INFLUENCE OF CRYOTHERAPY WITH PULSE COMPRESSION ON THE FUNCTIONAL CONDITION OF THE KNEE JOINT AFTER PARTIAL MENISCECTOMY

OBJECTIVE

The aim: To study the effect of cryotherapy with adjustable pulse compression in patients after arthroscopic partial meniscectomy on the functional state of the knee joint in the early period of rehabilitation.

PATIENTS AND METHODS

Materials and methods: A total of 63 patients took part in the research: the experimental group included 32 patients (23 men and 9 women), and the control group - 31 patients (21 men and 10 women). In order to determine the effect on the functional state of the knee joint after arthroscopic partial meniscectomy in the experimental group, cryotherapy with adjustable pulse compression was used with the help of «GIOCO CRYO - 2» system; ice bags were used in the control group. In the research process, the following methods were used: visual analogue point scale, sonography, goniometry and myotonometry.

RESULTS

Results: It was found that in the experimental group, under the influence of cryotherapy with adjustable pulse compression, there was a progressive decrease in the intensity of the pain syndrome, the accumulation of reactive synovial fluid, a dynamic increase in the amplitude of movements of the operated joint, and an improvement in the muscle tone of the quadriceps femoris (p<0,05-0,001).

CONCLUSION

Conclusions: Thus, cryotherapy with adjustable pulse compression has shown a positive effect on the functional state of the knee joint in the early period of patients' rehabilitation, after partial meniscectomy and can be recommended for use in clinical practice.

Determination of Normal Reference Values for Meniscal Extrusion Using Ultrasonography During the Different Range of Motion: A Pilot, Feasibility Study

OBJECTIVES

It is essential to know the normal extrusion measures in order to detect pathological ones. In this study, we aimed to define some normal reference values for meniscal extrusion in the normal knees during different ranges of motion.

METHODS

The amount of anterior and posterior portion of meniscal extrusion among 21 asymptomatic volunteers (42 knees) were tracked in 0, 45, and 90° of knee flexion using an ultrasound machine. The repeated measures analysis of variance (ANOVA) was used to show the interaction between the amounts of meniscal extrusion and the different degrees of knee flexion.

RESULTS

The anterior portion of the lateral menisci at full knee extension (0.59 ± 1.40) and the posterior portion of the medial menisci during 90° flexion (3.06 ± 2.36) showed the smallest and the highest mean amount of extrusion, respectively. The normal average amounts of anterior extrusion were 1.12 ± 1.17 and 0.99 ± 1.34 mm for medial and lateral menisci, respectively. The posterior meniscal normal extrusions were significantly increasing in both medial and lateral menisci during the survey (F = 20.250 and 11.298; both P values <.001) as they were measured 2.37 ± 2.16 and 1.53 ± 2.18 mm in order.

CONCLUSIONS

The medial meniscus can extrude 1.74 ± 1.84 mm normally while this amount was 1.26 ± 1.82 mm for the lateral meniscus. These measures commonly increased with the rising of knee flexion motion. Likewise, the posterior portion showed more extrusion than the anterior portion on both sides. These measures commonly increased with higher knee flexion.

Sonographic Diagnosis of Medial Meniscocapsular Separation of the Knee

Medial meniscocapsular separation (MCS) is an uncommon knee injury. No dedicated sonographic study on medial MCS has been reported thus far. This article retrospectively analyzes the sonogram of two patients with medial MCS confirmed by either magnetic resonance imaging (MRI) or surgery. Both patients are in their 30s with sports-related medial knee injuries. Sonograms of their medial knees displayed similar features of fluid collection between the medial meniscus and the deep portion of the medial collateral ligament (MCL), and an unsmooth outer surface of the meniscus. Meniscal tear and MCL injury were also found in both of these patients. Sonographic diagnostic criteria for the medial MCS are proposed based on the two patient cases. The differentiation of medial MCS from other cystic lesions in the medial parameniscal area is also discussed.