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Paper 141: Database for Knee Ligament Injuries: A Method for Prospective Data Collection and Analysis
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ABSTRACTS
the results a CT guided tibial tuberosity transfer for LTP and OPI. A total of 30 consecutive patients with LTP and 31 patients with OPI and an increased TT-trochlear groove (TG) distance underwent a subtle medial tuberosity transfer. Outcomes were documented at 3, 6, 12 and 24 months follow-up using the Lysholm scale, the Kujala score, and a visual analogue pain score. Postoperatively all but one patients reported good improvement in stability (no persistent subluxations or luxations). All patients had a marked improvement in pain and functional scores at follow up. Kujala scores improved from 61 to 89 for the LTP group, and from 55 to 84 for the OPI group. Lysholm scores improved from 62 to 90 for the LTP and from 57 to 87 for the OPI. VAS pain scores improved from 54 to 16 for the LTP and from 53 to 14 for the OPI. CT guided TT transfer appears to be satisfactory method for treating patients with both LTP and OPI caused an increased TT-TG.
Paper 141: Database for Knee Ligament Injuries: A Method for Prospective Data Collection and Analysis YIANNIS PENGAS, MRCS, UNITED KINGDOM, PRESENTING AUTHOR
ALISON HATCHER, UNITED KINGDOM PAULINE MURPHY, UNITED KINGDOM MICHAEL J MCNICHOLAS, UNITED KINGDOM ABSTRACT Purpose: The creation/design of a user friendly and “doctor proof” database that would allow quick and easy data entry and analysis at the touch of a button, for single or complex knee ligament reconstruction and other sport knee injury related procedures. Materials & Methods: Data is prospectively collected for each patient, starting from the pre-operative phase and continuing through to 5-10 years if required (stages are at 3, 6, 12, 24 months). The scoring systems in use consist of subjective questionnaires: Lysholm, KOOS and IKDC 2000 scores as well as the objective knee examination and IKDC 2000 surgical documentation. Results: Currently the database holds in excess of 200 patients who underwent knee soft tissue procedures and the data has been utilised for national and international presentations as well as local audits. We are at the stage that it has been shared with other knee ligament reconstruction centres in the UK and abroad. Conclusions: We would like to present our work to like-minded colleagues with the aim of sharing experiences and making the database available for their use, if requested.
Paper 142: Arthroscopic Knee Training Using a Porcine Model ADRIANO MARCHETTO, MD, MS, BRAZIL, PRESENTING AUTHOR WILSON MELLO, MD, BRAZIL PAULO CESAR FERREIRA PENTEADO, BRAZIL WANDER EDNEY DE BRITO, BRAZIL ABSTRACT We present an animal model for arthroscopic training with structural and anatomic characteristics very similar to the human knee. This model has low cost, is easy to use, obtain and transport. Can be stored in a regular freezer and can reproduce any “in vivo” arthroscopic surgery. The knees were obtained from pigs with 3 to 4 months of age (weight between 70 to 90 kg) from swine slaughter house. The knees joints were sectioned and fitted in a knee holder that allows movements in all directions. Anatomic dissections and roentgenograms were taken to compare it with the human knee. A 5mm, 30° arthroscope was used to the knee exam and the joint capsule was inflated with watter. The arthroscopic routine established was inspection of the femoro-patellar, lateral, central and medial compartments followed by probing the meniscus, cartilage and ligaments. The next step realized was partials meniscectomies, meniscus repairs, ACL and PCL reconstructions and a combined procedures. In all of the models we used the conventional arthroscopic portals and instruments. The arthroscopic, radiographic and anatomic exam showed that Landrace porcine knee was very similar to the human knee. However some anatomic differences where found like a longer and narrower intercondylar notch, a big troclear sulcus and a prominent meniscus anterior horn. We conclude that the pig knee is an excellent animal model for Knee arthroscopic training. Paper 143: Subchondral Insufficiency Fracture Complicating Arthroscopic Knee Surgery SAMUEL JOHN MACDESSI, MBBS, FRACS, AUSTRALIA, PRESENTING AUTHOR ROBERT H. BROPHY, MD, USA PETER G. BULLOUGH, MB, CH.B, USA RICHARD SHELDON LASKIN, MD, USA RUSSELL E. WINDSOR, MD, USA THOMAS P. SCULCO, MD, USA ABSTRACT Introduction: Spontaneous osteonecrosis has been reported as a rare complication of arthroscopic knee surgery. Despite this, no pathological evidence exists on whether osteonecrosis is responsible. Methods: A retrospective analysis of all patients presenting to our institution between 1995 and 2005 was
ABSTRACTS
the results a CT guided tibial tuberosity transfer for LTP and OPI. A total of 30 consecutive patients with LTP and 31 patients with OPI and an increased TT-trochlear groove (TG) distance underwent a subtle medial tuberosity transfer. Outcomes were documented at 3, 6, 12 and 24 months follow-up using the Lysholm scale, the Kujala score, and a visual analogue pain score. Postoperatively all but one patients reported good improvement in stability (no persistent subluxations or luxations). All patients had a marked improvement in pain and functional scores at follow up. Kujala scores improved from 61 to 89 for the LTP group, and from 55 to 84 for the OPI group. Lysholm scores improved from 62 to 90 for the LTP and from 57 to 87 for the OPI. VAS pain scores improved from 54 to 16 for the LTP and from 53 to 14 for the OPI. CT guided TT transfer appears to be satisfactory method for treating patients with both LTP and OPI caused an increased TT-TG.
