Summary

DOUBLE STRANDED SEMITENDINOSUS GRAFT FOR MENISCAL AUTOGRAFT TRANSPLANT WITH OUT DETACHING THE TENDON FROM TIBIA AND SHUTTLING IT THROUGH THE TIBIAL TUNNELS AND ANCHORING IT TO MENISCAL REMNANT GIVES GOOD FUCTIONAL OUTCOME

Abstract

TOTAL 9 PATIENTS WERE INCLUDED IN THE STUDY

INCLUSION CRITERIA
X RAY SHOWED ONLY MILD OA CHANGES
MRI SHOWED MENISCUS COMPLEX TEAR WITH OR WITH OUT ROOT TEAR .
ALIGNMENT -- THERE WAS NO VARUS VALGUS MALALIGNMENT .
INFLAMMATORY MARKERS -- NEGATIVE .
DIAGNOSTIC ARTHROSCOPY - NON SALVAGABLE MENISCUS.

PROCEDURE
PARTIAL MENISCECTOMY WAS DONE RETAINING STABLE PERIPHERAL RIM , SEMITENDINOSUS GRAFT WAS HARVESTED RETAINING THE TIBIAL ATTACHMENT. THE GRAFT WAS DOUBLED. TWO TUNNELS WERE MADE INTHE TIBIA , ONE FROM MEDIAL TIBIA TO THE POSTERIOR HORN AND ONE FROM MEDIAL TIBIA TO ANTERIOR HORN OF MENISCUS(MEDIAL OR LATERAL ACCORDING TO THE CASE. THE FREE END OF GRAFT WAS SHUTTLED THROUGH THE POSTERIOR TUNNEL AND BROUGHT INTRA ARTICULARLY AND AGAIN SHUTTLED THROUGH THE ANERIOR TUNNEL TO MEDIAL SIDE OF TIBIA . AN INSIDE OUT SUTURE WAS PUT AT THE CENTER AS STAY SUTURE AND THE GRAFT WAS FIXED POSERIORLY WITH 3 ALL INSIDE SUTURES , MIDDLE WITH 5 INSIDE OUT SUTURES AND ANTERIORLY WITH 3 OUTSIDE IN SUTURES.MORE SUTURES WERE ADDED WHEN REQUIRED, THE FREE END OF THE GRAFT WAS SUTURED BACK TO THE BASE OF THE TENDON AT THE TIBIAL ATTACHMENT. NONWEIGHT BEARING MOBILSATION WAS DONE FOR ONE MONTH , AND LATER MOBILSED WITH ELBOW CRUTCH FOR ONE MONTH .AT 2 MONTHS PATIENT WAS ALLOWED TO DO ALL ADL EXCEPT RUNNING.RUNNING WAS ALLOWED AFTER 6MONTHS

RESULT- IMPROVEMENT IS SEEN FOR KOOS PAIN SCALE ,KOS-ADLS,IKDC SCORE AND LYSHOLM