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Lymphoma is a malignant tumour of the lymphatic system. Neurolymphomatosis occurs when lymphoma cells invade the peripheral nervous system (PNS). Neurolymphomatosis has been reported involving the sciatic nerve, nerve roots and within the axilla and the upper arm. It can cause nerve dysfunction depending on the involved nerve. Neurolymphomatosis involving the ulnar nerve is rare. We report a patient with neurolymphomatosis of the ulnar nerve around the elbow that presented with features of cubital tunnel syndrome. A high index of suspicion is necessary in patients with cubital tunnel syndrome that present with uncommon symptoms such as sudden onset, rapid progression and/or severe pain. Level of Evidence: Level V (Therapeutic)

This study aimed to investigate unwanted radiation exposure of radiosensitive organs during computed tomography (CT) scans of the hand. Furthermore, we investigated the effectiveness of a shield in reducing unwanted radiation exposure. In a prospective observational study, the patients were randomized to receive a shield during the hand CT scan. Two group of patients were further randomized to undergo multi-detector CT (MDCT) or cone-beam CT (CBCT). The radiation dose was measured in the target point and the nearest skin surface of radiosensitive organs by attached the thermoluminescent dosemeter chips. When shielding was performed, the radiation doses had decreased significantly with a mean of 79% (65–91%) in the MDCT group and 88.6% (85–93%) in the CBCT group. In the non-shielded group, the radiation doses to the radiosensitive organs decreased inversely with increasing distance, which means that the closer the target point is, the more unwanted radiation exposure increases. It is important to keep radiosensitive organs as far as possible from the target point during CT scan. In particular, it is necessary to shield the radiosensitive organs closer to the target point. Level of Evidence: Level II, Prospective observational study.

Background: Few studies have reported the outcomes of primary volar locking plate fixation in Gustilo and Anderson type II and IIIA open distal radius fractures. We report the outcomes of treatment of Gustilo and Anderson type II and IIIA open distal radius fractures using primary volar locking plate fixation. Methods: We retrospectively reviewed 24 patients with open distal radius fractures who were treated using primary volar locking plate fixation. The range of motion (ROM) and modified Mayo wrist scores were measured to assess functional outcomes. Radiological outcomes included the bone union period, radial inclination, volar tilt, radial length and ulnar variance. Results: Functional outcomes, including mean ROM in flexion (39.1°) and extension (52.5°), improved following primary volar locking plate treatment. Radiological outcomes were as follows. Mean bone union period, radial length and ulnar variance were 7.8 months, 10.4 and 0.7 mm, respectively. Two patients had superficial wound infection 2 weeks after surgery and one patient had non-union of the radius that required implant removal, autologous iliac crest bone graft and plate re-fixation. Conclusions: Primary volar locking plate fixation is a safe and reliable treatment option for Gustilo and Anderson type II and IIIA open distal radius fractures. By providing firm stabilisation and allowing early ROM exercise, primary volar locking plate fixation resulted in good functional and radiological outcomes. Level of Evidence: Level IV (Therapeutic)

Gorham's disease is a rare disorder of the bone characterized by progressive massive osteolysis. The pathophysiology is unknown, and diagnosis is often difficult. Most cases are often recognized retrospectively. There is no standardized treatment and management for Gorham's disease. We report a case of an 18-year-old male presenting with a pathologic fracture in the humerus shaft diagnosed with Gorham's disease. Patient was treated with autogenous vascularized fibular graft with wide excision and a 10 years followup after first surgery.

Invasive aspergillosis typically occurs in immunocompromised patients and results in fatal complications. Musculoskeletal involvement of aspergillosis is extremely rare, therefore, when it occurs, its diagnosis and treatment could be delayed. In this paper, we report a rare case of primary invasive aspergillosis with radiologic findings in a patient with rheumatoid arthritis. A 57-year-old woman presented a palpable mass on the right hand with a previous medical history of long-term use of immunosuppressive agents due to rheumatoid arthritis. Magnetic resonance imaging showed a multilobulated and multiloculated cystic lesion with an enhancing wall. The wall of the cystic lesion showed low signal intensity on T2 weighted images and intermediate to high signal intensity on T1 weighted images. The mass was confirmed as chronic granulomatous inflammation with multiple acute branching and septated fungal hyphae, consistent with invasive aspergillosis. When a superficial multicystic mass in the hand of especially immunocompromised patients is encountered, invasive aspergillosis should be included in the differential diagnosis, although it is rare.

