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At least 289 records · Page 16Linked to original sources
PubMed1997

A novel method of tear collection: comparison of glass capillary micropipettes with porous polyester rods.

PURPOSE: To develop a rapid, user-friendly method of tear collection to facilitate tear-protein analysis. METHODS: Tears were collected from a total of 19 normal volunteers without evidence of ocular-surface disease with either porous polyester rods or glass-capillary micropipettes. Tear-collection rate and recovery of two tear proteins, epidermal growth factor (EGF, low abundance) and lactoferrin (LFR, high abundance) were compared between polyester rods and glass-capillary micropipettes. The recovery of LFR and EGF and the stability of these proteins after storage at -70 degrees C were quantitated by specific monoclonal enzyme-linked immunosorbent assay (ELISA). RESULTS: Polyester rods collected tears an average of 3.9-fold faster than glass-capillary micropipettes (p < 0.001). Both methods were comparable in efficacy of protein recovery. The polyester rods demonstrated a trend toward enhanced recovery, but this difference was not statistically significant (p = 0.12, LFR; p = 0.055, EGF). Analysis of the reliability and reproducibility of the tear-collection assay system revealed that ELISA analysis is highly reproducible, but there is significant day-to-day variation in tear-protein levels of both LFR and EGF for a given volunteer. Both LFR and EGF displayed a trend toward enhanced detection by ELISA shortly after freezing at -70 degrees C and slow decay after storage at -70 degrees C for up to 72 and 105 days, respectively. After stimulation of reflex tearing via the nasolacrimal reflex, LFR levels remained relatively constant, whereas EGF levels for most patients declined and then plateaued. CONCLUSIONS: Polyester rods provide a more rapid, user-friendly alternative to glass-capillary micropipettes for the collection and analysis of tear fluid and tear proteins. Polyester rods may have greater clinical utility, facilitating routine analysis of the preocular tear film.

Enzyme-Linked Immunosorbent Assay↗
PubMed2002

MR imaging of meniscal bucket-handle tears: a review of signs and their relation to arthroscopic classification.

Our objective was to review the MR imaging signs of meniscal bucket-handle tears and assess the relevance of these signs to the arthroscopic classification of displaced meniscal tears. Forty-five menisci in 42 patients who had a diagnosis of bucket-handle tear either on MR imaging or on subsequent arthroscopy (in which Dandy's classification of meniscal tears was used) were retrospectively analyzed for MR imaging findings of double posterior cruciate ligament (PCL), fragment within the intercondylar notch, absent bow tie, flipped meniscus, double-anterior horn, and disproportional posterior horn signs. Arthroscopy, which was considered as the gold standard, revealed 41 bucket-handle tears (either diagnosed or not diagnosed by MR imaging) in 38 patients (33 males, 5 females). There was a statistically significant male preponderance for the occurrence of meniscal bucket-handle tears. Overall, sensitivity and positive predictive value of MR imaging for the detection of meniscal bucket-handle tears were calculated as 90%. Common MR imaging signs of meniscal bucket-handle tears in arthroscopically proven cases of such tears were the fragment in the notch and absent bow tie signs (98% frequency for each). Double-PCL, flipped meniscus, double-anterior horn, and disproportional posterior horn signs, however, were less common (32, 29, 29, and 27%, respectively). An arthroscopically proven bucket-handle tear was found in all patients who displayed at least three of the six MR imaging signs of meniscal bucket-handle tears. The presence of three or more MR imaging signs of meniscal bucket-handle tears is highly suggestive of this condition.

Adolescent↗
PubMedDate not supplied

Results of early operative treatment of rotator cuff tears with acute symptoms.

