Showing papers in "Arthroscopy in 1985"
TL;DR: From this preliminary study, it was concluded that attention to detail is essential in performing a safe, reproducible arthroscopic examination of the elbow, thatArthroscopy of the elbows is an effective diagnostic procedure, and that operative elbow arthro scopy is effective in the treatment of certain elbow disorders.
Abstract: A technique of diagnostic and surgical arthroscopy of the elbow is presented, and the normal intraarticular anatomy as viewed from the anterolateral, anteromedial, and posterolateral portals is described. A preliminary study of 12 patients who underwent surgical arthroscopy of the elbow demonstrated that removal of loose bodies produced the best objective and subjective results. Less satisfactory results were obtained when procedures such as capitellum and radial head chondroplasties were performed. Using a preoperative and postoperative point accumulation rating system for four objective and four subjective criteria, the following results were noted. Before surgery 50% of the patients objectively rated their elbows as satisfactory (excellent or good), whereas postoperative ratings increased to 83%. Subjectively, 17% rated their elbows as satisfactory before surgery, improving to 58% satisfactory ratings postoperatively. The only complication was a transient median nerve palsy caused by the extracapsular extravasation of a local anesthetic. From this preliminary study, it was concluded that attention to detail is essential in performing a safe, reproducible arthroscopic examination of the elbow, that arthroscopy of the elbow is an effective diagnostic procedure, and that operative elbow arthroscopy is effective in the treatment of certain elbow disorders.
360 citations
TL;DR: Despite the tremendous increase in performance of these procedures, little attention has been paid to the complications associated with them, and a large number of these complicat ions occur in such a small percentage of cases.
Abstract: Since their introduction into the armamentarium of the orthopaedic surgeon, arthroscopy and arthroscopic surgery have Undergone rapid increased utilization in the diagnosis and treatment of knee pathology. The reduct ion in postoperat ive morbidity, hospitalization, and time away from work following arthroscopic knee surgery have led to the use of terms such as "bandaid surgery" by the lay public. Sadly, this concept of arthroscopic surgery being "bandaid surgery" has filtered into the orthopaedic community. Hence, despite the tremendous increase in performance of these procedures, little attention has been paid to the complications associated with them. Elliot (1), Fiddan and Porrier (2), Whipple and Bassett (3), and Hansen, et al. (4) reported no complications directly related to arthroscopy. Lindenbaum (5), mentions that complications following arthroscopy are rare. According to Zarins (6), complications following arthroscopy occur in 0.1-0.2% of patients, and Bunker and Thomas (7), report 0.6% complications. Since these complicat ions occur in such a small percentage of cases, a large
316 citations
TL;DR: Not only can a partial rotator cuff tear be debrided to initiate a healing response, but a definitive diagnosis can also be made and associated pathology identified, permitting the establishment of an appropriate rehabilitation program.
Abstract: Thirty-six patients with partial tears of the supraspinatus portion of the rotator cuff underwent arthroscopic examination and debridement of the lesion. All patients, whose average age was 22 years, were involved in competitive athletics; 64% were baseball pitchers. The average duration of symptoms prior to arthroscopy was 12 months. The most common presenting complaint was pain felt in the shoulder during overhead activities. Associated pathology included tears of the glenoid labrum and partial tearing or tendinitis of the long head of the biceps tendon. Of the 34 patients available for follow-up, 26 (76%) had excellent results, three (9%) had good results, and five (15%) had poor results. Eighty-five percent of the patients returned satisfactorily to their preoperative athletic activity. Our preliminary experience with arthroscopy of the shoulder in the management of patients with partial rotator cuff tears is encouraging. Not only can a partial rotator cuff tear be debrided to initiate a healing response, but a definitive diagnosis can also be made and associated pathology identified, permitting the establishment of an appropriate rehabilitation program.
277 citations
237 citations
TL;DR: Vascularity was investigated using dye and latex injections, and the nerve supply was studied microscopically using a variety of special stains to evaluate details of the vascular and nerve supply of the menisci in humans.
Abstract: Twenty-three fresh, cadaver knees were studied to evaluate details of the vascular and nerve supply of the menisci in humans. Vascularity was investigated using dye and latex injections, and the nerve supply was studied microscopically using a variety of special stains. Vessels arise mainly from medial and lateral inferior and middle geniculate arteries. Radial branches from a perimeniscal plexus enter the meniscus at intervals, with a richer supply to the anterior and posterior horns. Vessels supplying the body are limited to the peripheral one-third, except in the fetus. There is an avascular area adjacent to the popliteus tendon. The perimeniscal tissue is richly innervated. Most nerves are associated with vessels. Smaller nerves and axons run radially in convoluted patterns. Single axons course through the perimeniscal tissue, and many nerves are seen in the interstitial tissue of the outer one-third of the meniscus and in the anterior and posterior horns. The inner two-thirds has no nerve fibers.
