summarize and find the factors leading to the poor effect of conservative treatment in spontaneous osteonecrosis of the knee,which occurred on the medial femoral condyle,from the literature and clinical cases,at the same time,combined with the Koshino stage,to propose the strategy of stepwise spontaneous osteonecrosis of the knee treatment on the medial femoral condyle. METHODS:A systematic search of the literature database was conducted to summarize the factors leading to poor outcomes of conservative treatment in spontaneous osteonecrosis of the medial femoral condyle.Meanwhile,according to the Clinical&Health Records for analytics&Sharing system,the cases receiving conservative and surgical treatment in spontaneous osteonecrosis of the medial femoral condyle in the Department of Orthopedics of Guangdong Provincial Hospital of Chinese Medicine from January 2017 to January 2023 were analyzed retrospectively,then the causes of success and failure in typical cases were summarized and analyzed. RESULTS AND CONCLUSION:(1)Early diagnosis and treatment of spontaneous osteonecrosis of the knee were very important for prognosis.For sudden knee pain in some patients,if no obvious abnormality was found in the X-ray examination,and the symptoms persisted and could not be relieved for more than 1 week,an MRI examination was recommended to detect early spontaneous osteonecrosis of the knee.(2)The X-ray images of Koshino stage 1 and stage 2 of spontaneous osteonecrosis of the medial femoral condyle were difficult to be distinguished,which needed to be probed by MRI.MRI images of Koshino stage 1 were mainly characterized by bone marrow edema,and an osteonecrosis area with a clear boundary was not formed,while MR images of Koshino stage 2 showed a necrotic area with a clear boundary.(3)Five factors leading to the poor effect of conservative treatment on spontaneous osteonecrosis of the medial femoral condyle were summarized:a.The necrotic area was＞5 cm2;b.The necrotic area accounted for more than 40%of the condyle;c.relative compression percentage of medial meniscus≥33%(with or without medial meniscus injury and subchondral bone marrow edema);d.MRI depth of necrotic area(anterior-posterior diameter of sagittal necrotic area)＞20 mm;e.varus deformity of lower limb＞6°.(4)Conservative treatment of spontaneous osteonecrosis of the knee in Koshino stage 1 was good.For spontaneous osteonecrosis of the knee in Koshino stage 2,conservative treatment was preferred or combined with drilling decompression.If there was no relief or improvement of symptoms or in MRI after 3 months,while the patient had any of the previous five factors,then knee preservation surgery should be considered.For spontaneous osteonecrosis of the knee in Koshino stage 3 and stage 4,knee preservation surgery should be selected based on the previous five factors,including age,gender and activity level of the patient.Total knee arthroplasty was used for spontaneous osteonecrosis in Koshino stage 4,which was associated with symptomatic patellofemoral arthritis,valgus alignment,or necrotic area,which greatly affected the stability of unicondyle prosthesis.

Efficacy observation and imaging evaluation of arthroscopic repair of degenerative medial meniscus injury in middle-aged and elderly patients / 重庆医学

Objective To observe the clinical effect of arthroscopic repair of isolated degenerative medi-al meniscus injury in patients over 45 years old and to evaluate the healing after more than two years of fol-low-up through MRI.Methods A retrospective study was conducted on the clinical effects of 51 patients with isolated degenerative medial meniscus injury who underwent arthroscopic repair from January 2016 to Decem-ber 2020.The meniscus was sutured by total internal suture or total internal suture combined with internal-to-external technique.IKDC score,Tegner score and Lysholm score were recorded before operation and at the last follow-up(at least 24 months).The type and location of meniscus injury during operation,and the microscopic classification and location of cartilage injury were recorded.At the same time,MRI was used to observe the healing of meniscus and ICRS cartilage injury grading.On MRI,0-2 degree injury was defined as meniscus healing,and 3 degree injury was defined as nonunion.The clinical repair failure was judged according to the Barrett evaluation criteria.Results The average age of the patients was(57.3±8.4)years,and the average follow-up time was(55.0±15.3)months.There were 47.1％complex fissures,31.3％horizontal fissures and 21.6％other types.The Lysholm score increased from 53.5±6.4 preoperative to 87.6±7.9 postoperative,the IKDC score increased from 33.6±4.7 preoperative to 72.8±5.3 postoperative,and the Tegner score increased from 1.0±0.1 preoperative to 4.0±0.5 postoperative.Three patients were judged as clinical repair failure,and five patients had progressed cartilage injury after surgery.At the last follow-up,the meniscus healing was observed on MRI:0 degree in two cases(3.9％),1 degree in 17 cases(33.3％),2 degree in 11 cases(21.6％),3 degree in 21 cases(41.2％).Conclusion For middle-aged and elderly patients with isolated de-generative medial meniscus injury,if conservative treatment is not effective or there are mechanical obstruc-tion factors,arthroscopic meniscus repair can achieve good clinical results and low clinical repair failure rate.

