SMW Supplementum 193 - Swiss Medical Weekly

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35 S SWiSS Med Wkly 2012;142(Suppl <strong>193</strong>) · www.smw.ch Free communications of the tibial TKA (ST¹, ST²), the distance of each screw head to the central perpendicular of the tibial TKA (SL¹, SL²), the length of the TTO (O), the distance of the screw heads to each other (SS’), the length of proximal osteotomy (P), the maximal depth of the osteotomy (Q), the width of the proximal abutment (OT). All data were analyzed by a statistician using SPSS. Univariate analysis (Pearson chi square, p
Free communications FM140 Surgery of patellofemoral instability with trochlear dysplasia: Clinical and radiological results after osseous and ligamentous correction with a minimum follow-up of 2 years Mirjam Victoria Neumann, Michael Stalder, Andreas Schuster Spital Ziegler, Bern Introduction: Trochlear dysplasia is frequent in patients with chronic patellar instability. Various surgical procedures have been developed, all aiming at stability and prevention of patellofemoral osteoarthritis (PFOA). Reconstructions of soft tissues such as the medial patellofemoral ligament (MPFL) and vastus medialis obliquus muscle (VMO) are well established but were found to be insufficient for severe trochlear dysplasia. In these cases additional trochleaplasty was recognized safe to achieve stability but progression of the PFOA and high rates of patellofemoral pain were stated. We established a procedure using a parapatellar medial approach to perform the reconstruction of the medial soft tissues and trochleaplasty. Methods: We retrospectively reviewed the clinical and radiological outcomes of consecutive patients, all operated on by a single surgeon. A parapatellar medial approach – including reconstruction of the MPFL and reefing of the VMO when necessary – was carried out. During trochleaplasty, the osteochondral flake was fixed with 2 mm titan screws. Clinical data included apprehension sign and Kujala Knee Score. Pre- and postoperative plain radiographs were compared to evaluate correction of crossing signs, trochlear depth, changes in patella height, and signs of PFOA. Results: Data for 45 knees in 42 patients undergoing operation between 2003 and 2010 were reviewed. The Kujala Score improved from 57 points preoperatively to 80 points postoperatively; no patient suffered from patellar redislocation. On radiographs, signs of trochlear dysplasia disappeared, trochlear depth increased significantly from a mean of 4.2 to 6.5 mm (p 15 mm). The main anterior circumflex branch of the axillary nerve was in close contact with the posterior metaphysis (fig. 1). The mean distance between the nerve and the humeral implants was 5.8 ± 2.4 mm (range, 1.2 to 8.1 mm). Conclusions: The proximity of the axillary nerve to the posterior metaphysis or humeral implants may be a risk factor for neurologic lesions after reverse shoulder arthroplasty. SWiSS Med Wkly 2012;142(Suppl <strong>193</strong>) · www.smw.ch 36 S FM141 Screw-home mechanism and its influence on tibial tuberosity-trochlear groove distance (TTTG): Measurement on MR examinations of the knee in asymptomatic volunteers in full extension, 15°flexion and 30°flexion Sandro F. Fucentese, Michael Betz, Christian Pfirrmann, Peter Koch, Tobias Dietrich Uniklinik Balgrist Purpose: Increased tibial tuberosity-trochlear groove distance (TTTG) is one potential correcting parameter in patient suffering from lateral patellar instability. The so-called screw-home mechanism refers to an outward rotation of the tibia when the knee reaches full extension. We hypothesized that the screw-home mechanism of the knee increases the TTTG of the knee on MRI. Methods: Transversal T1-weighted spin-echo MR images of the knee were acquired at full extension, 15° and 30° flexion of the knee in 30 asymptomatic volunteers. MRI parameters: slice thickness: 3 mm, matrix: 256x384, FOV: 150x150 mm. Two observers measured the TTTG at all positions. Student t-test and intraclass correlation coefficient (ICC) served for statistics. Results: Mean TTTG for observer 1 was 15.1 ± 3.2 mm (range: 8.4–19.9 mm) at full extension, 10.0 ± 3.5 mm (range: 4.0–15.6 mm) at 15° flexion and 8.1 ± 3.4 mm (range: 2.5–14.6 mm) at 30° flexion (observer 2, full extension: 14.8 ± 3.3 mm, 15° flexion: 9.4 ± 3.0mm, 30° flexion: 8.6 ± 3.4 mm). Mean values were significantly different (p-value
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SMW Supplementum 193 - Swiss Medical Weekly

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