The distinction among an acute tear, acute symptoms of a chronic tear, or the acute extension of an existing chronic tear is very difficult, if not impossible, to make. In general, operative treatment of lesions with a sudden onset has yielded favorable results in many studies. However, the timing of the operation for tears with an acute onset of symptoms is still a very controversial issue, as are the treatment options for chronic tears with acute symptoms. This study analyzes the follow-up results of early operative treatment of rotator cuff tears with an acute onset of symptoms, regardless of tear type. Twenty-nine patients with a sudden onset of symptoms and significant impairment of shoulder function had a full-thickness rotator cuff tear. The patients were operated on within 3 weeks from the beginning of the symptoms. Twenty-six patients underwent follow-up. The results were evaluated by use of the UCLA shoulder rating scale. At follow-up, 22 patients (85%) had no pain and 21 (81%) had returned to normal activities and had normal shoulder function. Active forward flexion averaged 51 degrees preoperatively and 167 degrees at follow-up. After repair of the tear, shoulder strength was normal in 22 of 26 shoulders (85%); 3 patients had fair strength, all after repair of a massive tear. Of the patients, 25 (96%) were satisfied with the result. The overall result was excellent in 20 patients (77%), good in 4 (15%), fair in 1 (4%), and poor in 1 (4%). Early operative treatment appears to be better for rotator cuff tears with a sudden onset of symptoms and poor function to achieve maximal return of shoulder function. With time, the tear may enlarge, and the cuff may lose its elasticity, thus making the late surgical repair more difficult or even impossible.

Acute Disease↗
PubMed1996

Histological analysis of the coracoacromial arch: correlation between age-related changes and rotator cuff tears.

The purpose of this study was to analyze age-related changes in the coracoacromial arch and correlate these degenerative changes with rotator cuff tears. We obtained 80 shoulders from 40 cadavers. The mean age at death was 58.4 years. We performed a gross examination of the rotator cuff and the acromion and histological examination of the coracoacromial ligament. The statistical significance of any difference for each group considered was determined by Student's t-test. The rotator cuff was normal in 66 specimens; there was an articular-side partial tear in 4 cases, a bursal-side partial tear in 6 cases, and a full-thickness tear in 4 cases. Age was correlated with increasing incidence and severity of cuff tears. We noted age-related degenerative changes in the coracoacromial ligament, degeneration of the acromial bone-ligament junction, and acromial spur formation. Anterior acromial spur was not related to the morphology of the acromion. We observed an increased incidence of bursal-side and complete cuff tears when the acromion was curved or beaked. Degenerative changes in the undersurface of the acromion were also present when the rotator cuff was normal. Bursal-side and complete cuff tears were associated with severe degenerative changes in the acromion in 100% of cases. Articular-side cuff tears were not related either to acromial morphology or degenerative changes in the coracoacromial arch. The association between cuff tears and acromial spur was more evident in the presence of a type III acromion. Our results would suggest that the incidence and severity of rotator cuff tears are correlated with aging and with the morphology of the acromion. Rotator cuff tears that involve the bursal side are often associated with changes in the coracoacromial ligament and the undersurface of the acromion. However, degenerative changes in the coracoacromial arch are always related to aging, also in the presence of a normal rotator cuff. Articular-side partial tears do not cause damage to the undersurface of the acromion.

Acromioclavicular Joint↗
PubMedDate not supplied

Creation of reentry tears in aortic dissection by means of percutaneous balloon fenestration: gross anatomic and histologic considerations.

PURPOSE: To study the safety and efficacy of percutaneous fenestration in aortic dissection, transmural tears in canine and human aortae were created with conventional angioplasty balloons. MATERIALS AND METHODS: Tears created in the aortae of five living dogs were compared with tears created in postmortem specimens. Percutaneous fenestration was performed in a woman with acute type I dissection and ischemic hepatitis who died in multisystem failure, and the balloon tear was documented at autopsy. Additional tears in the human aorta were studied in necropsy specimens of normal, Marfanoid, atherosclerotic, and acutely and chronically dissected thoracic and abdominal aortae. RESULTS: In the canine aorta, transmural balloon tears resulted in rapid death of all five animals, and the tears were approximately 10% longer than tears created post mortem with the same balloon. In human aortic specimens, most transmural and all transseptal tears were linear and were oriented nearly perpendicular to the longitudinal axis of the aorta. Tears that were initiated near calcified plaques or large aortic branches extended in unpredictable directions. The transverse orientation of the tears coincided with the long axis of smooth muscle cells in the media of the intact aorta or the dissection septum. CONCLUSION: Percutaneous balloon fenestration, when performed in areas of the aorta relatively free of atherosclerosis, results in transverse tears in the aortic dissection septum. Percutaneous fenestration of the aortic dissection septum appears feasible and should be considered as a treatment option in carefully selected cases of aortic dissection with ischemic complications. A final conclusion regarding the safety and efficacy of percutaneous fenestration undertaken to relieve organ ischemia requires further clinical experience.

