scholarly journals SAUCERIZATION OF DISCOID LATERAL MENISCI. HOW MUCH RESIDUAL WIDTH IS RIGHT?

2020 ◽  
Vol 8 (7_suppl6) ◽  
pp. 2325967120S0044
Author(s):  
Abdalla Abdalla ◽  
Molly Meadows ◽  
Thomas Rauer ◽  
Charles Chan ◽  
Theodore Ganley ◽  
...  

Objectives: Discoid lateral meniscus (DLM) is a congenital anomaly of the knee where the normally “O” shaped lateral meniscus has redundant tissue filling the “O” and covering the lateral tibial plateau. The redundant tissue can degenerate and cause mechanical symptoms and pain. Treatment of symptomatic DLM is arthroscopic saucerization to reshape the meniscus to a more normal contour. Enough tissue must be removed to eliminate mechanical symptoms but not too much as to create instability. The residual width of the meniscus is crucial at the popliteus hiatus because here the peripheral rim is unattached to the capsule. The literature recommends a residual width of 6-8 mm. The primary purpose of this research was to determine the width of the meniscus at the popliteal hiatus in normal specimens. Our null hypothesis was that a residual width of 6-8 millimeters will be sufficient for saucerization of DLM. Methods: We made direct measurements of lateral meniscus radial width from the outer rim at the popliteus hiatus to the inner edge (Figure 1) in 19 specimens (ages 2 months to 11 years.) We measured one four-year-old specimen with bilateral complete DLM (Figure 2.) We also measured 39 digital images of specimens (ages 1-month to 12-years) using ImageJ. Finally, we made direct measurements of 8 skeletally mature specimens. Results: Figure 3 shows the relationship of meniscus width as a function age. The average width of specimens <3-years-old was 5.5mm. The average width of the ten-year-old specimens was 12mm. The average width of the skeletally mature specimens was 16mm. The four-year-old DLM specimen measured 19 mm. Conclusions: We rejected our null hypothesis. Direct measurements suggest that a residual width of 6-8mm is insufficient for children 8-years and older. A width of at least a full centimeter more closely approximates our findings, and for adolescents consider a residual rim of 15 mm. For children less than six-years-old a residual width of 6-8mm is sufficient.

2020 ◽  
Vol 8 (4_suppl3) ◽  
pp. 2325967120S0022
Author(s):  
Jamison G. Gamble ◽  
Abdalla B. Abdalla ◽  
Molly Meadows ◽  
Thomas Rauer ◽  
Charles M. Chan ◽  
...  

Background: Discoid lateral meniscus (DLM) is a congenital anomaly of the knee where the normally “O” shaped lateral meniscus has redundant tissue filling the “O” and covering the lateral tibial plateau. The redundant tissue can cause mechanical symptoms and pain. Treatment of symptomatic DLM is arthroscopic saucerization to reshape the meniscus to a more normal contour. Enough tissue must be removed to eliminate mechanical symptoms but not too much as to create instability. The residual width of the meniscus is crucial at the popliteus hiatus because here the peripheral rim is unattached to the capsule. The literature recommends a residual width of 6-8 mm.1,2 Purpose/Hypothesis: The primary purpose of this research is to determine the width of the meniscus at the popliteal hiatus in normal specimens. Our null hypothesis is that a residual width of 6-8 millimeters will be sufficient for saucerization of DLM. Methods: We made direct measurements of lateral meniscus radial width from the outer rim at the popliteus hiatus to the inner edge (Figure 1) in 19 specimens (ages 2 months to 120 months.) We measured one four-year-old specimen with bilateral complete DLM. We also measured 39 digital images of specimens (ages 1 month to 132 months) using ImageJ. Finally, we made direct measurements of 8 skeletally mature specimens. Results: Figure 2 shows the relationship of meniscus width as a function age. The average width of specimens <3-years-old was 5.5mm. The average width of the ten-year-old specimens was 12mm. The average width of the skeletally mature specimens was 16mm. The four-year-old DLM specimen measured 19 mm. Conclusions: We rejected our null hypothesis. Direct measurements suggest that a residual width of 6-8mm is insufficient for children 8-years and older. A width of at least a full centimeter more closely approximates our findings, and for adolescents consider a residual rim of 15 mm. For children less than six-years-old a residual width of 6-8mm is sufficient. References: Kocher MS, Logan CA, Kramer DE. Discoid lateral meniscus in children: diagnosis, management, and outcomes. J Am Acad Orthop Surg 2017;25:736-743. Hayashi LK, Yamaga H, Ida K, Miura T. Arthroscopic meniscectomy for discoid lateral meniscus in children. J Bone Joint Surg. 1988;70-A: 1495-1500. [Figure: see text][Figure: see text]