Advances in Arthroscopic Suture Techniques for Meniscal Injuries / 昆明医科大学学报

The meniscus in the knee joint plays an important role in bearing load,shock absorption,joint lubrication,and increasing the stability of the knee joint in various directions.Meniscal injury is a common ailment in knee joint injuries,which can cause severe knee pain and limited knee joint movement,significantly affecting the patient's quality of life.Arthroscopic minimally invasive treatment has become the main approach for treating meniscal injuries,with the consensus being to preserve the meniscus morphology and structure as much as possible.By introducing the structure and function of the meniscus,the mechanism of injury,and focusing on several suture techniques for arthroscopic meniscal injury treatment,analyzing their advantages and disadvantages,it aims to provide some reference for clinical research on arthroscopic suture of the meniscus.

Effect of acupuncture exercise therapy synchronizing isokinetic muscle strength training for postoperative rehabilitation of meniscectomy under arthroscopy / 中国针灸

OBJECTIVE@#To observe the effect of acupuncture exercise therapy synchronizing isokinetic muscle strength training on the motor function, stability and proprioception of knee joint, as well as the anxiety emotion in patients after meniscectomy under arthroscopy.@*METHODS@#A total of 70 patients after meniscectomy under arthroscopy were randomized into an observation group (35 cases, 2 cases were eliminated， 2 cases dropped off) and a control group (35 cases, 2 cases were eliminated, 1 case dropped off). Acupuncture was applied at Chize (LU 5), Neixiyan (EX-LE 4), Dubi (ST 35),Yanglingquan (GB 34), etc. on the affective side in the two groups. After 30 min, the needles of the knee joint area were withdrew, while the needle at elbow was continuously retained, the observation group was given acupuncture exercise therapy synchronizing isokinetic muscle strength training, and the control group was given conventional acupuncture exercise therapy. The treatment was given once a day, 7-day treatment was taken as one course, and totally 4 courses were required in the two groups. Before and after treatment, the knee joint Lysholm score, the knee joint isokinetic muscle strength flexion/extension ratio (H/Q), joint position sense measurement (JPS) and Hamilton anxiety scale (HAMA) score were compared in the two groups.@*RESULTS@#After treatment, the knee joint Lysholm scores and H/Q were increased compared with those before treatment in the two groups (P<0.001), and the knee joint Lysholm score and H/Q in the observation group were higher than those in the control group (P<0.001); the JPS and HAMA scores were decreased compared with those before treatment in the two groups (P<0.001), the JPS and HAMA score in the observation group were lower than those in the control group (P<0.05).@*CONCLUSION@#Acupuncture exercise therapy synchronizing isokinetic muscle strength training can effectively improve the motor function, stability and proprioception of knee joint, as well as the anxiety emotion in patients after meniscectomy under arthroscopy.

Treatment for posterior root tear of lateral meniscus through bone tunnel suture under arthroscopy / 中国骨伤

OBJECTIVE@#To evaluate clinical effects of posterior root tear of lateral meniscus through bone tunnel suture under arthroscopy.@*METHODS@#From January 2012 to December 2014, 23 patients with posterior root tear of lateral meniscus repaired through bone tunnel suture under arthroscopy, including 15 males and 8 females, aged from 19 to 48 years old with an average age of (25.0±4.7) years old; 10 knees on the left side and 13 knees on the right side. Complications were observed, Lysholm score before and after operation at 12 months were used to evaluate clinical results, and VAS score was applied to assess pain relief. MRI was used to check recovery outcomes of lateral meniscus injury.@*RESULTS@#All patients were followed up from 13 to 24 months with an average of (17.0±4.3) months. No injury of vessels, nerve and incision infection occurred. Motion of knee joint of 19 patients reached normal, 4 patients manifested limited activity of knee joint at12 months after operation. Postoperative Lysholm score 88.52±6.48 at 12 months was higher than that of before operation 46.12±7.35; Postoperative VAS score 0.8±0.7 at 12 months was lower than that of before operation 4.3±1.6.@*CONCLUSIONS@#Bone tunnel suture under arthroscopy for the treatment of posterior root tear of lateral meniscus could relieve pain, decrease postoperative complications and obtain good clinical efficacy.