Aged↗
PubMedDate not supplied

Results of rasping of meniscal tears with and without anterior cruciate ligament injury as evaluated by second-look arthroscopy.

PURPOSE: Meniscal rasping without suturing has been experimentally shown to stimulate vascular induction in tears in the avascular zone of menisci, resulting in meniscal healing. The goals of this study were to arthroscopically assess the results of meniscal rasping and analyze the factors affecting meniscal healing. TYPE OF STUDY: Retrospective cohort study. METHODS: Forty-eight torn menisci in 47 patients (age range, 14-47 years; average, 24 years) treated arthroscopically with the meniscal rasping technique were evaluated by second-look arthroscopy. The interval between the injury and the time of surgery ranged from 3 weeks to 13 years. There were 35 lateral and 13 medial meniscal tears associated with 44 anterior cruciate ligament injuries; 28 of the menisci had a full-thickness longitudinal tear and the other 20 had a partial-thickness tear. The length of the tears ranged from 10 to 33 mm (mean, 14.4 mm). The distance from the capsule to the tear ranged from 1 to 9 mm (mean, 5.0 mm). RESULTS: Thirty-four menisci (71%) healed completely (without a marked visible unhealed area), 10 (21%) healed incompletely, and 4 (8%) showed no evidence of healing. There were no relationships between outcome and age, gender, injured side, or time from injury and rasping. Both the distance from the capsule to the tear and the length of the tear were longer in the unhealed menisci. Stable tears had a high healing rate after meniscal rasping. CONCLUSIONS: Meniscal rasping without suturing is an easy procedure to perform and seems to be a reliable way to repair longitudinal tears in the avascular region of the meniscus, although the healing potential of the procedure is affected by the distance from the capsule to the tear site and the length and the stability of the tear.

Adolescent↗
PubMed2003

Magnetic resonance discography in cadavers: tears of the annulus fibrosus.

The purpose of this study was to investigate the diagnostic capabilities of magnetic resonance discography in the detection of tears of the annulus fibrosus, and to compare the findings with those derived from conventional magnetic resonance imaging. Twenty-four intervertebral discs from cadavers were examined with magnetic resonance imaging and magnetic resonance discography, and anatomic correlation was done. Forty-six annular tears were documented on anatomic inspection of the specimens. Magnetic resonance discography allowed significantly better observation of radial than transverse annular tears, and identification of radial tears was significantly better than that of concentric tears. With magnetic resonance discography, detectability of concentric tears was not significantly better than that of the transverse tears. No significant differences in the detection of different types of annular tears were appreciated on the magnetic resonance images obtained before discography. Magnetic resonance discography allowed direct diagnosis of radial, transverse, and concentric tears in 100%, 57%, and 21% of specimens, respectively. With magnetic resonance imaging, the diagnosis of radial, transverse, and concentric tears was possible in 67%, 71%, and 21% of specimens, respectively. Magnetic resonance discography does well in the evaluation of the clinically important radial tears of the annulus fibrosus, although not uniformly well in the identification of other types of annular tears.

Aged↗
PubMed1995

Digital subtraction shoulder arthrography in determining site and size of rotator cuff tear.

