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Each arthroscopic portal to the knee has a blind area that cannot be inspected directly. In particular, visualization of the posterior compartment is difficult to access. Although arthroscopic procedures for the posterior compartment of the knee joint have been developed through posteromedial, posterolateral and posterior trans-septal portal, the popliteal bursa remains as an area that is difficult to access and manipulate. We report a surgical procedure that can examine one of the blind spots in knee arthroscopy, popliteal bursa.

We describe the arthroscopic management of the posterior capsule tear using posterior trans-septal portal. This technique is usually used in acute cases where a torn capsule is found but we can also use this technique for reefing of stretched capsule by refreshing the injured capsule. When arthroscopic ligament reconstruction accompanies postero-medial or postero-lateral capsular insufficiency, using the posterior trans-septal portal could ensure better visualization of the capsule and a subsequent more accurate management of the capsule. Since it is helpful in lessening the instability, it could contribute to achieving successful clinical results although this is not a mighty procedure.

The aims of this study were to quantify the angle and placement of an anterior cruciate ligament (ACL) grafted with a single incision ACL reconstruction technique using postoperative magnetic resonance imaging (MRI), and to compare the results with those with a native ACL. Between February 1996 and May 2004, 96 consecutive patients, who had undergone postoperative MRI of the knee followed by an arthroscopically assisted ACL reconstruction with either a hamstring tendon or bone-patellar tendon-bone (BTB) autograft, were enrolled in this study. The femoral tunnel was drilled using the transtibial technique. The patients were divided into two groups; the hamstring tendon graft group (group H; 50 patients) and the BTB graft group (group B; 46 patients). All the patients including both groups in this study underwent postoperative MRI and were followed up for a minimum of 2 years. The control group (group C) consisted of 50 patients whose meniscus tear had been operated on by arthroscopy and whose ACL was intact. The orientation of the ACL ligament or graft was measured using three different methods: the sagittal ACL angle, the ACL-Blumensaat line angle, and the coronal ACL angle. The mean sagittal ACL angle in group C (58.7 +/- 3.8 degrees ) was significantly lower than in groups H (64.6 +/- 4.2 degrees ) and B (71.3 +/- 6.0 degrees ). The mean ACL-Blumensaat line angle in group C (8.6 +/- 3.6 degrees ) was also significantly lower than in groups H (12.8 +/- 5.2 degrees ) and B (18.0 +/- 5.3 degrees ). The mean coronal ACL angle in group C (65.9 +/- 4.4 degrees ) was lower than that in groups H (73.5 +/- 2.4 degrees ) and B (75.2 +/- 2.9 degrees ). The grafted ACL of the hamstring tendon and BTB grafts on the postoperative MRI showed a significant vertical angle in the coronal and sagittal plane compared with the native ACL. In the sagittal plane, the hamstring tendon graft was positioned more obliquely than the BTB graft, which had a larger angle of the tibial tunnel, in an attempt to prevent a graft-tunnel mismatch. The postoperative MRI study showed that the more horizontally the angle of the tibial tunnel can be placed in a single incision ACL reconstruction, the more efficiently it can produce a graft closer to the native ACL.

Few cases have been reported in which the femoral interference screw has migrated into the posterior compartment after an ACL reconstruction. It usually requires removal, because it leads usually to mechanical symptom. However, the arthroscopic removal of a screw is a technically demanding procedure, especially in the case of the femoral interference screw that has migrated into the femoral notch (posterior compartment), an intact integrated ACL graft or one that is encapsulated around the screw. We present a case in which a displaced femoral interference screw migrated within the posterior compartment 11 years postoperatively, after the graft had been incorporated at the femoral site. Although it is often technically challenging, through the use of a posterior trans-septal portal, we can successfully remove a displaced femoral interference screw even in the most difficult locations in the posterior compartment.

Pleurotus ostreatus No. 42 produced the ligninolytic enzymes, manganese peroxidase (MnP) and laccase, in agitation culture in glucose/peptone/wheat-bran medium. Formation of mycelial pellets 1-2 mm in diameter was essential for the production of MnP; and the concentration of dissolved oxygen in the culture medium greatly influenced the production of MnP, a concentration over 5 ppm being necessary for MnP production. The maximal activity of MnP was obtained on days 7-9 of culture, after the consumption of nutrient glucose. Introduction of oxygen from the start of the cultivation caused large pellet formation, which resulted in a low MnP activity level. P. ostreatus No. 42 produced two MnP isozymes in agitation culture. The major isozyme, F-2, was 36.4 kDa and had a pI of 3.95. The MnP characteristics, Km values, dependence on Mn2+ and optimum pH showed the similarity between this isozyme and MnP 3, which was produced under different culture conditions. Analysis of the N-terminal amino acid sequence indicated the close similarity of F-2 to MnP 3.