meniscal extrusion was greater and more severe in knees with a radial tear component than in knees without a radial component. The incidence and degree of major extrusion was similar in knees with root tears and non-root tears. A radial component and knee osteoarthritis severity were similarly predictive of absolute and relative extrusion. Meniscal extrusion in osteoarthritic knees was associated not only with degenerative meniscal tear but also with osteoarthritis severity. Therefore, arthroscopic meniscal procedures, especially meniscal repair, should be cautiously considered in patients with meniscal extrusion.

To examine the morphological changes of the medial meniscus in advanced knee osteoarthritis (OA) we examined 167 knee joints of 106 patients who subsequently underwent total knee joint arthroplasty from January to May, 2007. All 106 patients were females and their ages ranged from 57 to 83 years (mean 68.7 +/- 5.6 years). For patients with complete loss of medial joint space by weight-bearing radiography, the meniscal position was assessed by measuring meniscal subluxation and meniscal height. Meniscal morphology was assessed using a modified WORMS MRI-based method. Description of the prevalence of different meniscal morphologies and their respective positions are presented. The predominant type (32.2, 64.1 and 83.8% in anterior horn, mid-body and posterior horn, respectively) of meniscal morphology abnormality was a hypertrophied displaced tear. Medial meniscus height was found to be higher than lateral meniscus height. In persons with an hypertrophied meniscus the height of the medial meniscus was 8.06 +/- 1.15, 10.03 +/- 1.79, and 8.61 +/- 1.57 mm at anterior horn, mid-body and posterior horn, respectively, compared to those in other categories whose height was 6.04 +/- 0.92, 5.08 +/- 1.68 and 6.43 +/- 1.26 mm. A large proportion of persons with end stage varus knee OA have a paradoxically hypertrophied medial meniscus. This new finding of hypertrophied menisci highlights that not all menisci in persons with end stage OA are macerated or destroyed.

PurposeThe study was to compare the oncologic and functional outcomes of partial nephrectomy (PN) and radical nephrectomy (RN) for pathologically proven T1b renal cell carcinoma using pair-matched groups.Materials and MethodsWe reviewed our prospectively maintained database for RN and PN in T1b renal tumors surgically treated between 1999 and 2011 at five institutions in Korea. Of 611 patients treated with PN or RN for a solitary and NX/N0 M0 renal mass (4-7 cm), 577 (PN, 100; RN, 477) patients with pathologically confirmed pT1b remained for analysis. Study subjects were grouped by PN or RN, then matched by age, sex, comorbidities, body mass index, tumor size and depth, histologic type, and preoperative estimated glomerular filtration rate (eGFR) using propensities score. To evaluate oncologic outcomes, overall survival (OS), cancer-specific survival (CSS), and progression-free survival (PFS) rates were analyzed. The functional outcomes were evaluated by postoperative eGFR.ResultsThe median follow-up in the RN group was 48.1 and 42.6 months in the PN group. The estimated 10-year CSS rate (PN 85.7% vs. RN 84.4%, p=0.52) and 5- and estimated 10-year PFS rates (PN: 86.4% and 79.2% vs. RN: 86.0% and 66.1%, p=0.66) did not differ significantly between groups. The estimated 10-year OS rate was significantly higher in the PN group (85.7%) compared to the RN group (73.3%) (p=0.003). PN was less likely to induce new-onset chronic kidney disease (CKD) and end-stage CKD compared with RN.ConclusionOur study suggests that patients treated with PN demonstrate a superior OS rate and postoperative renal function with analogous CSS and PFS rates compared with pair-matched patients treated with RN.

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