190 citations
TL;DR: Twenty-one tibial plateau fractures with 1 to 5 years follow-up are reviewed for the purpose of demonstrating the positive impact arthroscopy can have on patients sustaining this injury.
Abstract: Twenty-one tibial plateau fractures with 1 to 5 years follow-up are reviewed for the purpose of demonstrating the positive impact arthroscopy can have on patients sustaining this injury Controversy between open and nonopen management has existed for decades Arthroscopy bridges that controversy, allowing the advantages of accurate reduction and rigid fixation without extensive operative exposure In addition, arthroscopy allows thorough lavage, removal of loose fragments, and accurate diagnosis of associated intraarticular pathology Since extensive exposure is avoided, rapid recovery with reduced pain and early full range of motion is achieved in patients managed arthroscopically Biomechanics of rigid percutaneous internal and external fixation are presented to demonstrate that no principles are compromised in arthroscopic management Associated meniscal and ligamentous injuries in this series are treated either arthroscopically or through secondary accessory incisions Fractures are classified as to the applicability of arthroscopic management
189 citations
TL;DR: It was determined that arthroscopy is of value in the management of tibial plateau fractures; acute fractures and associated soft tissue injuries can be precisely defined, allowing for timely management decisions.
Abstract: The value of arthroscopy in the management of tibial plateau fractures was evaluated in a series of 29 patients from 1979 to 1984. It was determined that arthroscopy is of value in the management of these fractures; acute fractures and associated soft tissue injuries can be precisely defined, allowing for timely management decisions; based on direct arthroscopic observation, selected fractures can be reduced and stabilized, and appropriate postoperative management determined; and healed but symptomatic fractures may benefit from arthroscopic surgery.
166 citations
TL;DR: The results of this experimental study indicate that arthroscopy of the posterior subtalar joint is technically feasible and Clinically, the possible indications for ar Throscopy would include state of the articular cartilage in suspected cases of degenerative arthritis, rheumatoid arthritis, and infection.
Abstract: Talocalcaneal articulations are relatively complex and functionally very important because they play a major role in the movements of inversion and eversion of the foot. Few reports on arthrography of the subtalar joints are available in the literature, and, similarly, little attention has been paid by arthroscopists to these joints. This preliminary study briefly defines the normal anatomy of the subtalar joints and describes a new technique of arthroscopic examination of the posterior subtalar joint. The distal lower extremities of six fresh cadavers were used in these experiments. All the subtalar joints were supple. A 2.7-mm arthroscope was used to carry out arthroscopic and anatomic examinations. A technique of examination with one anterior portal and one posterior portal is described in detail. When the anterior portal was used, the egress needle was placed posteriorly; when the posterior portal was used, the converse was true. By using the two portals, the following intraarticular structures could be visualized: a major part of the convex posterior calcaneal facet of the talus and the posterior talar facet of the calcaneus; the synovial lining laterally and posteriorly; the posterior aspect of the interosseous talocalcaneal ligament; and the posterior recess of the joint. The results of this experimental study indicate that arthroscopy of the posterior subtalar joint is technically feasible. Clinically, the possible indications for arthroscopy would include state of the articular cartilage in suspected cases of degenerative arthritis, rheumatoid arthritis, and infection; visualization of the joint after intraarticular fracture to evaluate chronic pain syndrome in the hindfoot; biopsy; management of sinus tarsi syndrome; loose body removal.
113 citations
TL;DR: A significant improvement in results of sepsis in major joints has been achieved and in conjunction with systemic antibiotic therapy, with all cases so treated being considered good to excellent at follow-up.
Abstract: It is well known that infection of a major weight-bearing joint can be a disastrous occurrence. Arthroscopy has been found to aid immeasureably in the diagnosis and treatment of this condition. Under arthroscopic control, adhesions can be broken down, necrotic tissue can be lavaged from the joint and, following the installation of drainage tubes, the processes of distension and irrigation can be carried out. By so doing, and in conjunction with systemic antibiotic therapy, a significant improvement in results of sepsis in major joints has been achieved, with all cases so treated being considered good to excellent at follow-up. It may be that the major benefit of the distention/irrigation method lies in the distension process which prevents loculation of necrotic tissue in the recesses of the joint and also prevents adhesion formation which might later restrict range of motion.