RATIONALE AND OBJECTIVES: To evaluate the value of digital subtraction arthrographic techniques in assessing the precise size and site of rotator cuff tear. PATIENTS AND METHODS: Prospectively interpreted findings of 29 digital arthrographs were compared with results after surgery in 22 patients and with results after arthroscopy in 7 patients. RESULTS: Surgery or arthroscopy revealed 14 full-thickness and 2 partial-thickness tears. Digital subtraction arthrography showed 88% (14 of 16) of the rotator cuff tears, 86% (12 of 14) of the full-thickness tears, and 100% (2 of 2) of the partial-thickness tears. The site of a tear could be shown in 86% (12 of 14), but the size was evaluated to be less extensive than that seen at surgery in most tears (63%, 10 of 16). CONCLUSIONS: The site of tears could be demonstrated in supraspinatus tendon tears, but measurements of the size of the tears were accurate only in small full-thickness and in partial-thickness tears. Very anterior and posterior tears may not be diagnosed with this method, and postexercise films were necessary to avoid false-negative findings.

Adult↗
PubMed1998

The fate of meniscal tears after anterior cruciate ligament reconstruction.

OBJECTIVE: To investigate the incidence of meniscal pathology and subsequent treatment at an index arthroscopically assisted reconstruction of acute ACL tears (<3 weeks after injury) and to determine the outcome of meniscal pathology. DESIGN: Cohort study with average postoperative follow-up of 40 months (range, 24-76 months). SETTING: University-based sports medicine center. PATIENTS: Series of 162 patients admitted between January 1989 and July 1993. Follow-up was obtained for 105 patients. MAIN OUTCOME MEASURES: Initial presence, location, and treatment of meniscal tears. Subsequent surgery performed and further investigation or surgery being planned. RESULTS: Approximately 40% of patients had meniscal pathology at the index procedure. Most tears were in the lateral meniscus (34 of 45). All posterolateral tears and most other small tears were left untreated (25 of 45). Partial meniscectomies were performed on 17 large, complex, or radial tears that were not amenable to meniscal resuturing. Three meniscal repairs were performed on large, unstable tears. Most patients achieved good functional results. Of the five patients who required late meniscal surgery, three had normal menisci at the index procedure. The other two were asymptomatic until experiencing a reinjury. Despite ACL reconstruction in the acute phase, only two patients required treatment for postoperative arthrofibrosis. Three patients required revision ACL reconstruction after return to full activities and experiencing reinjuries. CONCLUSIONS: Stable tears of both lateral and medial menisci remain asymptomatic at 2 to 6 years' follow-up if treated conservatively. Those requiring further surgery had de novo tears or tears that were asymptomatic before reinjury. Although repair may be of benefit for large flap or bucket-handle tears, it does not appear necessary for most tears and may increase the incidence of postoperative stiffness.

Adult↗
PubMed2003

Relative costs of various preserved artificial tear solutions for the treatment of dry eye conditions.

PURPOSE: Tear substitutes are one of the primary treatment modalities for dry eye conditions. The goal of this research was to determine the least costly preserved artificial tear product for treating patients with mild dry eye conditions. METHODS: Eight manufacturers' samples of artificial tears were examined to determine the effect of bottle angle on the dispensing drop size, the average drop volume, the number of drops per bottle, the measured volume of a bottle compared with its advertised volume, and the approximate cost per year for dry eye treatment. Drop sizes (mass) were determined by weighing to the nearest milligram. The retail cost was assessed to determine the most economical tear substitute. RESULTS: For all samples tested, a smaller drop was produced when the bottle was held at a 45-degree angle as compared with a 90-degree angle from horizontal. At a 45-degree angle, Natural Tears Formula by Murine and Artificial Tears by Heath Pride produced the smallest drops, less than 0.030 g, closest to the volume of the lacrimal lake. Smaller drop size produced accordingly more drops per bottle. The measured total bottle volume averaged 3.5% more than the volumes stated on the labels. The most inexpensive sample based on cost per year of treatment was Natural Tears Formula by Murine at $11.29 annually. CONCLUSIONS: Cost comparison of commercial over-the-counter artificial tears is an important factor to patients being treated for a dry eye condition. Several factors are important when considering the economics of article tear substitutes: drop size, number of drops per bottle, the volume of the bottle, and the cost of treatment per year. Because this information may not be readily available to patients, it is of great importance that physicians educate their patients to make treatment of dry eye as affordable as possible. The least expensive artificial tear treatments could require prolonged use of the same bottle, which may be associated with contamination of the contents of that bottle over time. The potential contamination with the long-term use of artificial tears in a bottle is significant. Patients using the least expensive artificial tear treatments should be advised against prolonged use of the same bottle.

