Masanori Yamamura

A Study of the Hypermobile Meniscus

We made a clinial study of 15 patients (16 knees) with hypermobile menisci. The mean age of patients was 16.3 years, ranging from 13 to 22 years. Three patients were male and 12 were female. All menisci were affected on the lateral side.McMurray test was positive in 87.5%, but the Apley test was only positive in 12.5%. These were considered to be characteristic findings. Arthroscopic partial meniscectomy was performed in 4 patients (4 knees), arthroscopic meniscoresis in 5 patients (5 knees), and 6 patients (7 knees) were treated conservatively. In principle conservative treatment is the treatment of choice for hypermobile menisci. Surgical treatment should be done only for cases with significant meniscal lesions and a long history.

Arthroscopic Debridement for Lateral Type Gonarthrosis

Between 1989 and 1991, we performed arthroscopic debridement for 10 patients (12 joints) with lateral type gonarthrosis. Fibrillation of chondral-bone was seen in 7 joints, erosion in 3 joints and large chondral-bone loss in 2 joints. Six of the 12 joints had a degenerative tear of the lateral discoid and the rest had severe degenerative tears of the lateral meniscus. All joints had a partial menisectomy with 2 joints additionally requiring drilling for chondral bone ulceration. Clinical evaluation was made using the Japanese Orthopaedic Assosiation (JOA score) criteria, with good results obtained. (Average score improved from 86.7±5.1 to 97.9±6.9, and the mean follow-up period was 30.0 months)

Luque Instrumentation after Posterior Decompression for Lumbar Degeneration of High Aged Patients

Eighteen cases of Luque instrumentation with spinous process wiring after posterior decompression for lumbar degeneration of high aged patients were discussed.The operative time and intraoperative bleeding of them were not so different from those of the cases without Luque instrumentation. The mean duration until ambulation was 10 days. The improvement rate of JOA score was 72%.Comfortable stabilization for decompressed segment was obtained. The decrease in total lumbar motion was about 10 degree, and it did not disturb the ADL so much.This method is easy, and has good application when high aged patients need early ambulation, and when the instability of multiple segments exists or will occur by decompression.