The history and MR images are consistent with lateral meniscus bucket handle tear. On the coronal view the meniscus is displaced into the notch and on the sagittal view it is displaced anteriorly. The best next step in management is arthroscopy with meniscus repair followed by immediate joint mobilization or a short period of immobilization. Prolonged knee immobilization is not advisable in meniscal repair patients.
The animal model experiment by Dowdy et al found that dogs that underwent meniscus repair followed by mobilization had a significantly greater collagen percentage in the healing meniscal incision than those that were cast immobilized for 10-weeks (% vs 27% collagen content).
Level 4 evidence from Barber found that successful meniscal healing occurred in 92% of repairs done with ACL reconstructions, but only 67% of meniscus repairs done in stable knees with no ACL injury. They concluded that no modification of an ACL reconstruction accelerated rehabilitation program is required for meniscus repairs performed in conjunction with ACL reconstruction.
Arthroscopic images of a displaced lateral meniscus bucket handle tear in a left knee are shown in Illustration A. Multiple methods of repair can be utilized including all-inside (Illustration B showing lateral meniscus repair with vertical mattress stitch), inside-out, and outside-in suture fixation techniques.
How to get a lean and muscular physique. The best way to build a muscular physique is to follow a training program that maximizes mechanical tension. This is the tension placed on the muscle by the weights that you’re lifting. The heavier the weight ( study ) and the larger the range of motion ( study , study , study ), the more muscle you’ll build. This is the most important factor when it comes to building muscle. The tricky part is that if the tension isn’t intense enough it won’t stimulate any muscle growth ( study ).
Two bumbling, but youthful-looking police force recruits (Hill and Tatum) are assigned to go undercover in a high school to investigate a dangerous drug ring. But they find that high school is nothing like they left it a few years earlier and soon they’re confronting the terror and anxiety of being a teenager again and all the issues they thought they’d left behind. The drastically slimmed down Jonah Hill is no less funny and makes a great double act with the surprisingly talented Tatum. Fans of the ’80s TV series may be disappointed to see it redone as a comedy. Johnny Depp, the star of that show, makes a cameo. [Critics: 84%] [Public: ] – Ranked: 1st Best Of The Year