Drug Costs↗
PubMed1994

Third degree obstetric anal sphincter tears: risk factors and outcome of primary repair.

OBJECTIVES: To determine (i) risk factors in the development of third degree obstetric tears and (ii) the success of primary sphincter repair. DESIGN: (i) Retrospective analysis of obstetric variables in 50 women who had sustained a third degree tear, compared with the remaining 8553 vaginal deliveries during the same period. (ii) Women who had sustained a third degree tear and had primary sphincter repair and control subjects were interviewed and investigated with anal endosonography, anal manometry, and pudendal nerve terminal motor latency measurements. SETTING: Antenatal clinic in teaching hospital in inner London. SUBJECTS: (i) All women (n = 8603) who delivered vaginally over a 31 month period. (ii) 34 women who sustained a third degree tear and 88 matched controls. MAIN OUTCOME MEASURES: Obstetric risk factors, defecatory symptoms, sonographic sphincter defects, and pudendal nerve damage. RESULTS: (i) Factors significantly associated with development of a third degree tear were: forceps delivery (50% v 7% in controls; P = 0.00001), primiparous delivery (85% v 43%; P = 0.00001), birth weight > 4 kg (P = 0.00002), and occipito-posterior position at delivery (P = 0.003). No third degree tear occurred during 351 vacuum extractions. Eleven of 25 (44%) women who were delivered without instruments and had a third degree tear did so despite a posterolateral episiotomy. (ii) Anal incontinence or faecal urgency was present in 16 women with tears and 11 controls (47% v 13%; P = 0.00001). Sonographic sphincter defects were identified in 29 with tears and 29 controls (85% v 33%; P = 0.00001). Every symptomatic patient had persistent combined internal and external sphincter defects, and these were associated with significantly lower anal pressures. Pudendal nerve terminal motor latency measurements were not significantly different. CONCLUSIONS: Vacuum extraction is associated with fewer third degree tears than forceps delivery. An episiotomy does not always prevent a third degree tear. Primary repair is inadequate in most women who sustain third degree tears, most having residual sphincter defects and about half experiencing anal incontinence, which is caused by persistent mechanical sphincter disruption rather than pudendal nerve damage. Attention should be directed towards preventive obstetric practice and surgical techniques of repair.

Anal Canal↗
PubMed2006

Characteristics of displaceable and nondisplaceable meniscal tears at kinematic MR imaging of the knee.

PURPOSE: To prospectively determine if kinematic magnetic resonance (MR) imaging of the knee may demonstrate displacement of menisci with tears and, if so, to characterize displaceable and nondisplaceable meniscal tears. MATERIALS AND METHODS: The study was approved by the hospital's review board, and informed consent was obtained. Forty-two patients (30 men, 12 women; mean age, 36.9 years) with 43 arthroscopically documented meniscal tears visible at 1.5-T MR imaging underwent kinematic MR imaging with an open-configuration 0.5-T MR imager with their knees in supine neutral, supine with 90 degrees flexion and external or internal rotation, and upright weight-bearing positions. Analysis of meniscal movement was performed in different knee positions in the coronal MR imaging plane. Meniscal displacement--that is, meniscal movement of 3 mm or more (in the medial direction for the medial meniscus, in the lateral direction for the lateral meniscus)--was compared with the patient's pain level as assessed with a visual analog scale by using analysis of variance. RESULTS: Between the different knee positions, meniscal displacement of 3 mm or more (displaceable meniscal tears) was noted in 18 (42%) of 43 menisci with tears. Simultaneous occurrence of grade II or III ipsilateral collateral ligament lesions was present in all 18 displaceable meniscal tears, whereas a normal-appearing collateral ligament or collateral ligament lesion (grade I) was present in 22 of 25 nondisplaceable tears (P < .05). Displaced menisci most commonly had complex, radial, or longitudinal tear configurations (16 of 18, 89%). Patients with displaceable meniscal tears had significantly more pain than did patients with nondisplaceable meniscal tears (P < .001), independent of the concomitant knee abnormalities. CONCLUSION: Displaceable meniscal tears usually have longitudinal, radial, or complex configurations; such tears are associated with substantial ipsilateral collateral ligament lesions and pain.