2021 ◽  
pp. 036354652110566
Author(s):  
Jamison G. Gamble ◽  
Abdalla B. Abdalla ◽  
Molly G. Meadows ◽  
Thomas Rauer ◽  
Charles M. Chan ◽  
...  

Background: A discoid lateral meniscus (DLM) is a congenital anomaly of the knee in which the lateral meniscus has an “O” shape and contains irregular, abnormal collagenous tissue. A DLM can cause mechanical symptoms and pain. Treatment of a symptomatic DLM is arthroscopic saucerization to reshape the meniscus to a more normal contour. Enough tissue must be removed to eliminate mechanical symptoms but not too much to create instability. The residual width of the meniscus is crucial at the popliteus hiatus because here the peripheral rim is unattached at the capsule. Reports in the literature recommend a residual width of 6 to 8 mm. Purpose/Hypothesis: The purpose of this research was to determine the width of the lateral meniscus at the popliteal hiatus in normal specimens. Our null hypothesis was that a residual width of 6 to 8 mm will be sufficient to approximate normal anatomy. Study Design: Cross-sectional study; Level of evidence, 3. Methods: We made direct measurements of the radial width of the lateral meniscus from the outer rim at the popliteal hiatus to the inner edge in 19 specimens (age, 2-120 months.) We measured one 4-year-old specimen with a bilateral complete DLM. We also measured 39 digital images of specimens (age, 1-132 months) using ImageJ. Finally, we made direct arthroscopic measurements of 8 skeletally mature specimens. Results: The average width of specimens <3 years old was 5.5 mm. The average width of the 10-year-old specimens was 12 mm. The average width of the skeletally mature specimens was 16 mm. A 4-year-old DLM specimen measured 19 mm. Conclusion: We rejected our null hypothesis. Direct measurements suggest that a residual width of 6 to 8 mm is insufficient for children ≥8 years old. A width of at least a full centimeter approximates the normal for 8-year-olds and at least 15 mm for adolescents.


Author(s):  
Iskandar Tamimi ◽  
David Bautista Enrique ◽  
Motaz Alaqueel ◽  
Jimmy Tat ◽  
Almudena Pérez Lara ◽  
...  