Paper 141: Database for Knee Ligament Injuries: A Method for Prospective Data Collection and Analysis YIANNIS PENGAS, MRCS, UNITED KINGDOM, PRESENTING AUTHOR
ALISON HATCHER, UNITED KINGDOM PAULINE MURPHY, UNITED KINGDOM MICHAEL J MCNICHOLAS, UNITED KINGDOM ABSTRACT Purpose: The creation/design of a user friendly and “doctor proof” database that would allow quick and easy data entry and analysis at the touch of a button, for single or complex knee ligament reconstruction and other sport knee injury related procedures. Materials & Methods: Data is prospectively collected for each patient, starting from the pre-operative phase and continuing through to 5-10 years if required (stages are at 3, 6, 12, 24 months). The scoring systems in use consist of subjective questionnaires: Lysholm, KOOS and IKDC 2000 scores as well as the objective knee examination and IKDC 2000 surgical documentation. Results: Currently the database holds in excess of 200 patients who underwent knee soft tissue procedures and the data has been utilised for national and international presentations as well as local audits. We are at the stage that it has been shared with other knee ligament reconstruction centres in the UK and abroad. Conclusions: We would like to present our work to like-minded colleagues with the aim of sharing experiences and making the database available for their use, if requested.
Paper 142: Arthroscopic Knee Training Using a Porcine Model ADRIANO MARCHETTO, MD, MS, BRAZIL, PRESENTING AUTHOR WILSON MELLO, MD, BRAZIL PAULO CESAR FERREIRA PENTEADO, BRAZIL WANDER EDNEY DE BRITO, BRAZIL ABSTRACT We present an animal model for arthroscopic training with structural and anatomic characteristics very similar to the human knee. This model has low cost, is easy to use, obtain and transport. Can be stored in a regular freezer and can reproduce any “in vivo” arthroscopic surgery. The knees were obtained from pigs with 3 to 4 months of age (weight between 70 to 90 kg) from swine slaughter house. The knees joints were sectioned and fitted in a knee holder that allows movements in all directions. Anatomic dissections and roentgenograms were taken to compare it with the human knee. A 5mm, 30° arthroscope was used to the knee exam and the joint capsule was inflated with watter. The arthroscopic routine established was inspection of the femoro-patellar, lateral, central and medial compartments followed by probing the meniscus, cartilage and ligaments. The next step realized was partials meniscectomies, meniscus repairs, ACL and PCL reconstructions and a combined procedures. In all of the models we used the conventional arthroscopic portals and instruments. The arthroscopic, radiographic and anatomic exam showed that Landrace porcine knee was very similar to the human knee. However some anatomic differences where found like a longer and narrower intercondylar notch, a big troclear sulcus and a prominent meniscus anterior horn. We conclude that the pig knee is an excellent animal model for Knee arthroscopic training. Paper 143: Subchondral Insufficiency Fracture Complicating Arthroscopic Knee Surgery SAMUEL JOHN MACDESSI, MBBS, FRACS, AUSTRALIA, PRESENTING AUTHOR ROBERT H. BROPHY, MD, USA PETER G. BULLOUGH, MB, CH.B, USA RICHARD SHELDON LASKIN, MD, USA RUSSELL E. WINDSOR, MD, USA THOMAS P. SCULCO, MD, USA ABSTRACT Introduction: Spontaneous osteonecrosis has been reported as a rare complication of arthroscopic knee surgery. Despite this, no pathological evidence exists on whether osteonecrosis is responsible. Methods: A retrospective analysis of all patients presenting to our institution between 1995 and 2005 was