Background: MENISCAL INJURY is a common problem that can lead to knee pain and dysfunction. MENISCAL repair and meniscectomy are two treatment approaches for MENISCAL INJURY, but the latter may increase the risk of osteoarthritis. We aimed to compare the 3-year outcomes of a new method of MENISCAL suturing with meniscectomy among patients with MENISCAL INJURY.    Methods: This retrospective cohort study compared MENISCAL repair (treatment group) and meniscectomy (control group) in patients with MENISCAL INJURY. We evaluated the outcomes of 134 patients. under treatment with these approaches based on the Lysholm scale, which measures knee function and symptoms. The study used the chi-square test and the Mann-Whitney U test to compare the proportion of patients with different outcomes and the Lysholm scale scores between the treatment and control groups. The study also conducted subgroup analyses based on gender and age using the Mann-Whitney U test. The level of significance was set at P < 0.05 for all statistical tests.    Results: The treatment group had a higher proportion of patients with excellent results, although the difference was not statistically significant (17.2% in the treatment group vs. 10.0% in the control group, P = 0.223). However, a comparative analysis of the proportion of patients with good results revealed statistically significant differences, with 67.2% of patients in the treatment group achieving good outcomes compared to 45.7% in the control group (χ2 = 6,256, df = 1 P = 0.012, HR 1,470 95%CI 1,081-1,999). The average score on the Lysholm scale was significantly higher in the treatment group (87.48, 95% CI 85.1-89.7, SD = 9.2) compared to the control group (81.73, 95% CI 78.4-84.9, SD = 13.7) (U = 1609, Z = -2.813, P = 0.005). Subgroup analyses based on gender and age also showed significant differences in the Lysholm scale scores.    Conclusion: The study demonstrates that MENISCAL repair is more effective than meniscectomy in improving patient outcomes, with a higher proportion of patients achieving excellent and good results and higher scores on the Lysholm scale. These findings support the use of MENISCAL repair as a preferred treatment approach for patients with MENISCAL injuries.

Background: Regarding the high incidence of MENISCAL injuries, a cost-effective, noninvasive, and also accurate diagnostic modality is highly needed. This study was conducted to assess the diagnostic value of sonography in detecting meniscus tears in comparison with arthrography.Methods: A total of 136 patients with symptoms of MENISCAL INJURY were examined with both sonography and arthrography by separate radiologists. The sensitivity, specificity, positive, and negative predictive values of sonography were calculated versus arthrography.Results: The sensitivity of sonography in diagnosing meniscustear was 75 percent, specificity 88 percent, positive predictive value 80 percent, and negative predictive value 85 percent.Conclusion: Our results show that we can't yet replace other methods with higher diagnostic value with sonography completely but regarding its advantages, it can be used along withother routine modalities.

Background: Knee maniacal and anterior cruciate ligament (ACL) injuries are common. Arthroscopic surgery for maniacal pathology is one of the most common arthroscopic operations done for knee derangement. Different clinical tests have been designed to pinpoint the status of ACL post trauma; such as Pivot Shift and Lachman. Meniscus tear is more commonly diagnosed clinically by Mc Murray test and joint line tenderness. Use of MRI, to confirm the diagnosis has become popular in recent years. Arthroscopic evaluation is a more direct and fruitful technique for diagnosis of such intra-articular pathologies. This study is aimed at assessing the value of clinical tests in diagnosis of ACL and meniscus injuries. Materials and Methods: 177 patients, underwent diagnostic knee arthroscopy in accordance with their positive clinical findings for meniscus or ACL INJURY. The clinical examinations were all done by a single surgeon and included Mc Murray testing, joint line tenderness, Lachman and Pivot Shift tests. The arthroscopic findings were compared with clinical pre-operative tests. The sensitivity, specificity, positive and negative predictive values of the clinical tests were calculated. Results: The sensitivities of tests for diagnoses of medial maniacal, lateral maniacal and ACL injuries were 98%, 60% and 95% respectively, while specificities were 97%, 100% and 98%. The positive predictive values were 97%, 100% and 96%; and the negative predictive value were 98%, 84% and 97%. Conclusion: Using Mc Murray test combined with joint line tenderness in the case of maniacal injuries, and Lachman test combined with lateral Pivot Shift test in the case of ACL injuries increases the sensitivity, specificity, reliability and accuracy of diagnosis in clinical examination of knee injuries.

Background: Because of day to day increasing frequency of sport injuries that lead to MENISCAL tears and several complications of meniscectomy and open surgery, and also with respect to the successful reports of arthroscopic repair of MENISCAL tears seen in different journals, the present study was performed over the patients with MENISCAL tears, referring to Akhtar and Mehr hospitals since 1997 till 1999. Materials and methods: In this clinical trial, patients were selected according to the clinical manifestations (pain, swelling, locked knee, feeling of giving way) or physical examination (McMurray, Lachman, Pivot shift, Anterior Drawer, difference of the quadriceps muscle diameter, and joint line tenderness). Patients were left out if radial and complex MENISCAL tear were revealed during arthroscopic examination. Results: 24 patients, including 20 males and 4 females, with the mean age of 23.8 years had entered this study. Symptoms were averagely manifested for 4.3 months (2-7 months) and 67% of the cases had previous athletic activities. Arthroscopic measured tear was 28.9±6.4 7 mm. Tear in the red-white zonw was reported in 10 cases (41.7%), whereas, red-red and white-white zone tears were recorded in 8(33.3%) and 6(25%) cases, respectively. Longitudinal tears were seen in 16(66.7%), whereas, bucket-handle was reported in 8 cases (33.3%). Fibrin clot was used in MENISCAL repair of 67% of the patients and ACL reconstruction was achieved in 21 % of the cases as well as MENISCAL repair. Conclusion: Patients were followed for 13.2 months (12-18 months) and out side-In technique was managed for MENISCAL repair. 8 patients (33.3%) were pain free before the study, but after that they have increased to 19 (79.2%). The difference was statistically significant. Swelling was reported in one case after the operation and feeling of giving was persisted in 6 cases (25%). Joint line tenderness and locked knee were not seen and wasting of quadriceps was significantly occurred. Mcmurray, Anterior Drawer and Pivot shift tests were negative but Lachman test was positive in one patient undergone ACL and MENISCAL repair. Range of motion was normal pre- and postoperatively. MENISCAL tears seek immediate management and arthroscopy seems to be useful and safe.