Disorder of Muscles around Knee with Meniscus Injury: Study with Surface Electromyography / 中国康复理论与实践

Objective:To investigate the influence of meniscus injury on the function of muscles around knee in patients with meniscus injury. Methods:From February, 2017 to February, 2018, the suface electromyography of vastus lateralis (VL), rectus femoris (RF), vastus medialis (VM) and biceps femoris (BF) were recorded and analyzed in 22 patiens with unilateral meniscus injury, during squatting down-standing up test and maximal isometric voluntary contraction at knee flexing 70°. Results:During squatting down-standing up test, the average electromyography (AEMG) of VL and BF was less in affected knee than in unaffected knee (t > 3.945, Z > 3.847, P < 0.001), and the coactivity ratio of hamstrings in affected knee was higher (t > 3.650, P < 0.01). The AEMG of VL, RF, VM and BF was less in affected knee than in unaffected knee (t > 2.907, Z = 4.107, P < 0.01) during maximal isometric voluntary contraction at knee flexing 70°. Conclusion:sEMG can be used to quantitatively evaluate the muscle function around knee for patients with meniscus injury in different motion states. Patients with meniscus injury demonstrate impaired muscular function and altered muscle balance around knee, which need to be corrected during rehabilitation.

Disorder of Muscles around Knee with Meniscus Injury: Study with Surface Electromyography / 中国康复理论与实践

Objective:To investigate the influence of meniscus injury on the function of muscles around knee in patients with meniscus injury. Methods:From February, 2017 to February, 2018, the suface electromyography of vastus lateralis (VL), rectus femoris (RF), vastus medialis (VM) and biceps femoris (BF) were recorded and analyzed in 22 patiens with unilateral meniscus injury, during squatting down-standing up test and maximal isometric voluntary contraction at knee flexing 70°. Results:During squatting down-standing up test, the average electromyography (AEMG) of VL and BF was less in affected knee than in unaffected knee (t > 3.945, Z > 3.847, P < 0.001), and the coactivity ratio of hamstrings in affected knee was higher (t > 3.650, P < 0.01). The AEMG of VL, RF, VM and BF was less in affected knee than in unaffected knee (t > 2.907, Z = 4.107, P < 0.01) during maximal isometric voluntary contraction at knee flexing 70°. Conclusion:sEMG can be used to quantitatively evaluate the muscle function around knee for patients with meniscus injury in different motion states. Patients with meniscus injury demonstrate impaired muscular function and altered muscle balance around knee, which need to be corrected during rehabilitation.

Lesiones degenerativas del menisco / Lésions méniscales dégénératives / Degenerative lesions of meniscus

Introducción: La enfermedad degenerativa articular afecta a todas las estructuras intrarticulares entre las que se encuentran el menisco y el cartílago. Las lesiones del menisco están asociadas a otras enfermedades que provocan dolor. Objetivo: Describir el comportamiento de las lesiones degenerativas del menisco en un grupo de pacientes. Métodos: Se realizó un estudio observacional analítico, con 230 pacientes que presentan diagnóstico clínico, imaginológico y artroscópico de lesiones degenerativas del menisco, atendidos en el Hospital Universitario Manuel Ascunce Domenech, del 9 octubre de 2012 al 22 de enero de 2018. Las variables del estudio fueron: edad, sexo, rodilla derecha e izquierda, menisco medial-lateral, las cinco variantes de la clasificación artroscópica de Boyer T, síntomas y signos, lesiones intrarticulares asociadas, lesión de cartílagos y procedimientos artroscópicos. Se empleó la distribución de frecuencias absoluta y relativa en el análisis de las variables cualitativas y la media aritmética para la variable cuantitativa edad. Para la relación entre variables cualitativas independientes se utilizó la prueba de chi-cuadrado. Resultados: El promedio de edades de los pacientes estudiados fue de 54,5 años. La proporción por sexo fue 2,5 mujeres por 1 hombre afectado. Según la clasificación artroscópica de Boyer T, hubo mayor incidencia del tipo I en los enfermos (47 por ciento). Predominó el dolor difuso de la articulación. La lesión asociada con mayor incidencia fue la de cartílagos grados III/IV. Los procedimientos artroscópicos más empleados fueron: el lavado articular, desbridamiento y la meniscectomía parcial. Conclusiones: Las lesiones degenerativas del menisco son frecuentes en pacientes con la enfermedad degenerativa articular. Se asocian a otras enfermedades articulares que provocan dolor, de ahí que sus síntomas y signos sean similares. El grado de afección del menisco no es simétrico al del cartílago. El tratamiento artroscópico es el de elección, por sus múltiples ventajas. Son necesarios varios procedimientos en un mismo enfermo(AU)