AbstractPrevious work has shown that the morphology of the knee joint is associated with the risk of primary anterior cruciate ligament (ACL) injury. The objective of this study is to analyze the effect of the meniscal height, anteroposterior distance of the lateral tibial plateau, and other morphological features of the knee joint on risk of ACL reconstruction failure. A nested case–control study was conducted on patients who underwent an ACL reconstruction surgery during the period between 2008 and 2015. Cases were individuals who failed surgery during the study period. Controls were patients who underwent primary ACL reconstruction surgery successfully during the study period. They were matched by age (±2 years), gender, surgeon, and follow-up time (±1 year). A morphological analysis of the knees was then performed using the preoperative magnetic resonance imaging scans. The anteroposterior distance of the medial and lateral tibial plateaus was measured on the T2 axial cuts. The nonweightbearing maximum height of the posterior horn of both menisci was measured on the T1 sagittal scans. Measurements of the medial and lateral tibial slope and meniscal slope were then taken from the sagittal T1 scans passing through the center of the medial and lateral tibial plateau. A binary logistic regression analysis was done to calculate crude and adjusted odds ratios (ORs) estimates. Thirty-four cases who underwent ACL revision surgery were selected and were matched with 68 controls. Cases had a lower lateral meniscal height (6.39 ± 1.2 vs. 7.02 ± 0.9, p = 0.008, power = 84.4%). No differences were found between the two groups regarding the bone slope of the lateral compartment (6.19 ± 4.8 vs. 6.92 ± 5.8, p = 0.552), the lateral meniscal slope (–0.28 ± 5.8 vs. –1.03 ± 4.7, p = 0.509), and the anteroposterior distance of the lateral tibial plateau (37.1 ± 5.4 vs. 35.6 ± 4, p = 0.165). In addition, no differences were found in the medial meniscus height between cases and controls (5.58 ± 1.2 vs. 5.81 ± 1.2, respectively, p = 0.394). There were also no differences between cases and controls involving the medial bone slope, medial meniscal slope, or anterior posterior distance of the medial tibial plateau. Female patients had a higher medial (4.8 degrees ± 3.2 vs. 3.3 ± 4.1, p = 0.047) and lateral (8.1 degrees ± 5.1 vs. 5.6 degrees  ± 5.6, p = 0.031) tibial bone slope, and a lower medial (5.3 mm ± 1.0 vs. 6.1 mm ± 1.2, p = 0.001) and lateral (6.6 ± 1.0 vs. 7.0 ± 1.2, p = 0.035) meniscus height, and medial (4.3 ± 0.4 vs. 4.8 ± 0.4, p =0.000) and lateral (3.3 ± 0.3 vs. 3.9 ± 0.4, p = 0.000) anteroposterior distance than males, respectively.The adjusted OR of suffering an ACL reconstruction failure compared to controls was 5.1 (95% confidence interval [CI]: 1.7–14.9, p = 0.003) for patients who had a lateral meniscus height under 6.0 mm. The adjusted OR of suffering an ACL reconstruction failure was 2.4 (95% CI: 1.0–7.7, p = 0.01) for patients who had an anteroposterior distance above 35.0 mm. Patients with a lateral meniscal height under 6.0 mm have a 5.1-fold risk of suffering an ACL reconstruction failure compared to individuals who have a lateral meniscal height above 6.0 mm. Patients with a higher anteroposterior distance of the lateral tibial plateau also have a higher risk of ACL reconstruction failure.


2021 ◽  
Vol 15 (11) ◽  
pp. 3101-3102
Author(s):  
Babar Javaid ◽  
Abrar Ahmed ◽  
Gohar Ali Arshad ◽  
M Shoaib Akhtar ◽  
Shazia Taj ◽  
...  

The study was designed to investigate the relationship of psychological well-being with depression and anxiety among heart patients.1 For this purpose, a sample of 200 patients was taken, including 100 men and 100 women, educated uneducated, employed and unemployed volunteers. The sample was taken from Nishtar Hospital, Combined military hospital and other private hospitals in Multan. The age range from 25 to 60 (mean age 43.085).2,3 Objective: To observe the effect of demographic variables (age, education, gender and source of finance) on psychological well-being and depression, anxiety in heart patients. Methods: 1. Low psychological well-being would be positively correlated with depression and anxiety. 2. Older age (above 50) heart patients would have low sense of psychological well-being as compared to younger age (above 35) heart patients. Results: Different statistical procedures were used to determine the relationship of psychological well-being with depression and anxiety among heart patients. Correlation was computed to see the relationship among variables. It was found that there is negative correlation between psychological well-being with depression and anxiety. Since the p-value in less than α (p-value < 0.01), so we reject null hypothesis Ho, and conclude that low psychological well-being is positively correlated with depression and anxiety. Conclusion: This study also finds out important findings on the role of stresses, feeling of worthlessness in depression and anxiety disorder. It is concluded that psychological well-being, depression and anxiety are not significant correlated with each other. Source of income or job and sex of the heart patients have significant effect on psychological well being. However there is no significant difference between men and women regarding the rate of depression and anxiety. Keywords: P-Value, Correlation, Null Hypothesis , Depression


2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Jan P. Kolb ◽  
Marc Regier ◽  
Eik Vettorazzi ◽  
Norbert Stiel ◽  
Jan P. Petersen ◽  
...  