93 citations
TL;DR: There is no evidence of ultrastructural damage to chondrocytes following treatment with bupivacaine or saline solution in vivo and there does not appear to be any contraindication to the use of intraarticular bupvacaine based on these findings.
Abstract: Isotonic saline solution causes acute inhibition of 35 SO 4 incorporation into intact articular cartilage slices in vitro, but there is no evidence of ultrastructural damage to chondrocytes following treatment with bupivacaine or saline solution in vivo. Also, there is recovery of 35 SO 4 incorporation by 1–3 days following in vivo intraarticular administration of bupivacaine in saline solution to young pigs and adult dogs. There does not appear to be any contraindication to the use of intraarticular bupivacaine based on these findings.
85 citations
TL;DR: The "intraarticular triangle" bounded by the humeral head, the glenoid rim, and the biceps tendon has been found to be an excellent intraarticular landmark for placement of an accessory anterior portal for shoulder arthroscopy.
Abstract: A posterior portal site has become the accepted standard for introduction of the arthroscope for routine diagnostic procedures of the shoulder. Few published guidelines exist, however, on the optimum and safe positions of accessory portals for introduction of a probe or surgical instruments during shoulder arthroscopy. The relatively thick surrounding muscle layers and the close proximity of vital neurovascular structures would make guidelines for safer and more reproducible accessory portal selection helpful to minimize the risk of injury to these structures. The "intraarticular triangle" bounded by the humeral head, the glenoid rim, and the biceps tendon has been found to be an excellent intraarticular landmark for placement of an accessory anterior portal for shoulder arthroscopy. Anatomical dissections on 20 cadaver shoulders have confirmed that instruments passed through this location are at little risk to injure adjacent neurovascular structures about the shoulder. Clinical data in 30 shoulder arthroscopies performed utilizing this landmark for placement of an anterior portal have confirmed this position to be a safe and useful location for portal placement if proper precautions are followed.
TL;DR: A prospective study of the results of arthroscopic partial meniscectomy in the presence of at least Outerbridge Grade III chondromalacia of the accompanying joint surface performed between 1980 and 1984, finding two patients had poor results related to progression of their arthritis and one developed osteonecrosis.
Abstract: Frequently, meniscal pathology accompanies degenerative changes affecting the articular surface of the knee. The attritional changes in the meniscus lead to fragmentation of the meniscus and a variety of tears, usually of the posterior horn of the medial meniscus. A prospective study of the results of arthroscopic partial meniscectomy in the presence of at least Outerbridge Grade III chondromalacia of the accompanying joint surface was performed between 1980 and 1984. Eighty-seven knees in 84 patients were studied. The mean age was 62 (29–84) years. The right knee was involved in 44 patients, and 47 were men. Preoperative radiographs demonstrated osteoarthritis in 53 patients. The medial meniscus was involved in 82, while the lateral meniscus was affected in nine knees. Four knees had involvement of both menisci. In 72 knees, the most frequent lesion was a tear of the posterior horn of the medial meniscus. The most frequent configuration of the tears was a flap in 42. The morbidity was small with the use of ambulatory aids being 10 ± 13 (mean ± SD) days. Subsequent surgery was performed on six knees consisting of two total knee arthroplasties, two upper-tibial osteotomies, one repeat arthroscopic meniscectomy, and one popliteal cyst excision. Two patients had poor results related to progression of their arthritis and one developed osteonecrosis. Five patients were unchanged from their preoperative status. Subchondral sclerosis or osteophytes on the preoperative radiographs correlated with 72% compared to 90% satisfactory results in the absence of these findings (p
TL;DR: Carbon dioxide and nitrogen have proven to be satisfactory insufflation agents, with no lasting untoward effects noted in a clinical series of diagnostic arthroscopic procedures, and the cost of laser generators and the lack of an ideal delivery system are limiting factors in clinical applications of this cutting mode.