Introduction: The articular degenerative disease affects all intra-articular structures, including meniscus and cartilage. Meniscus injuries are associated with other diseases that cause pain. Objective: To describe the behavior of meniscal degenerative lesions in a group of patients. Methods: An analytical observational study was carried out in 230 patients presenting a clinical, imaging and arthroscopic diagnosis of meniscus degenerative lesions; they were treated at Manuel Ascunce Domenech University Hospital, from October 9, 2012 to January 22, 2018. The variables of the study were age, sex, right and left knee, medial-lateral meniscus, Boyer's T five variants of arthroscopic classification, symptoms and signs associated intra-articular injuries, cartilage injury and arthroscopic procedures. The distribution of absolute and relative frequencies was used in the analysis of the qualitative variables and the arithmetic mean for the quantitative age variable. The chi-square test was used to assess the relationship between independent qualitative variables. Results: The average age of the patients studied was 54.5 years. The proportion by sex was 2.5 women per one affected man. According to Boyer T arthroscopic classification, there was higher incidence of type I in these patients (47 percent). The joint diffuse pain predominated. The highest incidence lesion associated was cartilages grades III / IV. Joint washing, debridement and partial meniscectomy were the most arthroscopic procedures used. Conclusions: Degenerative lesions of the meniscus are frequent in patients with degenerative joint disease. They are associated with other joint diseases that cause pain; hence, their symptoms and signs are similar. The degree of affection of the meniscus is not symmetrical to that of the cartilage. The treatment of choice is arthroscopic, due to its multiple advantages. Several procedures are necessary in the same patient(AU)

Introduction: La maladie articulaire dégénérative touche toutes les structures intra-articulaires, telles que le ménisque et le cartilage. Les lésions méniscales sont associées à d'autres affections qui provoquent la douleur. Objectif: Le but de cet article est de décrire le comportement des lésions méniscales dégénératives dans un groupe de patients. Méthodes: Une étude observationnelle et analytique de 230 patients diagnostiqués de lésions méniscales dégénératives par examen clinique, IRM et arthroscopie, et traités à l'hôpital universitaire Manuel Ascunce Domenech, du 9 octobre 2012 au 22 janvier 2018, a été réalisée. Les variables utilisées dans cette étude ont compris l'âge, le sexe, le genou affecté (gauche et droit), le ménisque médial-latéral, les cinq variables de la classification arthroscopique de Boyer, les symptômes et signes, les lésions intra-articulaires associées, la lésion de cartilages, et les méthodes arthroscopiques. On a employé la distribution des fréquences absolues et relatives pour l'analyse des variables qualitatives, et la moyenne arithmétique pour la variable quantitative de l'âge. Pour la relation entre les variables qualitatives indépendantes, on a utilisé le test du chi carré (χ2). Résultats: L'âge moyen des patients dans cette étude a été 54.5 ans. Le sex-ratio a été de 2,5 femmes contre 1 homme. Selon la classification arthroscopique de Boyer, les lésions de type I ont été les plus fréquentes chez les malades (47 %). La douleur diffuse de l'articulation a été en prédominance. La lésion intra-articulaire associée de plus haute incidence a été celle de cartilages grades III/IV. Parmi les procédés arthroscopiques les plus souvent utilisés, on peut trouver le lavage articulaire, le débridement et la méniscectomie partielle. Conclusions: Les lésions méniscales dégénératives sont fréquentes chez les patients atteints de maladie articulaire dégénérative. Elles sont associées à d'autres affections articulaires provoquant la douleur, c'est pourquoi leurs symptômes et signes sont similaires. Le grade d'atteinte du ménisque est différent à celui du cartilage. Étant donné ses multiples bénéfices, le procédé arthroscopique est le traitement de choix. Il faut utiliser plusieurs procédés chez un même malade(AU)