Adolescent↗
PubMed1995

Acute traumatic tears of the rotator cuff: value of sonography.

PURPOSE: To determine the value of sonography in the evaluation of acute traumatic tears of the rotator cuff. MATERIALS AND METHODS: Preoperative sonography was performed within 3 weeks of trauma in 184 patients, 98 of whom underwent surgery. The rotator cuff tears were preoperatively classified as partial-thickness tears or as small, large, or massive full-thickness tears. Sonographic findings were correlated with surgical findings (n = 70) and arthroscopic inspection (n = 28). RESULTS: Adequate examination was possible in 163 (88%) of 184 patients. Sonography demonstrated 42 (91%) of 46 full-thickness tears and seven (78%) of nine partial-thickness tears. Sonography showed more extensive tears than were found at surgery in four (4%) of 98 patients and less extensive tears in seven (7%) of 98 patients. Sonographic patterns were a defect (31 [63%] of 49 tears), focal thinning (10 [21%] of 49 tears), and nonvisualization (eight [16%] of 49 tears). CONCLUSION: Sonography is useful in the evaluation of acute shoulder trauma when a rotator cuff tear is suspected and findings at plain radiography are negative.

Adult↗
PubMedDate not supplied

Prospective evaluation of 1485 meniscal tear patterns in patients with stable knees.

BACKGROUND: Despite emphasis on classifying meniscal tears based on healing potential of the tear, research has concentrated on unstable knees, and few reports have provided information regarding associated clinical variables in stable knees. PURPOSE: To report on a large series of meniscal tears in stable knees that have been carefully mapped by tear shape and tear zones to allow comparison with meniscal tears in unstable knees. STUDY DESIGN: Prospective case series, reviewed retrospectively. METHODS: A total of 1485 meniscal tears in stable knees were evaluated. Preoperatively, each patient underwent a standardized assessment. Each tear was carefully mapped at arthroscopy. Statistical analysis was performed to determine factors that may be associated with peripheral meniscal tears. RESULTS: The distribution and shape of tears varied significantly within the radial and circumferential zones in this stable knee population. Five prospective variables were associated with peripheral tears: gender, presence of an effusion, positive McMurray test, varus alignment, or a loss of extension more than 5 degrees. CONCLUSIONS: Patient demographic information and physical examination can be useful in identifying patients who may have a peripheral meniscus tear.

Adult↗
PubMed2005

Isolated and combined tears of the subscapularis tendon.

BACKGROUND: Isolated and combined subscapularis tendon tears are rare and are described in the literature only in small numbers. HYPOTHESIS: The outcome of surgical intervention for isolated and combined subscapularis tendon tears may be influenced by the tear pattern of the anterior rotator cuff and the period of time between trauma and surgical procedure. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Between 1994 and 1999, 34 shoulders with isolated traumatic tears (16 shoulders) or subscapularis tendon rupture combined with a supraspinatus tendon tear were treated operatively. The average patient age was 51 years, and the mean follow-up period was 37 months. For statistical analyses, the Friedman and Mann-Whitney tests were used. RESULTS: In patients with isolated tears, the Constant score rose from an average of 43.9 to 88.7 points (P < .01), and in patients with combined tears, it rose from an average of 40.6 to 74.7 points (P <.01). Isolated tears improved 14 points more than combined tears (P <.05). The delay between trauma and surgical intervention was inversely proportional to the improvement in the Constant score. The Spearman coefficient of correlation was -0.97 in isolated tears and -0.89 in combined tears. CONCLUSIONS: Young patients with isolated traumatic tears of the subscapularis tendon and immediate repair have the best prognostic factors for treatment. Accuracy in the trauma history and the clinical and radiographic examination is demanded.

Adult↗
PubMed2006

Meniscal tear characteristics in young athletes with a stable knee: arthroscopic evaluation.