Background: Our aim was to make a comparative analysis of radiological and clinical outcomes of using either one or two interlocking distal screws on a Polarus intramedullary nail for the internal fixation of humeral shaft fractures. Methods: From January 2008 to March 2014, we enrolled 26 patients with humeral shaft fractures who were operated on using intramedullary nails. The patients were divided into 2 groups according to how many interlocking distal screws were used to lock the Polarus nail: in group 1, a single interlocking distal screw was used in 12 patients; and in group 2, double interlocking distal screws, in 14 patients. We compared the degree of recovery of the displaced fracture fragments between the two groups. To compare the nonunion and shoulder function, we assessed each patient’s modified American Shoulder and Elbow Surgerns (ASES) score. Results: We found that 10 of 12 fractures achieved union in group 1, and 13 of 14 fractures, in group 2. We did not find a meaningful difference in the time to bone union between the two groups. The percentage of recovery of displaced fracture fragments until union was 66.9% for group 1 and 59.41% for group 2. At the final follow-up, we found that the scores for shoulder joint modified ASES was 78.7 for group 1 and 80.7 for group 2. Conclusions: Our results show that if locked appropriately, even a single screw on a Polarus nail can provide satisfactory radiological union and improved clinical outcome after intramedullary nailing of humeral shaft fractures.

Introduction The prevalence of sesamoid bone in hand is known to be variable among populations of various geographic origins. Since counting with radiographs might be inaccurate due to superimposition of adjacent digits, we tried to overcome this obstacle using 3D-reconstructed CT in Korean patients. The purpose was to provide an accurate incidence of sesamoid bones using 3D-CT. Methods Sesamoid bones were examined in 427-CT images. 3D-CT images were analyzed by one observer and parts of hands (411-hands) were evaluated with radiograph to compare with CT results. Statistical analysis between the CT and radiograph results was performed. Results Sesamoids of metacarpo-phalangeal (MP) joint of the thumb were always present on both radial and ulnar sides, except for 9-cases (2.1%) where they were not present on radial side and 6-cases (1.5%) where they were not present on ulnar side. MP joint of the little finger was the second most prevalent location (62.8%). The sesamoid of the index finger MP joint and thumb interphalangeal joint was observed in 44% and 42.4%, respectively. There was a rare incidence in the MP joints of middle and ring finger (0.7%). The incidence of sesamoid bone was statistically different between the two counting methods for the MP joints of index and little finger and thumb interphalangeal joint ( P Discussion We could observe five frequent sesamoid bones in the MP joints of the thumb, index, and little finger, and the interphalangeal joint of the thumb in Korean individuals. 3D-CT images revealed the accurate incidences of hand sesamoid bones.

Purpose: The purpose of this study is to evaluate the clinical results of arthroscopic biceps long head suprapectoral tenodesis using an interference screw. Materials and Methods: We reviewed the cases of 30 patients who underwent arthroscopic biceps long head suprapectoral tenodesis using an interference screw between January 2008 and January 2010. The minimum follow up period was one year. Twenty patients had rotator cuff tears. The results were analyzed by VAS, ASES, tenderness in the bicipital groove, fixation failure, and the degree of deformity. Results: VAS, ASES scores showed a statistically significant increase during the final observation in all patients, compared with those before surgery. However, five patients (17%) had anterior shoulder pain and tenderness in the biceps groove, and three patients (10%) had Popeye deformity. Better results were achieved in patients without rotator cuff tear than in patients with rotator cuff tear (p Conclusion: Arthroscopic biceps long head tenodesis above the pectoralis major using an interference screw in patients with a pathologic lesion of the proximal biceps tendon showed good results at the last follow up. However, further study for tenderness in the biceps groove in 17% of patients is needed.

The purpose of this study was to compare functional outcomes and tendon integrity between the suture bridge and modified tension band techniques for arthroscopic rotator cuff repair. A consecutive series of 128 patients who underwent the modified tension band (MTB group; 69 patients) and suture bridge (SB group; 59 patients) techniques were enrolled. The pain visual analogue scale (VAS), Constant, and American Shoulder and Elbow Surgeons (ASES) scores were determined preoperatively and at the final follow-up. Rotator cuff hypotrophy was quantified by calculating the occupation ratio (OR). Rotator cuff integrity and the global fatty degeneration index were determined by using magnetic resonance imaging at 6 months postoperatively. The average VAS, Constant, and ASES scores improved significantly at the final follow-up in both groups (p

