Pellegrini-Stieda's disease is a post-traumatic disorder of the knee. It is characterized by a crescentric-like bony formation in the region of the medial condyle of the femur, which usually makes its appearance upon roentgenographic examination three or more weeks after injury to the knee. During the three and a half years from January 1979 to July 1982, eleven patients were treated by conservative method and only one patient was treated by operation. The results were as follows; l. All give a history of trauma. 2. The major findings in this disease were pain in motion, local tenderness, and limitation of motion. 3. In roentgenographic findings of these cases, we noted the followings: 1) The most common site of the calcification was the proximal area of the tibial collateral ligament. 2) In seven cases (58%), the evidence of calcification was noted in 4 weeks to 12 weeks following original trauma. 3) Eight cases (67%) showed a radiolucent area from 0.5 to 3mm in thickness between the bony shadow and the femur. 4) Eight cases (67%) showed a crescentric shape of calcified area. 5) In seven cases (58%), the size of calcified mass was 1.5 to 3.5cm in length and 1 to 3mm in width. The mean size of calcified mass about 3cm in length and about 2.5mm in width. 4. Eleven cases were treated conservatively and one case was treated operatively. The results were satisfactory, and all patients were able to return to their works.
Clinical Study ; Femur ; Humans ; Knee ; Medial Collateral Ligament, Knee ; Methods

The author reviewed 67 cases having medial instability of the knee joint from 1971 to 1980 who were treated by surgery at the Department of Orthopaedic Surgery at Ewha Womans University Hospital. The author reviewed 67 cases which showed medial instability from 1971 to 1980 who had been treated by surgery in the Department of Orthopaedic Surgery at Ewha Womans University Hospital and summarized as follows. 1. The majority of the medial instability was due to rupture of medial collateral ligament with capsular ligament (43.3%), and the rest were due to rupture of tibial collateral ligament only (35.8%). 2. The medial instability also produced by rupture of the other structures of the medial side of the knee joint without tibial collateral ligament rupture. 3. The stress radiogram was important guide line for the diagnosis of the injury of the medial structures of the knee joint. 4. The degree of medial joint space opening was increased with the number of structures injured.
Collateral Ligaments ; Diagnosis ; Female ; Humans ; Joints ; Knee Joint ; Knee ; Ligaments ; Medial Collateral Ligament, Knee ; Rupture

OBJECTIVE: To explore the clinical effect of arthroscopic combined with small needle knife in the treatment of degenerative medial meniscus (MM) injury of knee joint by releasing the superficial layer of medial collateral ligament (SMCL). METHODS: From February 2016 to November 2018, 56 patients (56 knees) with limited pain, strangulation and flexion in medial knee joint space were selected. X-ray Kellgren-Lawrence grading was I-II. MRI showed medial meniscus injury(III degree) of knee joint. There were 30 males(30 knees) and 26 females(26 knees). Arthroscopic MM plasty and small needle knife were used to release SMCL. The Lysholm knee score was used to evaluate the effect of operation. RESULTS: All 56 patients were followed up, and the duration ranged from 3 to 24 months, with an average of 10 months. According to the Lysholm knee score standard, the final follow-up was compared with that of before operation. The results showed that the preoperative knee score was 37.24±1.32, the latest follow-up knee score was 85.72±5.28, the knee score was higher than that before the operation(<0.05). CONCLUSIONS Arthroscopy combined with small needle knife release of superficial medial collateral ligament in the treatment of degenerative medial knee meniscus injury can effectively improve the mechanical balance of the knee joint, improve Lysholm knee score in patients with knee meniscus injury, and promote the recovery of knee joint function, which has clinical value.
Arthroscopy ; Collateral Ligaments ; Female ; Humans ; Knee Joint ; Male ; Medial Collateral Ligament, Knee ; Menisci, Tibial ; Treatment Outcome

Chronic anteromedial rotatory instability has not been demonstrated to have a satisfactory solution and we have experienced recurrence of the instability after operations. So the authors devised a new operative technique for the TCL (Tibial collateral ligament), that is, burying of the torn end of the ligament beneath the “ㄷ” shaped bony flap. It would better be called advancement and bony reinsertion operation. And we performed modifed MacIntosh tenodesis for the torn anterior cruciate ligament. The results were as follows: l. Of six knees, four (66.6%) rated “good”, two (33.3%) “fair”, and none (O%) “poor” (follow-up period; at least 6 months). 2. The technical problem of the advancement and bony reinsertion operation was discussed.
Anterior Cruciate Ligament ; Knee ; Ligaments ; Medial Collateral Ligament, Knee ; Methods ; Recurrence ; Tenodesis

The posterior cruciate ligament in the stoutest ligamentous structure in the knee joint. Kennedy and Hawkins have confirmed its strenght to be about 2 times that of the anterior cruciate ligament or tibial collateral ligament. This would appear to offer the support that this ligament has a vital role to play in knee stabilization. But, in the past, non-surgical management was frequently elected either because of the belief that most kness with posterior cruciate insufficiency are asymptomatic or because it is difficult to access surgically. Recently, Hughston and Trickey reported good results after surgical repair of the rupture of the posterior cruciate ligament. And current trend is to repair it surgically. So, we analyzed the 36 cases of acute posterior cruciate ligament injuries, who were admitted and treated surgically in Severance Hospital between Jan. 1981 to Dec. 1985, and obtained the following results. 1. Single rupture of the posterior cruciate ligament largely results in good outcome. 2. When the rupture site is in the substane, we can obtain relatively good results with the augmentation using the medial head of the gastrocnemius. 3. When combined with medial or lateral compartment injuries, the chance of later instability and reconstruction is high.
Anterior Cruciate Ligament ; Clinical Study ; Head ; Knee ; Knee Joint ; Ligaments ; Medial Collateral Ligament, Knee ; Posterior Cruciate Ligament ; Rupture

