Popliteomeniscal fascicles tears with lateral meniscus instability: outcomes of arthroscopic surgical technique at mid-term follow-up.

PURPOSE: The popliteomeniscal fascicles (PMFs) are a crucial part of the posterolateral corner of the knee. They provide stability to the lateral meniscus and stabilize the joint during tibial internal rotation. The clinical diagnosis of a torn PMFs is difficult, and magnetic resonance imaging (MRI) may be inconclusive as well. The aim of the present study was to report the outcomes of a continuous series of patients affected by PMF lesions and treated with an arthroscopic repair. METHODS: Seventeen patients (average age of 22 ± 3.6 years) with PMF lesions and lateral meniscus instability were prospectively enrolled. All patients were evaluated with clinical examination, International Knee Documentation Committee (IKDC), Lysholm and Tegner scores and 1.5 T MRI. All patients had the same arthroscopic procedure consisting of meniscal repair with an all-inside meniscal repair system (mean 2.2 ± 0.77 anchors) and followed with the same postoperative protocol. RESULTS: All patients were available at a mean follow-up of 68 ± 24 months (range 49-84 months). Mean IKDC increased from 60.2 ± 13.5 to 83.1 ± 12, mean Lysholm score improved from 56.7 ± 8.2 to 89.8 ± 3.2, and mean Tegner score improved from 2.9 ± 1.3 to 6.5 ± 2. No intraoperative or postoperative complications were reported. MRI evaluation at 6-month follow-up showed successful healing of the menisco-popliteal fascicles in all cases. CONCLUSIONS: The diagnosis and treatment of tears of the PMFs is still debated. Diagnostic confirmation of tearing of the PMFs is usually determined at the time of arthroscopy. Meniscal repair with an all-inside meniscal repair system appears to be an excellent treatment option, since it yields good functional results at mid-term follow-up, no local complications, and complete radiographic healing at 6-month follow-up MRI. Further studies are needed to confirm these promising early results. LEVEL OF EVIDENCE: Case series, 4.

The influence of neglected stimuli on free drawing in a patient with hemi-inattention.

A patient with severe left hemi-inattention was found to be influenced by neglected stimuli in free drawing tasks. He was presented 64 sheets of paper: 32 had geometric figures on the left side and 32 on the right side. The patient was asked what he saw and invited to draw a subject of his choice on the sheet of paper. The patient always denied seeing anything when the figures were on the left side, while he identified the figures on the right side. Four judges examined the patient's drawings and all of them agreed that 11 drawings were influenced by neglected stimuli and none by non-neglected ones. The drawings he made were similar but not the exact reproduction of neglected figures. This finding confirms that visual processing can proceed without awareness in a patient with hemi-inattention.

Evaluation of the influence of illiteracy on neuropsychological performances by elderly persons.

The aim of the present study was to verify the role of the primary notions acquired in early school in the formation of a general strategy in elaboration of information. For this purpose we selected a tiny rural village in southern Italy which comprises a substantial number of elderly persons having very little formal schooling. These subjects were screened using a test battery composed of classic neuropsychological tests and reaction-time tests. In the subjects studied we observed a significant correlation between the amount of education and the neuropsychological performances, although no such correlation existed for reaction times. Subjects having little schooling (up to 3 years) performed better than the illiterate persons on the Constructional Apraxia test and on the Raven Matrices. However, the reaction times were similar in these groups. On this basis we claim that reaction-time tests might form a basic tool in evaluating cognitive performances of persons with very little schooling. Further, the primary notions learned during the first few years of schooling induce an improvement in mental strategies that is well-preserved in the normal aging process.