Purpose: To assess the effectiveness of internal fixation using a precontoured locking compression plate for the treatment of the displaced clavicle fracture by analyzing both radiological and clinical outcomes. Materials and Methods: We reviewed 34 cases of displaced clavicle shaft fracture treated by internal fixation using precontoured locking compression plates between May 2009 and February 2010. Radiological outcomes were analized on the basis of bone union and the differences between the time for bone union depending on sex and age. Clinical outcomes were analyzed on the basis of quick DASH Scores and the differences in the range of motion of the affected shoulder compared to the contralateral shoulder. Results: In the radiological evaluation, all fractures showed bone union, and the average time for bone union was 12.3 weeks, without delayed unions. Time for bone union did not differ significantly with respect to sex and age (p=0.87). In the clinical evaluation, the average final quick DASH Score was 23.5 (range, 12~42). At final follow up, the range of motion after bone union in the affected shoulder was not significantly different from that of the contralateral shoulder (p=0.69). Conclusion: The internal fixation achieved using precontoured locking compression plate in displaced clavicle shaft fracture showed effective bone union and can be considered as a reliable method with fine clinical results showing early range of motion at the shoulder joint.

SummaryArthroscopic meniscal repair has been a common procedure for the treatment of a torn meniscus, since the importance of meniscal preservation is widely understood. Over the years, the complications associated with suture material have been reported. Meniscal cyst is also one of those things. But ganglion cyst triggered by non-absorbable suture material was not documented in the literature. We report the case of a 19-year-old boy who underwent arthroscopic ACL reconstruction and repair of the medial meniscus by inside-out technique using 2-0 non-absorbable polyester sutures. The patient returned to our clinic at 4-year F/U with right knee pain due to medial meniscus tear and ganglion cyst. We suspect non-absorbable suture materials itself might have caused soft tissue irritation with repetitive trauma that lead to mucoid degeneration which results in ganglion cyst formation in the end.

Purpose:This study aimed to describe the reverse digital artery cross-finger flap (RDAC flap) in the treatment of failed finger replantation.Methods:This study retrospectively reviewed the records of patients who underwent modified RDAC flap reconstructions for failed finger replantation and assessed their outcomes. Of the patients who underwent soft tissue reconstructions for finger injuries between March 2011 and February 2015, we enrolled 11 patients in whom RDAC flap reconstruction procedures were performed to treat the failed replantations.Results:The flaps survived in all cases, with a mean static, two-point discrimination value of 5.3 mm (range, 4–7 mm) in the healed flaps. The sizes of the flaps ranged from 2 × 1 cm2to 2.3 × 1.5 cm2.Conclusion:The RDAC flap was introduced by Lai et al., and it is a mixed form with the advantages of both cross-finger flap and heterodigital island flap. Our results suggest that it could provide reliable coverage of the sensate soft tissue of fingers with failed replantation.

[Introduction][1] We describe a surgical release for patients who have a lack of elbow flexion limiting the ability to perform activities of daily living after trauma. ![Figure][2] ![Figure][2] [Step 1: Mobilize the Ulnar Nerve][3] Mobilize the ulnar nerve through the cubital tunnel with the accompanying superior ulnar collateral vessels. ![Figure][2] [Step 2: Dissect the Triceps and Resect the Posterior Aspect of the Capsule][4] Dissect the triceps from the distal part of the humerus and resect the posterior aspect of the capsule to expose the olecranon tip and fossa. ![Figure][2] [Step 3: Resect the Posterior Band of the Medial Collateral Ligament][5] Release the posterior band of the medial collateral ligament while continually checking the flexion arc until >130° of flexion can be achieved. ![Figure][2] [Step 4: Resect the Anterior Aspect of the Capsule][6] Perform an anterior approach if there is persistent flexion contracture or any impingement restricting full flexion. [Step 5: Lengthen the Triceps If Indicated][7] Consider triceps lengthening if you cannot achieve >130° of passive flexion with two fingers. ![Figure][2] [Step 6: Transpose the Ulnar Nerve Anteriorly][8] Locate the released ulnar nerve over the medial humeral epicondyle on the fascia overlying the common flexor-pronator muscles. [Step 7: Postoperative Management][9] Physical therapy consists of active-assisted and gentle passive flexion and extension exercises of the elbow, usually for two to six months. [Results][10] Forty-two patients with 130° of flexion can be achieved. ![Figure][2] [Step 4: Resect the Anterior Aspect of the Capsule][6] Perform an anterior approach if there is persistent flexion contracture or any impingement restricting full flexion. [Step 5: Lengthen the Triceps If Indicated][7] Consider triceps lengthening if you cannot achieve >130° of passive flexion with two fingers. ![Figure][2] [Step 6: Transpose the Ulnar Nerve Anteriorly][8] Locate the released ulnar nerve over the medial humeral epicondyle on the fascia overlying the common flexor-pronator muscles. [Step 7: Postoperative Management][9] Physical therapy consists of active-assisted and gentle passive flexion and extension exercises of the elbow, usually for two to six months. [Results][10] Forty-two patients with

