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Preoperative Diagnosis and Treatment Outcomes of Incarcerated Inferiorly Displaced Flap Tear of the Medial Meniscus: Comparison between Flap Tears with and without Incarcerated Fragment

 Min Jung  ;  Dong Hoon Lee  ;  Sung-Jae Kim  ;  Chong Hyuk Choi  ;  Sung-Hwan Kim  ;  Seokhwan Jin  ;  Kun-Bo Park 
 BIOMED RESEARCH INTERNATIONAL, Vol.2018 : 5941057, 2018 
Journal Title
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The purpose of this study was to compare preoperative variables and postoperative outcomes between flap tears with and without incarceration of inferiorly displaced fragments of medial meniscus and find distinct features of incarcerated flap tear of medial meniscus to improve preoperative diagnosis. 79 patients who underwent partial meniscectomy for flap tear of medial meniscus were classified into two groups: group U, usual flap tear without incarcerated fragment; group I, flap tear with incarcerated inferiorly displaced fragment. Patient characteristics and preoperative variables including duration of symptom aggravation were investigated. A comprehensive physical examination including joint line tenderness was performed. Magnetic resonance imaging (MRI) examination was carried out on all patients. Clinical assessments were performed with functional scores including visual analogue scale (VAS), and radiologic evaluation was conducted. Preoperative values and postoperative outcomes measured at the minimum follow-up duration of 2 years were compared between the groups. The groups did not differ significantly regarding postoperative outcomes by functional and radiological evaluations (p > 0.05). In making preoperative diagnosis, sensitivity of diagnosis based solely on MR images was significantly lower in group I (68.8%) than that in group U (90.5%) (p = 0.040). The following clinical features differed significantly between the groups: Patients in group I had higher scores in preoperative VAS (group U = 6.6; group I = 7.7) (p = 0.011) and shorter duration of symptom aggravation (group U = 13.8 weeks; group I = 3.9 weeks) (p < 0.001). Joint line tenderness was positive more distinctly in group I (100%) than in group U (74.6%). If displaced flap tear was properly resected, improved outcomes did not differ regardless of incarceration of flap tear. In diagnosing incarcerated inferiorly displaced flap tear, sensitivity of diagnosis based solely on MR images could be low. Distinguishing clinical findings would be helpful in obtaining a more appropriate diagnosis.
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1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Sung Jae(김성재)
Kim, Sung Hwan(김성환) ORCID logo https://orcid.org/0000-0001-5743-6241
Park, Kun Bo(박건보) ORCID logo https://orcid.org/0000-0002-8839-4870
Lee, Dong Hoon(이동훈)
Jung, Min(정민) ORCID logo https://orcid.org/0000-0002-7527-4802
Jin, Seokhwan(진석환)
Choi, Chong Hyuk(최종혁) ORCID logo https://orcid.org/0000-0002-9080-4904
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