Background: anterolateral ligament (ALL) is known since it was found in 1879 by Paul Segond. During more than 130 years this anatomical structure was not popular, later it became especially relevant, when its involvement in knee joint rotational stability was demonstrated by different studies. However, data about anterolateral ligament in the knee joint is controversial and limited so further research is necessary.Purpose of the study: to investigate frequency of occurrence, severity and features of topography of anterolateral ligament of the knee joint in the context of stabilizing procedures on the knee joint.Materials and methods: the study included 60 samples of lower limbs obtained from 30 unfixed corpses of people who died at the age from 69 to 99 years. Topography-anatomical study was performed with knee bent at 90° with internal rotation of lower leg using basic surgical instruments set and precision preparation instruments set. When the ligament was identified, relationship with the lateral meniscus body was evaluated, relationship with peroneal collateral ligament (mainly by connective fibers) and the presence of lateral lower knee vessels (artery and veins) were evaluated. Also, the place of ligament attachment on lateral epicondyle of femur and lateral condyle of tibia were measured.Results: the incidence of ALL in studied age group is 56.6 percent. ALL was observed in both knee joints in 100% of cases. In women ALL was observed in 66.7% (24 joints out of 36), in men — 41.6% (10 joint out of 24). The average length of the ALL was 38.5±4.4 mm. The average width at the level of joint gap — 4.45±0.85 mm.The location of the attachment to the lateral epicondyle of the femur was represented in three anatomical variants: posterior and proximal to the lateral collateral ligament — 64.7%, anterior to the lateral collateral ligament — 23.5%, in the place of attachment of popliteal muscle tendon or next to it — 11.8%. The place of attachment on lateral condyle of the tibia is typical — approximately in the middle of the line from fibula head to Gerdy tubercle.Conclusion. Based on the authors’ findings and findings of foreign studies the optimal area for proximal channel formation is the posterior position and proximal to place of lateral collateral ligament beginning. Also, the anatomical regularity of lateral lower knee vessels is obtained, that allows to preserve one of the main blood supply sources of anterolateral area of the knee joint.

Aim: to evaluate the efficacy of conservative treatment in patients with degenerative meniscal tear (DMT) in the setting of knee osteoarthritis (OA) as an alternative to combined treatment. Patients and Methods: a prospective comparative study included 236 patients aged 45–65 years with DMT in the setting of stage I–III OA according to the Kellgren-Lawrence classification (70 of them — men). Group 1 consisted of 122 patients (86 of them — women) who underwent combined treatment: arthroscopy for DMT of the knee joint and complex therapy in the postoperative period: NSAIDs (celecoxib), a combined drug from the group of symptom-modifying slow-acting drugs SYSADOA (chondroitin sulfate + glucosamine sulfate), exercise therapy, physiotherapy. Group 2 (n=114) received only complex therapy. Control tests (pain assessment on the visual analog scale (VAS), WOMAC scale, life quality assessment on the EQ-5D scale, treatment satisfaction) were performed 10 and 20 weeks after the therapy initiation. Results: there was a statistically significant (p<0.05) improvement in VAS and WOMAC indicators, which continued to decline by week 20 after 10 weeks of both combined and conservative treatment. Also, it did not depend on gender, age, concomitant pathology, but on the body mass index and OA stage according to the Kellgren-Lawrence classification, which was confirmed by the results of the correlation analysis. Patients’ treatment satisfaction and improvement in their life quality were noted in 50% of patients in both groups. Conclusion: arthroscopic meniscectomy should not be indicated as the first treatment stage in patients with DMT during OA. Complex therapy, including the use of drugs from the NSAID and SYSADOA groups at the recommended doses, has demonstrated high treatment efficacy and safety of patients with DMT during OA. KEYWORDS: knee arthritis, degenerative meniscus tear, arthroscopy, celecoxib, chondroitin sulfate, glucosamine sulfate, life quality. FOR CITATION: Bessarab M.S., Krasnov G.O., Charchyan A.M., Khoroshkov S.N. et al. Comparative analysis of the arthroscopy efficacy and complex therapy in the treatment of degenerative meniscal tears in patients with knee osteoarthritis. Russian Medical Inquiry. 2021;5(2):71–77. DOI: 10.32364/2587-6821-2021-5-2-71-77.