Purpose To describe an arthroscopic technique for complete removal of the synovium from the elbow joint and to investigate the clinical outcomes of arthroscopic synovectomy in patients with rheumatoid elbow. Methods Arthroscopic synovectomy was performed on 26 rheumatoid elbows in 25 patients with radiographic changes of Larsen grade 3 or less. We performed total synovectomy of the elbow using multiple portals and by dividing the elbow into the anterior, posterior, and radiocapitellar compartments. At a mean follow-up of 33.9 months (range, 13 to 68 months), pain was evaluated with a visual analog scale and range of motion was measured. The Mayo Elbow Performance Score was used to assess total elbow function. Radiologic changes were determined according to the Larsen grading system. Results The mean visual analog scale score for pain decreased from 6.5 to 3.1, and the mean flexion arc increased from 98.1° to 113.3° after the operation. The mean Mayo Elbow Performance Score improved from 58.5 to 77.4 points. There were 2 excellent, 17 good, 4 fair, and 3 poor results. Radiologic assessment showed no change in 13 elbows, improvement in 6, and progression in 7. Clinically apparent synovitis recurred in 4 elbows, in which the result was considered unsuccessful. Conclusions Arthroscopic synovectomy of the elbow by use of multiple portals is a technically feasible procedure. It can effectively relieve pain, increase range of motion, improve Mayo Elbow Performance Score, and delay radiologic progression in rheumatoid elbows, resulting in a high satisfaction rate, although recurrent synovitis occurs in some patients. Level of Evidence Level IV, therapeutic case series.

Stability of the distal radioulnar joint (DRUJ) is provided by bony architecture and by soft tissues such as the triangular fibrocartilage complex (TFCC), the joint capsule, and surrounding muscles.1) Cadaver studies have demonstrated that the volar and dorsal distal radioulnar ligaments, which are components of the TFCC, play a major role in stabilizing the joint.2-5) Many authors have made various attempts to restore DRUJ stability surgically following trauma. Some have employed indirect methods such as tenodesis using the flexor carpi ulnaris tendon or the extensor carpi ulnaris tendon.6-8) However, these nonanatomic procedures are not reliable in that the normal stability of the joint is not restored and the joint motion may be restricted. Anatomic reconstruction of the major structures responsible for joint stability is the most important principle for the treatment of instability of an injured joint with an intact articular surface. In this sense, some authors have tried to achieve anatomic reconstruction of the volar and dorsal distal radioulnar ligaments for DRUJ stability. Scheker et al.9) reconstructed the ligaments in 15 patients by using a tendon graft whose ends were anchored in pre-drilled holes in the radius and the ulna. Adams and Berger10) reported the clinical results of a procedure in which a tendon graft was passed through near the normal anatomic attachment site of the volar and dorsal distal radioulnar ligaments to attempt the best possible anatomic reconstruction. The objective of this study was to analyze clinical outcomes after anatomic reconstruction of the distal radioulnar ligaments in patients with posttraumatic chronic instability of the DRUJ. The study was based on the idea that the best outcomes can be obtained with anatomic reconstruction of the soft tissue stabilizers and realignment of the DRUJ.

Periarticular cysts in the shoulder joint are relatively rare. The most common are paralabral cysts, which can cause suprascapular nerve entrapment syndrome. Acromioclavicular juxtaarticular cysts have been described in association with full-thickness rotator cuff tears and a degenerated acromioclavicular joint. Intramuscular cysts of the rotator cuff are a relatively rare and unknown type of periarticular cyst. We report a case of an intramuscular cyst of the rotator cuff that was associated with a tear of the rotator cuff.