Evaluation of an arthroscopic stifle lever for stifle joint distraction in toy breed dogs

Arthroscopy has become an attractive modality in the diagnosis and treatment of joint diseases in toy breed dogs. However, the application of arthroscopy is limited by small joint space. Our objective was to evaluate the efficacy of a stifle lever for joint distraction during stifle arthroscopy in toy breed dogs. Paired stifles (n = 32 each) collected from 16 cadavers of toy breed dogs were randomly assigned to one of two groups: the stifle lever group or the external manipulation group. All stifles underwent arthroscopic cranial cruciate ligament transection, and the visualization of the medial meniscus was evaluated. Medial meniscal release (MMR) was then performed. Following arthroscopic examination, the success rates of MMR and damages of tibial and femoral cartilages were evaluated. Visualization of the medial meniscus was significantly better, and meniscal probing was significantly easier, in the stifle lever group than in the external manipulation group (p = 0.001). There were no significant differences between groups for MMR success or articular cartilage damage. Using the stifle lever on arthroscopic examination improved visualization and probing on the medial meniscus in toy breed dogs. The stifle lever can be used as a good modality in assessing medial meniscal pathology in toy breed dogs.

Arthroscopic meniscus partial resection in treatment of knee meniscus injury / 中国内镜杂志

Objective?To explore the effect of meniscus partial excision under arthroscopy for meniscus injury of knee joint, and compare it with meniscus plasty and conservative treatment.?Methods?The clinical data of 95 patients with meniscus injury of knee joint from September 2012 to September 2015 were analyzed retrospectively. According to the treatment plan, the patients were divided into partial meniscectomy group (37 cases), meniscus angioplasty group (30 cases) and conservative treatment group (28 cases). After 6 months of treatment, the clinical curative effect was evaluated. After 6 months and 2 years of treatment, L-ROM was used to measure the range of motion, and the visual analogue scale (VAS) was used to evaluate the pain degree. The knee function score (Lysholm) was issued to evaluate knee function. The incidence rates of long-term complications in the three groups were recorded.?Results?The total response rate in partial meniscectomy group (97.30%) and meniscus angioplasty group (86.68%) were higher than conservative treatment group (53.57%) (P < 0.05). There was no significant difference between partial meniscectomy group and meniscus angioplasty group (P > 0.05);After 6 months and 2 years of treatment, the knee range of motion and Lysholm scores of the three groups were significantly higher than those before treatment while VAS scores were significantly lower (P < 0.05). However, there were no significant differences between partial meniscectomy group and meniscus angioplasty group (P > 0.05) but there was significant difference, compared with conservative treatment group (P < 0.05). Lysholm scores of partial meniscectomy group were significantly higher than meniscus angioplasty group and conservative treatment group (P < 0.05), and there was significant difference between meniscus angioplasty group and conservative treatment group (P < 0.05).?Conclusion?The effect of arthroscopic surgery in the treatment of meniscus injury of knee joint is accurate. Arthroscopic partial meniscectomy has more advantages in improving the knee function.

Effects of Intra-articular Injection of Tranexamic Acid on Joint Swelling,Pain and Recovery of Joint Function in Patients with Simple Meniscus Injury / 中国药房