Abstract: Laboratory investigations demonstrate the theoretical feasibility of utilizing CO2 laser energy for arthroscopic resection of the knee meniscus Infrared light of 106 micron wavelength is sufficiently absorbed by fibrocartilage with byproducts of heat, water vapor, and a small residue of carbon ash The remaining meniscus rim demonstrates viable chondrocytes in close proximity to the margin of resection, and gross collagen fiber architecture is preserved The depth of penetration of the laser beam can be controlled by limiting the duration of exposure Arthroscopic application of CO2 laser energy requires a gas medium Carbon dioxide and nitrogen have proven to be satisfactory insufflation agents, with no lasting untoward effects noted in a clinical series of diagnostic arthroscopic procedures The cost of laser generators and the lack of an ideal delivery system are limiting factors in clinical applications of this cutting mode for meniscectomy
TL;DR: The response of the meniscus to partial meniscectomy (in the avascular zone) was evaluated in 15 dogs as discussed by the authors, and 10 of the 15 dogs (67%) demonstrated a remodeling of the cut surface of the Meniscus.
Abstract: The response of the meniscus to partial meniscectomy (in the avascular zone) was evaluated in 15 dogs. Following surgery 10 of the 15 dogs (67%) demonstrated a remodeling of the cut surface of the meniscus. This process appeared to begin with a fibrin clot which adhered to the meniscectomy surface. The organized clot was then populated by fibrocytes and eventually modulated into a fibrocartilage-like tissue by 12 weeks. The origin of the cells is unknown and may represent a migration of cells from the synovium, a proliferation of meniscal fibrochondrocytes, or both. The remodeling process appears to be associated with the presence of a fibrin clot, presumably from residual hemarthrosis. In those menisci that did not remodel [five of 15 (33%)], the meniscectomy surface remained relatively unchanged with no signs of progressive degeneration.
TL;DR: The results were adversely affected by the severity of the chondromalacia, work-related injury, prior knee surgery, simultaneous lateral meniscectomy, and increased knee laxity.
Abstract: Results of 150 arthroscopic partial medial meniscectomies were analyzed by computer to identify the factors that lead to an unsatisfactory (fair or poor) outcome. The average follow-up for the group was 36 months (range 24-60 months). One-hundred ten men and 40 women were involved, with an average age of 48 years. The overall results were 58% excellent-good, 28% fair, and 14% poor. Most tears involved the posterior horn (76%). Bucket handle, longitudinal, and flap tears were rated 88% excellent-good, whereas horizontal cleavage and degenerative and complex tears had only 45% excellent-good scores. The results were adversely affected by the severity of the chondromalacia, work-related injury, prior knee surgery, simultaneous lateral meniscectomy, and increased knee laxity. Because degenerative posterior horn tears had such a high percentage of unsatisfactory results, the question remains as to whether all these tears need to be removed.
TL;DR: The direct lateral position is changed to a semilateral position in which the patient is allowed to rotate 30 to 40 degrees posteriorly, thus putting the shoulder joint on a horizontal plane, and the problem of traction neuropraxia has been eliminated.
Abstract: This paper proposes a modification of the classical position for shoulder arthroscopy. Two changes are proposed to improve visualization, accentuate pathology, and give better access to the inferior one half to one third of the shoulder joint. The direct lateral position is changed to a semilateral position in which the patient is allowed to rotate 30 to 40 degrees posteriorly, thus putting the shoulder joint on a horizontal plane. This allows for more comfortable arthroscopy and instrumentation. Also, if capsulorrhaphy is desired, better penetration of the scapula is possible since the scapula is vertical; thus, the angle of the approaching staple is less severe. The second change is to apply traction in a plane perpendicular to the long axis of the humerus rather than parallel to it. This modification elevates the humerus out of the glenoid rather than distracts the humerus into a subluxed position. The result accentuates labral pathology and gives a significantly improved view of the inferior one half to one third of the glenoid capsule. This new plane of traction allows excellent visualization with very little traction; thus, the problem of traction neuropraxia has been eliminated.
TL;DR: This work has shown that synovectomy can now be accomplished effectively with arthroscopic techniques, and this has greatly diminished the previous morbidity and cost associated with open synoveCTomy.
Abstract: Synovectomy is an effective procedure in many of the synovial proliferative diseases. It is the treatment of choice in pigmented villonodular synovitis and synovial chondromatosis. In addition, it may be a useful adjunct to treatment in carefully selected patients with rheumatoid arthritis and hemophilia. Synovectomy can now be accomplished effectively with arthroscopic techniques, and this has greatly diminished the previous morbidity and cost associated with open synovectomy. However, the indications for synovectomy remain the same, regardless of the technique.
TL;DR: It is concluded that the lowest current setting possible should be utilized for meniscal surgery and the risk of articular cartilage damage from inadvertent injury is not excessive.
