The definition of indication for the surgical treatment on menisci

Elena Baburkina

Abstract


Pathology of knee menisci (KM) leads to osteoarthritis (OA) de­velopment in 20–40% in nearest 7–10 years after primary surgical treatment. The same situation is observed after the arthroscopic interventions.

Goal of investigation: to show the most common tactical mistakes during the surgical interventions on menisci.

Methods of investigation: the results of treatments of 131 patients with meniscus pathology of different genesis from 5 to 36 years after primary surgery. The patinets were divided into 3 groups: I (85 patietns) — meniscogenic syndrom, determined by congenital predisposition, II (19 patients) — traumatic injury of meniscus; III (7 patients) — pathic pathology. OA stages were determined according to Kellgren-Lawrence classification.

Results: the most common mistakes in the meniscus surgery were determined. It was found out, that the worst results developed in the conditions of frontal deformity on knee level. The resection of meniscus under these circumstances increased OA development. The development of pain, in remote terms after operation, localized in anterior parts determined by the status of femur-patella joint. It was proved that if an angle of varus deformity on knee joint (KJ) is equal to 8°, pressure on medial meniscus is increased on 30.8 %, that provokes its disruption. Outcome: its necessary to assess KJ structure during the planning of meniscus surgery. Lateral X-ray view charcterizes the interrelationship between patella and distal femur joint surface contacting with patella, that play a large role for determing an abnormality of patella-femoral joint. MRI and CT are the modern methods of investigation, meanwhile they allow to assess meniscus damage only, but not the status of KJ in general. That is why these methods of investigation are just additional for the patients with meniscus abnormality.

Keywords


meniscus; arthroscopy; knee joint structure abnormality; treatment tactics

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DOI: https://doi.org/10.15674/0030-59872016134-40

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