With the increasing use of arthroscopy and MRI for the diagnosis of shoulder problems, SLAP (superior labrum from anterior to posterior) lesions are more commonly diagnosed, and the incidence of SLAP repair surgery is increasing. Clinical diagnosis of SLAP is difficult to achieve, and many specific physical exam maneuvers have been described. However, neither these exam maneuvers nor history can provide a definitive diagnosis of a SLAP lesion. Despite this limitation, it is helpful to establish a more precise and accurate examination and to construct a preoperative plan. The purpose of this article is to review the original descriptions for specific physical exam maneuvers in SLAP, along with statistical analysis where available. This will help clinicians in deciding which tests are useful, how they should be implemented, and how to interpret the results.

We aimed to identify the clinical and structural outcomes after arthroscopic repair of full-thickness rotator cuff tears of all sizes with a modified tension band suture technique.Among 63 patients who underwent arthroscopic rotator cuff repair for a full-thickness rotator cuff tear with the modified tension band suture technique at a single hospital between July 2011 and March 2013, 47 were enrolled in this study. The mean follow-up period was 29 months. Visual analog scale scores, range of motion, American Shoulder and Elbow Surgeons scores, Constant scores, and Shoulder Strength Index were measured preoperatively and at the final follow-up. For radiologic evaluation, we conducted magnetic resonance imaging 6 months postoperatively and ultrasonography at the final follow-up. We allocated the small and medium tears to group A and the large and massive tears to group B and then compared clinical outcomes and repair integrity.Postoperative clinical outcomes at the final follow-up showed significant improvements compared with those seen during preoperative evaluations (P .001). However, group B showed worse clinical results than group A. Evaluation with magnetic resonance imaging performed 6 months postoperatively and ultrasonography taken at the final follow-up revealed that group B showed a significantly higher retear rate than did group A (69% vs. 6%, respectively; P .001).Arthroscopic repair with the modified tension band suture technique for rotator cuff tears was a more suitable method for small to medium tears than for large to massive tears.

The purpose of this study was to compare the early clinical results of arthroscopic extensor carpi radialis brevis (ECRB) release with and without bone decortication in the treatment of lateral epicondylitis.Thirty-eight patients who were surgically treated for lateral epicondylitis between 2004 and 2008 were included in this retrospective review. Among these 38 patients, 19 underwent arthroscopic ECRB release and 19 patients underwent both ECRB release with decortication of the lateral epicondyle. Outcome measures included pain assessment measured by visual analog scale (VAS) preoperatively, on postoperative day one, at two and 4 weeks postoperatively, and at the final follow-up visit. Functional evaluation was made with the Mayo Elbow Performance Index and grip strength measurement.Patients who underwent simple ECRB release had significantly less pain than patients who underwent ECRB release and decortication immediately postoperatively (p0.05). This group also showed a lower VAS score on exertion 2 weeks and 4 weeks after simple ECRB release (p0.05). The mean time taken to return to work was 24.2 ± 18.3 days in the group that underwent simple ECRB release and 39 ± 22.7 days in the group that underwent ECRB release with decortication (p0.05).Arthroscopic release of the ECRB is an effective method of treatment in patients with recalcitrant lateral epicondylitis. Decortication of the lateral epicondyle leads to increased pain postoperatively and did not improve clinical results.

Suprascapular nerve neuropathy is frequently reported as being caused by a cyst of the spinoglenoid notch of the scapula. It can be also caused by a complication of open surgical procedures requiring dissection of the posterior shoulder joint. The transglenoid suture technique for the Bankart repair can injure the suprascapular nerve if the drilling is performed too deep and without sufficient caution. We describe a case of isolated infraspinatus atrophy due to suprascapular nerve injury below the spinoglenoid notch by improper anchor insertion during the superior labral anterior posterior (SLAP) repair.

45세 남자 환자가 특별한 외상 없이 1개월 전부터 서서히 발 생한 장무지 굴곡력의 약화를 주소로 내원하였다. 이학적 검 사상 무지의 지관절의 수동적 굴곡은 가능하였으나 능동적 굴 곡은 불가능 하였고 해부학적 취약함(anatomic snuffbox)에 압통이 있었다. 과거력상 10년 전에 손목을 다쳤으나 특별한 치료는 받지 않았다. 방사선 검사에서 주상골 중간부에서 불 유합과 함께 원위 골편의 전방 전위와 곱사등 변형(humpback deformity)이 관찰되었으나 요수근 관절의 퇴행성 변화 는 없었다(Fig. 1). 자기공명영상에서 주상골 근위 골편의 무 혈성 괴사는 없었다. 이에 수장 도달법을 이용하여 수술을 시 행 하였다. 수술 소견에서 주상골 불유합 부위에서 전방 관절 Flexor Pollicis Longus Tendon Rupture due to Scaphoid Nonunion