OBJECTIVE:To investigate the effects of intra-articular injection of tranexamic acid on joint swelling,pain and recovery of joint function in patients with simple meniscus injury. METHODS:A total of 62 patients with simple meniscus injury receiving arthroscopic surgery of the knee in orthopedics department of Chongqing people's hospital during Oct. 2016-Apr. 2017 were selected and divided into control group and observation group according to random table,with 31 cases in each group. Both groups received meniscus excision or trimming under knee arthroscopy. Control group was given intra-articular injection of 0.9%Sodium chloride injection 10 mL after wound suture. Observation group was given intra-articular injection of Tranexamic acid for injection 2.0 g added into 0.9% Sodium chloride injection 10 mL after wound suture. The drainage tube was not placed in all the patients,The tourniquet was loosened after the pressurized dressing of wound. Circumferential diameter of the knee and VAS scores of 2 groups were observed before surgery,1,3,5 and 7 d after surgery. Lysholm scores were observed before and one month after surgery. The occurrence of ADR was recorded. RESULTS:There was no statistical significance in circumferential diameter of the knee,VAS score or Lysholm score between 2 groups before surgery(P>0.05). 1,3,5 and 7 d after surgery,circumferential diameter of the knee in 2 groups was significantly bigger than before surgery,but the observation group was significantly smaller than the control group 1,3 d after surgery,with statistical significance(P<0.05). There was no statistical significance in circumferential diameter of the knee between 2 groups 5 and 7 d after surgery(P>0.05). VAS score of observation group 1,3 d after surgery and control group 1,3 and 5 d after surgery were significantly higher than before surgery,but the observation group was significantly lower than the control group 1,3,5 d after surgery,with statistical significance(P<0.05). There was no statistical significance in observation group 5,7 d after surgery and control group 7 d after surgery,compared to before surgery and 7 d after surgery(P>0.05).One month after surgery,Lysholm scores of 2 groups were significantly higher than before surgery,and the observation group was significantly higher than the control group,with statistical significance(P<0.05). No severe ADR was found in 2 groups during medication,and there also was not deep venous thrombosis after surgery. CONCLUSIONS:Intra-articular injection of tranexamic acid can effectively reduce the degree of early knee swelling after knee arthroplasty,relieve postoperative early pain.It promotes the recovery of knee function with good safety.

Clinical application of MRI measurements in knee joint meniscus / 局解手术学杂志

Objective To measure the scope of normal meniscus by magnetic resonance imaging(MRI),and create a database of meniscus size of each part.Methods The MRI image measured rake angle and back angle,body height and width of each part and the angular distance of rake and back angle of 303 meniscus of normal knee joint.Results The width and height of anterior horn,anterior exterior angle,body,angulus posteriolateralis and back angle of the medial meniscus were (5.67 ± 1.37) mm and (3.53 ± 0.86) mm,(7.24 ± 1.91) mm and (4.38 ±1.01) mm,(5.61 ± 1.73)mm and (4.25 ±1.07) mm,(11.01 ±3.53) mm and (5.41 ± 1.66)mm,(9.21 ±2.71)mm and (5.02 ± 1.39)mm,respectively.Rake and back angle of angular distance was (38.51 ± 10.88)mm.The width and height of the anterior horn,anterior exterior angle,body,angulus posteriolateralis and back angle of the lateral meniscus were (6.95 ± 1.69) mm and (3.83 ± 0.91) mm,(7.48±1.90)mmand (4.06 ± 0.97) mm,(6.51± 1.79) mm and (5.10±1.01)mm,(7.62±1.99)mm and (5.18±1.19)mm,(6.68 ± 1.41) mm and (5.64 ± 1.12) mm,respectively.The rake and back angle of angular distance was (38.51 ± 10.88) mm.Conclusion In this study,we obtained the data of meniscus for normal people by MRI,which provides reference values for diagnosis of meniscus injury and transplantation.

Arthroscopic debridement and meniscectomy in treatment of meniscus injury combined with osteoarthritis / 中国内镜杂志

Objective To investigate the effect of arthroscopic debridement and meniscectomy in treatment of moderate or severe meniscus injury combined with knee osteoarthritis in early or middle stage. Methods 156 cases diagnosed with moderate or severe meniscus injury combined with knee osteoarthritis in early or middle stage were collected from October 2011 to October 2014. Lysholm knee score and preoperative examinations such as anteroposterior, lateral, axial radiographs, the standing full leg length X-ray film and MRI scan of the knee were recommended to definitively understand the osteoarthritis staging and meniscus injury grading. All patients were treated with arthroscopic debridement and meniscectomy. After operation, physical rehabilitation exercises and regular clinical follow-up were carried out as planned. The Lysholm knee score data from preoperation and terminal follow-up was statistical analyzed. Results No patient experienced any perioperative and postoperative complications. Statistical analysis showed that the Lysholm knee score of postoperation was significantly higher than that of preoperation [(87.3 ± 7.9) vs (67.5 ± 4.9), P < 0.05). Conclusion Arthroscopic debridement and meniscectomy in treatment of moderate or severe meniscus injury combined with knee osteoarthritis in early or middle stage, gains beneficial effects for its minimal invasion and quick recovery.