Abstract: The use of high energy devices has been suggested for intra-articular surgery. Experimental studies have been performed using the laser and electrocautery. However, clinical application has primarily been with the use of the electrocautery. Electrosurgery is currently being used for lateral retinacular release as well as meniscal surgery. Inadvertent damage to articular cartilage may occur, especially during meniscal resection. The objective of the current study is to assess the effect of the Concept electrocautery with the meniscal cutting electrode on fresh human articular cartilage. Twenty fresh tibial plateaus removed at the time of total knee arthroplasty were subjected to electrocautery currents ranging from 25 to 82.5 W. The articular cartilage was stained with hematoxylin and eosin. The extent of cartilage necrosis was quantitated as a percentage of the thickness of the articular cartilage. A dose response curve was developed. The extent of articular cartilage necrosis with the electrocautery setting of 20 (24.4 W) commonly used for meniscal resection resulted in only an 11.4%-injury to the articular cartilage. At the manufacturer's recommended setting of 24 (27 W), a 16% depth of laceration of the articular cartilage may be anticipated. We conclude that the lowest current setting possible should be utilized for meniscal surgery and the risk of articular cartilage damage from inadvertent injury is not excessive.
TL;DR: Arthroscopic chondroplasty of the patella for chondromalacia patellA has proved to be as satisfactory as or superior to more radical surgical approaches; however, conservative care should be the initial and primary method of treatment for this disease.
Abstract: Following failure of conservative treatment, arthroscopic chondroplasty was performed on 41 knees in 40 patients with chondromalacia of the patella as the only lesion. Within a follow-up period averaging 40 months, results were excellent in 10%, good in 39%, fair in 44% and poor in 7%. Seventy-eight percent of patients were subjectively satisfied with their surgery. Age or sex of the patients, grade of the lesion, and duration of the symptoms prior to surgery did not correlate with the final result. The method is considered safe since the few complications recorded were minor and did not affect the end result. Arthroscopic chondroplasty of the patella for chondromalacia patella has proved to be as satisfactory as or superior to more radical surgical approaches; however, conservative care should be the initial and primary method of treatment for this disease.
TL;DR: The anatomy, pathomechanics, and clinical presentation of medial shelf or "plica" syndrome along with treatments suggested in the orthopedic literature are reviewed here.
Abstract: Medial shelf or "plica" syndrome is a pathological condition of the knee that often follows knee injury in young athletes, the symptoms of which often mimic other internal derangements of the knee. Its anatomy, pathomechanics, and clinical presentation along with treatments suggested in the orthopedic literature are reviewed here. Two-year follow-up studies on the treatment of this syndrome by arthroscopic resection in 51 knees in 42 patients are presented as well.
TL;DR: Five patients with chronic hemophilic arthropathy of the knee who underwent arthroscopic synovectomy between June 1980 and June 1981 represent the source for this discussion, and two of these patients subsequently developed a stress-induced joint bleed, and one persisted in having an effusion but no recurrent bleeds.
Abstract: Synovectomy for chronic hemophilic arthropathy is performed for the main purpose of stopping recurrent hemarthroses. The indications are frequent recurrent bleeds and persistent synovial hypertrophy. Five patients with chronic hemophilic arthropathy of the knee who underwent arthroscopic synovectomy between June 1980 and June 1981 represent the source for this discussion. Two of these patients subsequently developed a stress-induced joint bleed, one persisted in having an effusion but no recurrent bleeds, whereas the other patient developed recurrent bleeds and required a second synovectomy 4 years later. Another patient required a second arthroscopic procedure, with posteromedial synovial resection 10 months after the initial synovectomy not including the posteromedial compartment. He has not had a joint bleed since. The remaining two patients have had no recurrence of joint bleeding or synovial hypertrophy. All patients obtained their preoperative motion. No complications occurred as a result of these synovectomies. Subsequent synovectomies have produced one complication of a severe immediate postoperative hemarthrosis.
TL;DR: It is concluded that to be able to improve knee function in the unstable knee, other modes of treatment than bracing are necessary and bracing should be seen as a complement to these other treatments.
Abstract: In this article we have tested a ready-made brace to evaluate whether it could improve function in the anterior cruciate ligament injured patient. All patients had their full extent of injury mapped out at arthroscopy. We believe that arthroscopy before treatment for a torn anterior cruciate ligament injury is necessary in order to treat meniscus lesions that could interfere with the rehabilitation. In this study, 26 patients were unstable with a positive pivot-shift, and 16 patients were operated on and thus stable. All patients performed a performance test with and without the brace in a randomized order. Before the start of the investigation, we postulated that patients with a quadriceps atrophy who were unstable would improve their function with the derotation brace. We could not find any effects of the brace in this study. The brace did not significantly improve function in the group of patients who were unstable with a quadriceps atrophy. On the other hand, the brace did not impair function in the patients. We conclude that to be able to improve knee function in the unstable knee, other modes of treatment than bracing are necessary. Bracing should be seen as a complement to these other treatments.