Perilunate dislocation represents approximately 3% of all carpal injuries and is diagnosed late in 25% of cases. Neglected perilunate dislocation accompanies many complications. Multiple flexor tendon rupture is a very rare complication of neglected perilunate dislocation. Three cases have been reported in the English literatures. No case has been reported in Korean literature. We report on a case of multiple flexor tendon ruptures with compressive neuropathy of median and ulnar nerve caused by neglected volar perilunate dislocation.

전완부는 주관절과 완관절을 연결하는 부위로, 회내 및 회 외 운동기능을 가지고 있다. 따라서 전완부 간부 골절의 치료 는 주관절과 완관절 기능의 회복 및 회전 운동을 유지하는데 목적을 두어야 하며 이를 위해서는 양 골의 정상 길이와 요골 정상 만곡의 유지가 필수적이다. 그러나 전완부 간부 골절은 다른 장골 골절과 비교하여 불유합, 지연유합 또는 부정유합 등의 발생 빈도가 높을 뿐만 아니라 도수 정복 유지에도 어려 움이 있어 많은 치료 방법과 기구들이 사용되어 왔다. 보존적 치료로는 요골의 정상적인 만곡을 유지하기 어렵고 정복된 골 편을 만족스럽게 유지시키기 어려워 일반적으로 추천되는 치 료 방법은 관혈적인 해부학적 정복 및 저접촉 역동성 압박 금 속판(limited contact dynamic compression plate, LCDCP)을 이용한 견고한 내고정으로 그 결과 또한 우수한 것으 로 보고 되고 있다. 잠김 압박 금속판(locking compression plate, LCP)은 잠 김 나사를 사용함으로써 생역학적으로 견고한 고정력을 가질 뿐만 아니라, 골 내막의 혈행을 보존하여 골 유합률을 높일 수 있으며 이는 다중 파편 골절에서 골 유합에 있어서 효과적이 Comparison of Locking versus Dynamic Compression Plates for Treatment of Diaphyseal Forearm Fracture

The purpose of this study was to morphologically classify the superior labral anterior and posterior (SLAP) lesion in people with athletic injuries and further research into the clinical result of arthroscopic repair of type II SLAP lesions. January 2005 to June 2012 occurred after sports activity in patients with shoulder pain diagnosed with isolated SLAP lesion by magnetic resonance imaging and arthroscopy were classified according to the tear type. Of these patients, 40 cases of type II SLAP patients were evaluated using American Shoulder and Elbow Surgeons (ASES) questionnaire and range of motion. Also satisfaction of surgery was evaluated by following up through phone calls using translated short form-36 (SF-36). At average of 35 months postoperatively, external rotation decreased slightly from 60.4 degrees to 56.2 degrees, forward elevation and internal rotation were both recovered to a range of pre-surgery but no significant changes were noticed statistically (p>0.05). Visual analogue scale, ASES scores, physical component summary, and mental component summary of SF-36 improved from 5, 1 to 1.2 (p=0.01), from 65.4 to 91.5 (p=0.017), 42.6 to 52.5 (p=0.047), and from 48.5 52.6 to (p=0.036), respectively. In comparison of a group of patients over forty years and less than forty, both groups showed good results, but group of patients less than forty years showed more improvement in pain relief, functional test, and postoperational satisfaction (p=0.004). Arthroscopic repair showed good results in patients with type II SLAP lesion due to athletic injuries especially when they were less than 40 years and it can be regarded as a good treatment with high satisfaction.

Summary Arthroscopic meniscal repair has been a common procedure for the treatment of a torn meniscus, since the importance of meniscal preservation is widely understood. Over the years, the complications associated with suture material have been reported. Meniscal cyst is also one of those things. But ganglion cyst triggered by non-absorbable suture material was not documented in the literature. We report the case of a 19-year-old boy who underwent arthroscopic ACL reconstruction and repair of the medial meniscus by inside-out technique using 2-0 non-absorbable polyester sutures. The patient returned to our clinic at 4 year F/U with right knee pain due to medial meniscus tear and ganglion cyst. We suspect non-absorbable suture materials itself might have caused soft tissue irritation with repetitive trauma that lead to mucoid degeneration which results in ganglion cyst formation in the end.