Gait Analysis of Anterior Cruciate Ligament Deficient Patients with or Without Meniscus Injury / 中国运动医学杂志

Objective To identify the differences of three-dimensional knee kinematics of unilateral anterior cruciate ligament (ACL) deficient patients with and without the meniscus injury.Methods A total of 39 subjects including unilateral isolate ACL-deficient patients (ACL group,n=13),ACL deficient patients combined with meniscus tear (ACL+M group,n=13) and healthy controls (C group,n=13) participated in this study.In the gait analysis,three-dimensional knee kinematic and kinetic parameters were collected synchronously and compared.Results The peak knee flexion angles were greater in the ACL+M group and C group compared with the ACL group (P=0.001,P=0.001),with no significant differences between the former two groups (P=0.847).Lower first peak vertical ground reaction force,peak posterior ground reaction force,sagittal plane knee excursions and peak knee extension moment were found in ACL-injured side compared with the contralateral side (P=0.001,P＜0.001,P=0.006,P=0.001).Greater peak knee abduction moment was found in group ACL+M compared with both the ACL and C groups (P=0.045,P=0.014).However,no significant difference was observed between the ACL group and C group in peak knee abduction moment (P=0.616).Conclusions The altered loading in unilateral ACL deficient patients can lead to lower ground reaction force in injured knee and greater ground reaction force in the contralateral side,which may increase the risk of developing knee osteoarthritis.The greater internal knee abduction moment in ACL deficient patients combined with meniscus injury may be a risking factor for the knee osteoarthritis.

Application of pie-crusting the medial collateral ligament release in arthroscopic surgery for posterior horn of medial meniscus in knee joint / 中南大学学报(医学版)

Objective:To explore the effectiveness and safety of pie-crusting the medial collateral ligament release (MCL) in treating posterior horn of medial meniscus (PHMM) tear in tight medial tibiofemoral compartment of knee joint.Methods:Thirty-two consecutive patients with PHMM tear in tight medial tibiofemoral compartment of knee joint were admitted to our department from January,2013 to December,2014.All patients were performed pie-crusting the MCL release at its tibial insertion with 18-gauge intravenous needle.All patients were evaluated by valgus stress test and bilateral valgus stress radiograph at postoperative 1st day,4th week and 12th week.Visual Analogue Scales (VAS),Lysholm scores,Tegner scores and International Knee Documentation Committee (IKDC) scores were recorded at the 1st,3th,6th month follow-up,then follow-up every 6 months.Results:The mean follow-up was 28 (24-36) months.All cases were negative in valgus stress test.MCL rupture,femoral fracture,articular cartilage lesion and neurovascular injury were not found at the last follow-up.The median medial joint space width of affected side and unaffected side for valgus stress radiographs were 6.8 mm and 4.3 mm (P＜0.05) at the 1st day,5.5 mm and 4.2 mm (P＜0.05) in the 4th week and 4.8 mm and 4.3 mm (P＞0.05) at the 12th week,respectively.VAS scores was changed from 4.5±1.5 preoperatively to 1.7±1.0 at the final follow-up (t=16.561,P＜0.05).Lysholm scores was changed from 52.3±5.8 preoperatively to 93.2±6.3 at the final followup (t=-41.353,P＜0.05).Tegner scores was changed from 4.1±1.1 preoperatively to 5.5±0.6 at the final follow-up (t=-18.792,P＜0.05).IKDC scores was changed from 54.5±6.2 preoperative to 93.8±4.5 at the final follow-up (t=-38.253,P＜0.05).Conclusion:Pie-crusting the medial collateral ligament release is a safe,minimal invasive and effective surgical option for posterior horn of medial meniscus tear in tight medial tibiofemoral compartment of knee joint.

Feasibility study of magnetic resonance imaging(MRI) diagnosis of knee meniscus injury / 中国医学装备

Objective:This study focuses on the changes of the knee meniscus injury imaging to evaluate the clinical efficacy and feasibility of MRI in its diagnosis.Methods: A total of 110 cases of patients with knee meniscus injury in our hospital were selected and were randomly divided into two groups. The observation group was carried out MRI while the control group did routine CT examination. All were confirmed by surgery or arthroscopy. Evaluating the diagnostic value of MRI on the knee meniscus injury according to the comparative analysis based on examined results for the two groups.Results:In selecting a total of 55 patients, the knee meniscal injuries were unilateral, in which there were 51 medial meniscus injuries and 40 lateral meniscuses. There were 28 cases of the level 1 injuries, 43 cases of the secondary injury and 20 cases of the level 3 injuries. Therefore, there were no differences between the observation group and the surgery or arthroscopy examination(t=0.416,t=0.323,t=0.121;P>0.05). The analysis of the differences was statistically significant between the control group and the surgery or arthroscopy examination(Z=-2.491,P<0.05). Conclusion: MRI can determine the extent of damage by morphological and signal changes of the knee meniscus. It can provide a very reliable basis for clinical diagnosis, which has high diagnostic value.