Background: Meniscus tear is a common finding in patients with anterior cruciate ligament (ACL) INJURY and may affect the natural history of the INJURY and the outcomes of treatment. In the current study, the characteristics of meniscus tears in patients who underwent arthroscopic ACL reconstruction were investigated. Methods: The hospital records of 1022 patients were reviewed. The measured variables included the presence of meniscus tear, ramp and root INJURY, the zone of INJURY based on the Cooper classification, and the type of tear. The ACL tears with delay more than 3 months for ACLR were recorded as chronic injuries. Results: The incidence of meniscus tear was 44. 4%; among whom, bucket-handle INJURY was the most common type (30. 4%) and the ramp lesion was found in 20. 5%. The meniscus was repaired in 56. 6%. The incidence of medial meniscus INJURY was significantly higher in chronic ACL tears and vice versa (P<0. 001). The incidence of ramp lesion (9. 1% Vs 20. 5%) and root tear (1. 3% Vs 2. 9%) were significantly higher in the chronic and acute tears, respectively (P<0. 001). Conclusion: Delay more than 3 months in ACLR was associated with the increased incidence of MENISCAL INJURY, specially the medial meniscus, and ramp lesion. It seems that early ACLR may be more helpful for the patients.

Background: Anterior Cruciate Ligament (ACL) is one of the main knee stabilizing ligaments. Because of high incidence of ACL tearing especially in young athletes its reconstruction is very important. The aim of this study was to evaluate short-term results of anterior cruciate ligament ruptures using four strand hamstring auto graft and Bone patellar tendon autograph.Methods: The study group included 96 patients (3 female and 93 male) with ACL teared who had been referred to our center in 5 years period (2002-2007). The subject which were Accessed in this study included MENISCAL INJURY concomitant chondral INJURY, determine the most common cause of ACL tearing, comparision of IKDC and lysholm score in all patients before and after surgery, and limitation of rang ofmotion of knee  post operation. Results: Involvement was in the right knee in 38 patients and in the left knee in 58 patients. Mean age of patients was 27.6 years (19-48). Mean surgical delay was 18 month (1-77). The most common cause of tear was playing soccer. MENISCAL INJURY was in 78 patients. (Medial meniscus in 63 patients, lateral meniscus in 29 patients) Concommitent chondral INJURY was in 54 patients (56.25%). 68% of patients returned to preoperative functions sport activity. There was no limitation in extension and there was 6 patients limitation in flexion about 20º. In last visit of patients IKDS in class A and B was 96. Conclusion: It is seem that arthroscopic reconstruction of ACL is a safe and good method in treatment of Knee stability. Use of IKDC and lysholm score for comparision of patients before and after surgery is helpful. The operation should be done early after INJURY. Reconstruction of ACL in older patients in the abscense of DJD is effective.

MENISCAL root tears are defined as radial tears located within 1 cm from the MENISCAL attachment or a bony root avulsion. This INJURY is biomechanically comparable to a total meniscectomy, leading to compromised hoop stresses resulting in decreased tibiofemoral contact area and increased contact pressures in the involved compartment. These changes are detrimental to the articular cartilage and ultimately lead to the development of early osteoarthritis. Surgical repair is the treatment of choice in patients without significant osteoarthritis (Outerbridge grades 3 or 4). Root repairs have been reported to improve clinical outcomes, decrease MENISCAL extrusion and slow the onset of degenerative changes. Here we describe the anatomy, biomechanics, clinical evaluation, treatment methods, outcomes, and post-operative rehabilitation for posterior MENISCAL root tears.

Background: Various studies have reported the incidence of MENISCAL injuries in anterior cruciate ligament (ACL)‑ deficient knee. It is responsible for the development and progression of knee osteoarthritis (OA) in patients with ACL INJURY and concomitant MENISCAL tear. Objective: The objective of this study is to find out an occurrence of MENISCAL tear and its pattern in patients with ACL INJURY. Materials and Methods: We studied 124 patients diagnosed with ACL INJURY by arthroscopy at a rural tertiary care center of Central India region. The study was conducted from July 2016 to June 2018. Standard protocol was used to collect information for sociodemographic characteristics. Condition of the INJURY was assessed at the time of arthroscopic procedure and noted. Data were collected and analyzed by Epi Info software. Results: We diagnosed 124 patients with ACL INJURY, out of which 106 (85. 5%) were male and 18 were female (14. 5%). The mean age of the patients was found to be 28. 7 years (± 10. 7), with a range of 14– 59 years. The present study observed the incidence of medial meniscus tear in 30 (24. 2%) and lateral MENISCAL tear in 18 (14. 5%) study participants. Conclusion: The present study showed a substantial number of cases with MENISCAL damage. Hence, it is imperative to screen patients with ACL tear clinically and radiologically and even during arthroscopic procedure so that chances of OA association can be minimized by early intervention.