Background. The influence of increasing lateral plateau widening on the frequency of meniscal and ligamentous lesions in lateral tibial plateau fractures has been examined in very few studies using plain radiographs. Because the amount of this parameter cannot be measured accurately on plain radiographs, the purpose of this survey was to look for a possible correlation between the extent of lateral plateau widening, as measured on multidetector CT (MDCT) scans, and different soft-tissue injuries determined from magnetic resonance imaging (MRI). Materials and Methods. 55 patients with a lateral tibial plateau fracture were included in this retrospective case series. Patient age averaged 52.6 years (SD = 18.0). The degree of lateral plateau widening was measured on CT images. MRIs were screened for meniscal and ligamentous injuries. Results. We found a significant effect of increasing lateral plateau widening on the incidence of lateral meniscus lesions (P = 0.021), lateral collateral ligament tears (P = 0.047), and the overall quantity of meniscal and ligamentous lesions (P = 0.001). Discussion. MRIs are not widely used as a diagnostic tool in lateral plateau fractures of the tibia. Reasons might be the costs and the fact that it is a time-consuming examination. The results of this study may help to estimate the probability of specific soft-tissue lesions in lateral tibial plateau fractures based on measurements of lateral plateau widening on MDCT scans, and they may guide the decision for additional MRI and/or arthroscopically assisted repair.


2019 ◽  
Vol IV (I) ◽  
pp. 21-30
Author(s):  
Malik Amer Atta ◽  
Qayyum Nawaz ◽  
Hafiz Azmat Ullah

The Problem under study was the relationship of population composition with enrollment of children at primary level. The study was significant because we can make forecasting of educational plans keeping in view the relationship. All the Primary School of the District Bannu was included in the population for the study. The sample was 05 Urban Male School, 05 Urban Female School, 05 Rural Male School, and 05 Rural Female School. The research instrument was a questionnaire. Through this questionnaire data was collected regarding schools from 2013 to 2019 in different classes. The null hypothesis that there is no relationship between the population composition and enrollment was tested. The result shows that the correlation between the enrollment and the population growth is 0.98. It is high correlation which indicates the strong relationship between the number of enrollment of student and population


2020 ◽  
Vol V (II) ◽  
pp. 35-44
Author(s):  
Malik Amer Atta ◽  
Qayyum Nawaz ◽  
Hafiz Azmat Ullah

The Problem under study was the relationship of population composition with enrollment of children at primary level. The study was significant because we can make forecasting of educational plans keeping in view the relationship. All the Primary School of the District Bannu was included in the population for the study. The sample was 05 Urban Male School, 05 Urban Female School, 05 Rural Male School, and 05 Rural Female School. The research instrument was a questionnaire. Through this questionnaire data was collected regarding schools from 2013 to 2019 in different classes. The null hypothesis that there is no relationship between the population composition and enrollment was tested. The result shows that the correlation between the enrollment and the population growth is 0.98. It is high correlation which indicates the strong relationship between the number of enrollments of student and population


2017 ◽  
Vol 5 (2_suppl2) ◽  
pp. 2325967117S0004
Author(s):  
Tunay Erden ◽  
Suat Batar ◽  
Gökçer Uzer ◽  
Demet Pepele Kurdal ◽  
Nurzat Elmalı

The use of arthroscopy in the management of tibial plateau fractures is not a particularly new concept. It has been used successfully for Schatzker types I–III fractures. In addition to evaluating the fracture itself, it is easier to evaluate the other intraarticular structures. Coventionally, reduction for lateral tibial plateau fractures have been performed through a laterally based metaphyseal window, which is not without limitations, including difficulty with reduction of the fracture, as well as bone grafting though the resultant short subchondral tunnel. Also, there is a risk of lateral vascular supply distrubtion because of same side fracture. A medially based metaphyseal window to approach lateral tibial plateau fractures allows for minimal insult to the soft tissues, with advantageous ease of reduction and grafting through a longer tunnel for subchondral support. We aimed to present our initial experiences in twelwe cases approaching lateral tibial plateau fractures through a medial metaphyseal window. Material-Methods: Our series involves 12 patients with 7 Schatzker type II, 3 Schatzker type I, and 2 Schatzker type III fractures. There were 8 males and 4 females. The average age at the time of surgery was 37 (25-57) years. All of the patients underwent plain radiography and BT in each knee Time from injury to surgery was 6.2 days. Follow up was 18 months (9-22 months).Firstly diagnostic arthroscopy was performed. Concomittant pathology was adreessed as needed. There was 3 lateral meniscus tear that treated with partial meniscectomy. An ACL guide pin was placed percutaneously anteromedial tibia approximately 9 cm distal to the joint line. Once stisfactory positioning a cortical window 1x2 cm. made around the guide pin. Reduction was accomplished with a bone tamp that fits easily into the tunnel. Screws were used as rafters to support the articular surface and subchondral bone. We used in 7 patients lateral plate and screws and in 5 patients only screws. Care was taken to keep pump pressure at approximately 40 millimeters of mercury for alleviate the risk of compartment syndrome. Results: No complications related to the procedure were observed. No secondary loss of reduction was observed in radiological controls. Functional assessment according to HSS of the patients were excellent in 5 cases, good in 5 cases and fair 2 cases. Discussion: Because depressed fragments are elevated from distal cortical windows, the importance of an intact, or easily restored, “cortical envelope” is paramount. This case series showed satisfactory early clinical results. [Figure: see text][Figure: see text]