Clinical effect of arthroscopic repair and reconstruction of anterior cruciate ligament (ACL) combined meniscus injury / 中国内镜杂志

Objective To investigate the clinical effects of arthroscopic repair and reconstruction of anterior cruciate ligament repair (ACL) combined meniscus injury. Methods 40 cases of patients with anterior cruciate ligament (ACL) combined meniscus injury were selected, they were divided into experimental group (also repair ACL and meniscus), control group (meniscus repair), the Lysholm scores before and after surgery of the two groups, as well as the postoperative Lysholm scores of the two groups were observed. Then compared the meniscal healing rate after surgery and meniscal reoperation rate after 2 years of the two groups. Results The postoperative Lysholm score after surgery was higher than before surgery, but the Lysholm score of the experimental group was higher than that in control group. The healing rate of the experimental group was higher than that in control group, the meniscus reoperation rate after 2 years was lower than that in control group. Conclusion Arthroscopic repair and reconstruction of anterior cruciate ligament (ACL) and meniscus injury can improve the cure rate, is conducive to postoperative rehabilitation, and the long-term effect is obvious, so is worthy of promoting.

DIAGNOSTIC SIGNIFICANCE OF MEDIAL MENISCUS INJURY IN ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION FAILURE / 中国修复重建外科杂志

OBJECTIVE: To explore the relationship between anterior cruciate ligament (ACL) reconstruction failure and medial meniscus injury and decide whether medial meniscus injury could be the judgment index for ACL reconstruction failure without trauma history. METHODS: Between March 2011 and December 2015, 117 patients underwent ACL reconstruction, and the clinical data were analyzed retrospectively. All patients had no trauma history after ACL resconstruction. MRI examination showed medial meniscus injury in 56 cases (observation group) and no medial meniscus injury in 61 cases (control group). There was no significant difference in gender, age, side, reconstructive surgery, and follow-up time between 2 groups (P>0.05). The KT-2000 arthrometer was used to measure the difference value of tibial anterior displacement between two knees in 30° knee flexion. Then wether the ACL reconsruction failure was judged according to the evaluation criteria proposed by Rijke et al. RESULTS: In observation group, the difference value of tibial anterior displacement was 5 mm in 38 patients. In control group, the difference value of tibial anterior displacement was 5 mm in 12 patients. The ACL reconstruction failure rate of observation group (67.9%) was significantly higher than that of control group (19.7%) (χ2=27.700, P=0.000). CONCLUSIONS: After ACL reconstruction, medial meniscus injury occurs under no trauma history circumstances, indicating ACL reconstruction failure.

Clinical observation of arthroscopy surgery on patients with meniscus injury / 中国综合临床

Objective To explore the clinical effect of arthroscopy surgery on patients with meniscus injury. Methods Eighty-six patients with meniscus injury were randomly and voluntarily divided into the control group(n=43)and observation group(n=43). The patients in the control group were given traditional half open meniscectomy,while in the observation group were given arthroscopy surgery. The operation time,time of postoperative functional activity,time of hospitalization,complications and clinical effect between the two groups were recorded and compared. Results The operation time,time of postoperative functional activity,time of hospitalization in observation group were(56. 8 ± 9. 8)min,(24. 6 ± 6. 8)d,(6. 6 ± 2. 5)d and 4. 7%,lower than that in control group((84. 6 ± 16. 5)min,(39. 2 ± 9. 4)d,(9. 9 ± 3. 2)d),and the differences were statistically significant(t=5. 428,4. 763,4. 784;P ﹤0. 05). The complications rates in observation group was 4. 7%( 2/43 ),significantly lower than that of control group( 20. 9%( 9/43 ),χ2 =5. 473,P ﹤0. 05 ). The efficient of the observation group was 93. 0%( 40/73 ),obviously higher than that of control group( 74. 4%(32/43),χ2 =5. 460,P=0. 019). Conclusion The arthroscopic assisted surgery treatment of meniscus injury can maximum limit retains the meniscus and restore the function of the knee joint. It is minimally invasive and worth popularizing in clinical application.