Simplified Technique for Arthroscopic Repair of the Meniscus Root Tear of the Knee.

This report describes the arthroscopic transtibial pullout repair technique using multiple simple stitch (MSS), which was used to treat a medial meniscus posterior root tear (MMPRT) of the knee. The most commonly used technique to address this type of MMPRT is currently arthroscopic transtibial pullout repair. MSS pullout repair technique can provide excellent pullout strength and large tissue-bone contact area, which facilitates successful healing potential.

A technique for repairing rotator cuff transtendinous tears with a remnant attached to the footprint.

Background: Some unusual rotator cuff (RC) tears are located in more proximal tendinous portions, with substantial remnant tissue attached to the footprint. The two options for surgical repair are sacrificing or preserving the remnant tissue. We introduce a surgical repair technique that preserves as much of the remnant footprint as possible.

Staged patellar tendon reconstruction using doubled bone-patellar tendon-bone allograft for infected patellar tendon rupture: a rare case report of three years follow-up.

Background: Patellar tendon rupture is a relatively rare injury that usually requires surgical treatment. The optimal therapeutic strategy is still controversial, especially when either concomitant patellar tendon infection or soft tissue infection surrounds the patellar tendon. Until recently, most reported reconstruction methods are extensive and difficult to apply because of the poor condition of the soft tissue surrounding the patellar tendon.

Arthroscopic treatment of Mycobacterium massiliense septic arthritis outbreak after intra-articular injection: A case-series report and literature review.

Non-tuberculous mycobacteria (NTM) comprise mycobacteria, with the exceptions of Mycobacterium (M.) leprae and the M. tuberculosis complex.

Preservation of the Tibial Remnant in Anterior Cruciate Ligament Reconstruction May Improve Postoperative Proprioceptive Function.

The purpose of this study was to retrospectively compare clinical results, including proprioceptive function, after anterior cruciate ligament (ACL) reconstruction between 2 groups using techniques that preserve and eliminate the tibial remnant. Forty-eight patients who were followed for at least 24 months after ACL reconstruction with 4-strand hamstring tendon autografts were enrolled in this study. They were then divided into 2 groups: the remnant-preserving group (group A, 26 patients), in whom more than 7 mm of the remnant tibial stump (approximately 20% of the mean length of the ACL) was preserved; and the remnant-eliminating group (group B, 22 patients), in whom the tibial remnant was eliminated during ACL reconstruction.

A potential risk factor of total knee arthroplasty: an infected Baker's cyst - a case report.

Background: In adults, Baker's cyst development is attributable principally to secondary alterations after degenerative changes. The latter changes often accompany osteoarthritis, and we frequently encounter patients with Baker's cysts seeking total knee arthroplasty (TKA). Baker's cysts are not usually subject to extensive preoperative evaluation because the cysts often disappear naturally after surgery, unaccompanied by any adverse symptoms.

Isolated tear of the cord-like middle glenohumeral ligament in Buford complex: A case report.

Rationale: We describe a rare case of the isolated tear in the cord-like middle glenohumeral ligament (MGHL) in Buford complex. To the best of our knowledge, this is the first report in the English literature about the isolated tear of cord-like MGHL in Buford complex. The present report describes in detail our experience with the diagnosis of isolated tear of the cord-like MGHL in Buford complex and management.

Does the tibial remnant of the anterior cruciate ligament promote ligamentization?

Background: The purpose of this study was to clarify the difference in ligamentization between the remnant-preserving (RP) and remnant-sacrificing (RS) techniques in anterior cruciate ligament (ACL) reconstruction using magnetic resonance imaging (MRI).

Methods: A retrospective comparative study was carried out on 98 patients undergoing ACL reconstruction using either an RP (n=56) or RS (n=42) technique. MRI was performed at one of four time points postoperatively, and the signal intensity of the ACL graft was analyzed using the signal to noise quotient (SNQ) ratio and inter-bundle high signal intensity, along with an analysis of the survival rate of remnant tissue.

Clinical features and treatment outcomes of septic arthritis due to Mycobacterium massiliense associated with intra-articular injection: a case report.

Background: There are increasing reports on nosocomial Mycobacterium massiliense infection, but septic arthritis and osteomyelitis because of that microorganism is rare. This report focuses on the clinical aspects of M. massiliense arthritis outbreak concurrent with soft tissue infection.

Anatomic Single-Bundle Anterior Cruciate Ligament Reconstruction With Remnant Preservation Using Outside-In Technique.

This report describes a modified anatomic single-bundle anterior cruciate ligament (ACL) reconstruction technique using the FlipCutter guide pin (Arthrex, Naples, FL) as a retrograde drill and a cortical suspensory fixation device (TightRope; Arthrex) with an adjustable graft loop length. Preservation of the ACL remnant as a biological sleeve for the graft is an important issue from the viewpoints of acceleration of revascularization and ligamentization, preservation of the proprioceptive nerve fibers, enhancement of the biological environment for healing, and maintenance of the anchor point at the native tibial attachment, in addition to yielding a lower incidence of tibial bone tunnel enlargement. The goal of our technique is to obtain some advantages of the remnant-preserving technique through an anatomic single-bundle ACL reconstruction, which is performed to minimize damage to the ACL tibial remnant.

Concomitant Osteochondral Autograft Transplantation and Fixation of Osteochondral Fragment for Treatment of a Massive Osteochondritis Dissecans: A Report of 8-Year Follow-up Results.