2021 ◽  
Vol 9 (12) ◽  
pp. 232596712110622
Author(s):  
Joseph M. Brutico ◽  
Margaret L. Wright ◽  
Sarah I. Kamel ◽  
Adam C. Zoga ◽  
Kirsten Poehling-Monaghan ◽  
...  

Background: Several cadaveric imaging studies have demonstrated that the articular cartilage thickness on the tibial plateau varies depending on coverage by native meniscal tissue. These differences are thought to partially contribute to the rates of cartilage degeneration and development of osteoarthritis after meniscectomy. Because there is greater tibial plateau coverage with meniscal tissue in the setting of a discoid meniscus, these findings may also have implications for the long-term health of the knee after saucerization of a torn discoid meniscus. Purpose: To evaluate the relationship between lateral compartment articular cartilage thickness and the presence or absence of a discoid meniscus. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Included in the study were 25 patients younger than 40 years of age who had undergone a 1.5-T or 3-T knee magnetic resonance imaging (MRI) between 2010 and 2016 at a single institution and had an intact, lateral discoid meniscus. Only patients with an otherwise asymptomatic lateral compartment were included. The authors then identified 35 age-matched controls with a nondiscoid, intact lateral meniscus who underwent knee MRI at the same institution and during the same period. The articular cartilage thicknesses in 6 zones of the lateral femoral condyle (LFC) and lateral tibial plateau (LTP) were measured for each patient by 2 musculoskeletal radiologists, and the mean thicknesses were compared between the study and control groups. Results: The average age at MRI was 22.63 years (range, 8.30-35.90 years) for the discoid group and 20.93 years (range, 8.43-34.99 years) for the nondiscoid group. The nondiscoid group had significantly greater mean articular cartilage thickness in all 6 zones of the LTP ( P < .05 for all). When comparing the zones of the LFC, there was no significant difference in the mean thickness in any zone between the 2 groups. Conclusion: Patients with discoid menisci had thinner baseline articular cartilage thickness in the LTP compared with those patients without discoid menisci.


2021 ◽  
Vol 258 ◽  
pp. 12013
Author(s):  
Klara Gabdrakhmanova ◽  
Gulnara Izmailova ◽  
Lilia Samigullina ◽  
Muhammad Majidov

This article discusses the multiple regression analysis techniques to determine the effectiveness of the factors used. The study examines the various relationships between the elements. It is important to identify which factor will be the most important when selecting wells to determine the amount of oil recovery. Nowadays, the most important problem in the fields of Tatarstan and Bashkortostan is the depletion of deposits. To maintain the profitability of mining companies, therefore, the issue of preparing new reserves remains relevant. This process involves high costs and risks. For a more reliable picture, it is crucial to determine the most relevant factors. The use of the triad of studies proposed by the authors makes it possible to more reliably determine the effectiveness of oil companies. The initial data are direct measurements and methods of mathematical statistics that allow more accurate predictions. Statistical analysis made it possible to identify the parameters on which the effectiveness of the factors depends. In domestic practice, the assessment of resources and reserves of hydrocarbons is usually made by deterministic methods, while abroad the statistical method is used. When studying the relationships between objects, the analyst should be interested not only in the presence and quantitative assessment of the relations but also in the form and relationship of the effective and factor characteristics, its analytical expression. Correlation and regression analysis help to solve these problems. Correlation analysis aims to measure the tightness of the relationship between the varying variables and to evaluate the factors that have the greatest impact on the resulting trait. Regression analysis is designed to select the form of the relationship, to determine the calculated values of the dependent variable (the effective feature) [1]. For the factor analysis, we used data on the oil industry published in the annual statistical collections of Rosstat, as well as specialized periodicals for ten years.


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