BACKGROUND: There has been great interest in the literature regarding meniscal tears in unstable knees, but there is not as much information available on stable knees. PURPOSE: To report the characteristics of isolated meniscal tears (type and location) in athletes with intact cruciate ligaments. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Arthroscopic surgery was performed on 314 (83.1%) knees in the acute phase ( < 6 weeks) of injury and on 64 (16.9%) knees more than 6 weeks after injury for a total of 364 athletes (378 knees). Cooper's classification was used to classify the meniscal tears according to the type and location. RESULTS: Overall, 262 of 378 tears (69.3%) were located in the medial meniscus and 116 (30.7%) in the lateral meniscus. Vertical tears (77.5%) were significantly more frequent than were horizontal tears (22.5%; chi(2) test, P < .001). A total of 23.2% of tears involved the peripheral zones (zone 0 or 1), and tears that extended into the posterior horn accounted for 75.7%. Regarding the tear shape between male and female athletes, on both sides there were no statistically significant differences in the percentage of horizontal, bucket-handle, longitudinal, or radial tears. CONCLUSION: The characteristics of isolated meniscal tears differ with regard to the sport, sex, and tear location and type from those seen in unstable knees. This knowledge is useful in knee injury management.

Adolescent↗
PubMedDate not supplied

The frequency of Baker's cysts associated with meniscal tears.

We reviewed the films of 1760 patients who had magnetic resonance image scanning of the knee joint to assess the most common pathologic changes associated with an incidental finding of a Baker's cyst. Of the 1760 knees scanned, Baker's cysts were noted in 238. The cysts were classified as small (55%), medium (30%), or large (15%) and were primarily found on the medial side of the knee (94%). The menisci were evaluated and changes were classified as complete tears, where signal contacts the surface, or degenerative intrasubstance tears. One hundred eleven (47%) complete meniscal tears were found, and 88 (37%) degenerative tears. The majority of tears were found in the posterior horn of the medial meniscus (65 complete tears and 45 degenerative tears). Thus, 199 tears were found in 170 knees, and 106 of the 170 knees (62%) had tears of the posterior horn of the medial meniscus. Baker's cysts are frequent findings on physical examinations and on magnetic resonance imaging scans of the knee. They are thought to be due to intraarticular pathologic changes, usually posterior meniscal tears. This study documents the association between Baker's cysts and meniscal tears and notes that a complete tear is not necessary for the cyst to be present.

Adolescent↗
PubMed2001

Meniscal tears after anterior cruciate ligament reconstruction.

The aim of this study was to follow patients in whom preoperative MRI demonstrated grade-3 lesions in the medial meniscus but no visible tears at arthroscopic ACL reconstruction, and to ascertain whether these meniscal lesions would progress to definite tears after reconstruction. The Study population consisted of 19 patients with a mean age of 23.2 years. Intraoperative arthroscopy showed normal appearance in 16 of 19 menisci and mild degree superficial legions in 3 menisci. None of the patients had any special treatment for the menisci at surgery. As controls, 39 patients who showed no tears on MRI and arthroscopy were studied. All MR studies were performed on a 0.5 T MR unit with field echo pulse sequences. A slice thickness of 1.5 mm was used with no interslice gap. Grade-3 legions progressed to definite tears in 8 of the 19 studied patients (42.1%) 12 to 33 months after ACL reconstruction. The Remaining 11 patients showed only symptoms or signs suggesting meniscal tears during a mean follow-up of 26.1 months. In the controls, medial meniscal tears occurred in 2 of the 39 patients (5.1%) 15 to 18 months after reconstruction. The studied patients were divided into a tear group (n=8) and a no-tear group (n=11). When the number of slices with grade-3 lesions was compared between the 2 groups, the mean slice number in the tear group (5.8 slices) was significantly greater than that in the no-tear group (3.1 slices) (P<0.05). These results suggest that even if no visible tear is found at surgery, patients in whom grade-3 lesions are identified in many slices have a high risk of developing definite tears after ACL reconstruction.

Adolescent↗