Anterior Cruciate Ligament Injuries ; Humans ; Knee Injuries ; diagnosis ; surgery ; Medial Collateral Ligament, Knee ; injuries ; Posterior Cruciate Ligament ; injuries

Adult ; Female ; Humans ; Male ; Medial Collateral Ligament, Knee ; injuries ; surgery ; Middle Aged ; Reconstructive Surgical Procedures ; methods

PURPOSE: To evaluate the role of standard axial MR images for the diagnosis of meniscal tears of the knee. MATERIALS AND METHODS: Forty-five patients with a prior MRI examination that underwent arthroscopic surgery of the knee due to clinical impression of a meniscal tear were included in the study group. The sequence for meniscal evaluation was an axial fat-saturated proton density-weighted image with a 4 mm slice thickness. Axial MR images were independently reviewed by two radiologists and were compared with findings of arthroscopy. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the axial MR scan for the diagnosis of the meniscal tear were calculated. RESULTS: A total 90 menisci of 45 patients were evaluated in the axial MR scans. Forty-two patients had meniscal tears, and two of the patients had tears in both menisci; thus, a total of44 meniscal tears were found by arthroscopy. For meniscal tears, the sensitivity of the axial plane was 76.2%, the specificity was 89.1% and the accuracy was 81.1%. False negative meniscal tears were seen in 12 cases and false positive meniscal tears were seen in 5 cases on the axial MR images. CONCLUSION: In standard knee MRI examinations, axial images may be valuable for the detection and localization of meniscal tears.
Arthroscopy ; Diagnosis* ; Humans ; Knee Injuries ; Knee Joint* ; Knee* ; Magnetic Resonance Imaging ; Medial Collateral Ligament, Knee ; Menisci, Tibial ; Protons ; Sensitivity and Specificity

Objective To explore the feasibility and clinical value of ultrasonography in evaluating the morphology and function of medial collateral ligaments (MCL) after total knee arthroplasty (TKA). Methods Totally 38 patients undergoing routine KTA (group A) and 22 patients undergoing constrained condylar knee arthroplasty KTA with MCL injury (group B) were included. Long axis views of MCL were taken and the MCL thickness was measured on femur side and tibial side 1 cm away from the joint line, respectively. The thicknesses were compared between the two groups. Subsequently, the gap between the metal part of the femoral prosthesis and the spacer after dynamic valgus stress was measured. The distribution and composition of the gap between the two groups were compared. Results High-frequency ultrasound clearly showed the prosthesis and MCL after TKA. MCL fiber structures of both groups were intact. The MCL thickness on the tibial side in group B was (0.25±0.06)cm, which was significantly thinner than group A [(0.32±0.14)cm] (t=2.12, P=0.040).For the femur side, there was no significant difference (t=1.65, P=0.110) between these two groups [(0.37±0.09) cm in group B versus (0.42±0.12)cm in group A]. Under the condition of valgus stress, the gaps between the metal part of the femoral prosthesis and the spacer could be found in 11 cases in group B but only in 1 case in group A. The proportion of gaps in group B was significantly higher than that in group A (Fisher's exact test, P=0.000). Conclusions High-frequency ultrasound can clearly show the prosthesis and MCL after TKA. The injured MCL can be well joined but the thickness is thinner. Under the condition of valgus stress of the knee, the stability of the TKA can be evaluated according to the gap between the prosthesis and the spacer.
Arthroplasty, Replacement, Knee ; Femur ; Humans ; Knee Joint ; Medial Collateral Ligament, Knee ; anatomy & histology ; diagnostic imaging ; physiology ; Tibia ; Ultrasonography

OBJECTIVETo explore the therapeutic results of surgical treatment for patellofemoral pain syndrome.

METHODSOne hundred patients (35 males and 65 females, ranging from 50 to 70 years old with an average age of 63 years) with patellofemoral pain syndrome were randomly and equally divided into treatment group and control group. All patients underwent arthroscopic treatment. The patients in treatment group were treated with medial patellofemoral ligament overlap and lateral patellar retinaculum release, and the patients in control group were just treated with lateral patella retinaculum release which is a current widespread operation.

RESULTSAll patients were followed-up with the mean time of 13 months, and were evaluated with HSS (hospital for special surgery) scoring system for the therapeutic effect. The mean score of treatment group (73.52+/-11.17) and control group (65.50+/-13.70) had statistical difference (P<0.05), which indicated that the therapeutic effect of medial patellofemoral ligament overlap and lateral patellar retinaculum release for treatment of patellofemoral pain syndrome was satisfying.

CONCLUSIONCompared with lateral patellar retinaculum release, this procedure is superior in correcting the abnormal movement of patellofemoral joint, easily balancing patellofemoral joint space, effectively relieving the pain of anterior knee. No postoperative complications occur, such as intraarticular haematoma, necrosis and dislocation of patella and so on.

Aged ; Arthroscopy ; Female ; Humans ; Male ; Medial Collateral Ligament, Knee ; surgery ; Middle Aged ; Patellar Ligament ; surgery ; Patellofemoral Pain Syndrome ; surgery