Numerous procedures exist to treat osteochondritis dissecans (OCD); however, it remains a topic of debate which procedure is most ideal. When restoring a massive osteochondral defect, the use of only one procedure may not always allow complete filling of the defect. This case report presents a massive OCD with displaced osteochondral fragment and loose body in the knee joint that occupied almost all of the weight bearing area of the medial femoral condyle and was treated with concomitant osteochondral autograft transplantation and fixation of displaced osteochondral fragment.

A pulled sutures technique for bony Bankart lesion.

In an attempt to present a new surgical technique for arthroscopic bony Bankart fixation, the authors developed the pulled sutures technique. In executing the new method, the authors first passed several non-absorbable sutures through labroligamentous tissue with displaced articular fragment by mimicking transglenoid suture technique. Aimed at achieving a safe and stable fixation, using a knotless anchor rather than transglenoid suture, was deployed.

A case of intra-articular synovial lipoma of the knee joint causing patellar dislocation.

Intra-articular synovial lipoma is rare and clinically manifested mostly by mass effect and occasionally by torsion of the stalk. Patellar dislocation rarely occurs owing to a mass effect of intra-articular tumor of the knee joint. The authors present a case of large intra-articular synovial lipoma at the lateral gutter of the knee joint, which presents as patellar dislocation.

Immunohistochemical study of mechanoreceptors in the tibial remnant of the ruptured anterior cruciate ligament in human knees.

This study was performed to identify the mechanoreceptors in the tibial remnants of ruptured human anterior cruciate ligaments (ACL) by immunohistochemical staining. Thirty-six specimens of tibial ACL remnants were obtained from patients with ACL ruptures during arthroscopic ACL reconstruction. As control, two normal ACL specimens were taken from healthy knee amputated at thigh level due to trauma.

A case of compression fracture of medial tibial plateau and medial femoral condyle combined with posterior cruciate ligament and posterolateral corner injury.

We report a case of compression fracture of anterior margin of medial tibial plateau and medial femoral condyle combined with the posterior cruciate ligament and posterolateral corner disruption. A thirty-seven-year old male had undergone the left knee injury 6 months before. The physical examination revealed positive posterior drawer test and tibial dial test, which evidenced the posterior cruciate ligament and posterolateral corner insufficiency.

Migration to the popliteal fossa of broken wires from a fixed patellar fracture.

Breakage of K-wires and wires which are used for fracture fixation is not uncommon, but migration is rare. The authors experienced two cases of symptomatic migration of broken K-wire and wires used for patellar fixation to the popliteal fossa. Migration of broken hardware happened 3 and 4 years after fixation.

Arthroscopic excision of the ganglion in the posterior septum by posterior trans-septal portal: report of two cases.

We report two cases of ganglion cysts in the posterior septum of the knee joint, one as parameniscal cyst from the posterior horn of the lateral meniscus extending to posterior septum, and the other as a cyst located in the posterior septum adjacent to the posterior cruciate ligament, which were both arthroscopically excised expediently by posterior trans-septal portal. The posterior compartment of the knee is not readily accessible by ordinary arthroscopic portals, and therefore has been considered as 'blind spot' conventionally. The posterior trans-septal portal is useful for assorted diagnostic or manipulative procedures in the posterior compartment of the knee.

Comparison of clinical results according to amount of preserved remnant in arthroscopic anterior cruciate ligament reconstruction using quadrupled hamstring graft.

Purpose: The purpose of this study was to analyze the clinical results of anterior cruciate ligament (ACL) reconstruction with the remnant-preserving technique by use of a hamstring graft and looped sutures according to the amount of the tibial remnant of the ACL.

Methods: Sixteen subjects had undergone ACL reconstruction with the remnant-preserving technique by use of 4 strands of a hamstring tendon and a looped suture technique and were followed up for at least 12 months. The mean follow-up was 35.

Bilateral symptomatic discoid medial meniscus: report of three cases.

Discoid medial meniscus is very rare and bilateral discoid medial meniscus is extremely rare. We report symptomatic bilateral discoid meniscus with abnormal attachment to anterior cruciate ligament (ACL) in three patients and we think that our report is a combination of very rare conditions. The patients had symptoms in both sides and we performed magnetic resonance imaging (MRI) and operated five knees.

Arthroscopic anterior cruciate ligament reconstruction with the tibial-remnant preserving technique using a hamstring graft.

We propose that the tibial remnant of the anterior cruciate ligament (ACL) is able to enhance the revascularization and cellular proliferation of the graft, to preserve proprioceptive function, and to be able to acquire anatomic placement of the graft without roof impingement. Therefore, it seems reasonable to assume that preserving the tibial remnant as much as possible as a source of reinnervation, if technically possible without causing impingement, would be of potential benefit to the patient. Our surgical technique was developed to maximize the preservation of the tibial remnant.

Arthroscopic retrieval of a very rare penetrating foreign body of the knee.

We report the very rare case of an 8-year-old boy who accidentally fell on the ground, causing the lead of a pencil to penetrate his left knee joint cavity. After radiographic diagnosis, the pencil was removed by a physician at a private clinic and the boy was referred to our department for further evaluation. We performed arthroscopic retrieval of the pencil lead through standard arthroscopic portals without an accessory portal.

Arthroscopic treatment of symptomatic discoid lateral meniscus in a 26-month-old girl.

Discoid lateral meniscus is a well-documented pathology, but symptomatic discoid lateral meniscus in a very young child and arthroscopic management are extremely rarely reported. We report a case of symptomatic discoid lateral meniscus in a 26-month-old girl who showed limping and extension loss after a minor trauma. Physical examination revealed clicking and 10 degrees terminal extension loss, which was suggestive of the torn discoid meniscus.