TL;DR: The purpose is to describe the technic used to provide local anesthesia with sedation for the performance of both diagnostic and operative arthroscopy of the knee.
Abstract: Our purpose is to describe the technic we use to provide local anesthesia with sedation for the performance of both diagnostic and operative arthroscopy of the knee. This technic has been well accepted by majority of the patients and proved to be quite safe.
TL;DR: In a series of 3,250 patients with knee disorders, a painful shelf was diagnosed and resected in 39 knees of 32 patients, and a cord-like mass, palpable in 30 knees, disappeared in 25 postoperatively.
Abstract: In a series of 3,250 patients with knee disorders, a painful shelf was diagnosed and resected in 39 knees of 32 patients. Thirty of them were done by arthroscopy and nine by arthrotomy. There were 10 men and 22 women whose ages ranged from 4 to 55 years, with an average of 19 years. The follow-up period ranged from 1 to 6 years. Postoperatively, the pain was relieved in 26 knees and diminished in 13. A cord-like mass, palpable in 30 knees, disappeared in 25 postoperatively. Clicks were noted in 34 knees; 28 of these were not audible or palpable postoperatively. The provocation test 1 result was positive in 23 of 28 knees preoperatively, negative in 21, and diminished in 2 postoperatively. The provocation test 2 was performed in 23 knees; it produced pain and/or palpable click in 14 preopratively, and was negative in 12 and diminished in 2 postoperatively.
TL;DR: The authors question the feasibility of arthroscopic repair of anterior cruciate ligament tears and suggest a more objective evaluation of this procedure.
Abstract: The authors present their preliminary results of arthroscopic primary repair of anterior cruciate ligament tears performed on five patients, with a mean follow-up time of 9.2 months. All patients were re-evaluated by subjective questionnaire and clinical examination, and tested for anterior drawer at 20° flexion using the KT-1000 Knee Ligament Arthrometer and the UCLA Instrumented Clinical Knee Testing Apparatus. Subjectively, four patients were rated as fair and one as good. The Lachman test was negative in two and trace or mildly positive in three patients. Pivot shift test was negative in all. Instrumented testing demonstrated three patients with increased anterior laxities outside the normal range, and two of these patients also showed reduced anterior stiffnesses which were beyond the normal range. Based on these results, the authors question the feasibility of arthroscopic repair of anterior cruciate ligament tears and suggest a more objective evaluation of this procedure.
TL;DR: A retrospective review of 350 knees was carried out, it was concluded that the torn meniscus does not pose a significant threat to the integrity of the articular cartilage; this was also true in those patients in whom the anterior cruciate ligament was torn.
Abstract: A retrospective review of 350 knees was carried out to determine the effect, if any, of a torn meniscus and a torn anterior cruciate ligament on the articular surfaces of the knee. There were no professional or college athletes in this group, although a few were enthusiastic sandlot-type players. The time interval between injury and surgery was known, as was the state of the articular surfaces, which were graded from 1 to 4. As the time interval between injury and surgery increased, so did the incidence of lesions of the articular surfaces, although in most cases these lesions were quite minor. On the basis of this and other studies, it was concluded that the torn meniscus does not pose a significant threat to the integrity of the articular cartilage; this was also true in those patients in whom the anterior cruciate ligament was torn.
TL;DR: The anatomy of the bovine stifle joint was comparable to that of the human knee and proved to be a suitable model for arthroscopic surgery and instrumentation designed specifically for the intraarticular application of electrothermal energy facilitated meniscectomy with minimal effect on adjacent tissue.
Abstract: Bovine stifle joints were utilized for the application of electrothermal energy in arthroscopic surgical procedures. The anatomy of the bovine stifle joint was comparable to that of the human knee and proved to be a suitable model for arthroscopic surgery. Partial and total meniscectomies were performed in vitro and in situ on cadaveric stifle joints using 1.5% glycine as a liquid medium. Histologic preparations revealed no adverse effects associated with the use of glycine, and coagulation necrosis never extended more than 0.1 mm into the meniscal substance. Instrumentation designed specifically for the intraarticular application of electrothermal energy facilitated arthroscopic meniscectomy with minimal effect on adjacent tissue.