POSTER ABSTRACTS - ISAKOS

educed with OKC method in comparison with
non-injured knees. In ACL deficient knees with
CKC method, knee torque was also reduced
because hip and ankle joint torque was increase
in compensation for the decreasing knee torque
and the direction angle of force on the foot plate
was reduced against the axis of lower leg. It was
meant that hip extensor and hamstring muscle
was dominantly activated and thus to prevent the
anterior translation of the tibia This study showed
that isokinetic CKC exercise was quite safe for the
ACL deficient and reconstructed knees.
E-poster #403
Systematic Review or Metanalysis: What to do
and How to Identify Quality of Orthopaedics?
Alvaro Nagib Atallah, Sao Paulo, BRAZIL,
Bernardo Garcia de Oliveira Soares, Sao Paulo,
BRAZIL
Gustavo Jeranimo de Mello, Sao Paulo, BRAZIL
UNIFESP-FEDERAL UNIV. OF Sao PAULO, Sao
Paulo, BRAZIL
The systematic review is a type of study aimed at
making the elaboration of guidelines and
planning of clinical research easier. A great
amount of results of clinical researches are
adequately assembled and organized in a
systematic review. Finally, meta-analysis is a
rigorous statistical method but when performed in
the absence of a systematic review lacks quality. It
assembles under strict statistical methods, the
results of two or more primary studies (Clarke,
2003).
Objective: To evaluate quality of on the anterior
cruciate ligament
Method : methodologic quality of meta-analysis
was evaluated according to the Cochrane
Collaboration criteria
Results Both studies ignored data bases (note
that the mentioned Journals have an impact
factor, for instance: Arthroscopy and American
Journal of Sports Medicine) of important clinical
trials, such as: LILACS, EMBASE, COCHRANE
LIBRARY, etc and also included articles published
only in the English language generating very
important bias of selection. That is, although
these journals where these reviews were
published are indexed to the ISI and have a
reasonable impact factor, the two systematic
reviews have several methodological problems, as
mentioned before.
Conclusion The best systematic review, the one
with the greatest validity, must include clearly all
criteria and with a minimum of omission. As the
systematic review is a scientific process, the
methodology must be described with sufficient
details to make reproducibility of the studies
possible and to generate similar results. At the
Cochrane Collaboration, the Systematic Reviews
are published in the Cochrane Library after a
rigorous process of editorial review of the protocol
and complete review which are at least annually
updated.
E-poster #404
A Meta-Analysis of Anterior Cruciate Ligament
Reconstruction Stability Rates as a Function of
Hamstring Versus Bone-Patellar Tendon-Bone
Graft Selection and Fixation Type
Chadwick C Prodromos, Glenview, IL, USA,
Presenter
Brett L Keller, Glenview, IL USA
Illinois Sports Medicine & Orthopaedic Center,
Glenview, IL, USA
TYPE OF STUDY: Meta-analysis
INTRODUCTION: Hamstring (HS) anterior
cruciate ligament reconstruction (ACLR) has been
felt to result in less morbidity but also less
stability than bone-patellar tendon-bone (BTB)
ACLR. However, since a quadruple HS (QHS)
graft is far stronger than a 10mm BTB graft, and
since modern HS fixation and tunnel healing have
been shown to be as strong as for BTB, we
hypothesized that QHS ACLR should produce
equal or greater stability than BTB. We
hypothesized that lower reported stability with HS
grafts was from older, double HS (DHS) grafts with
older fixation. We also hypothesized that since
the fixation areas of HS grafts are viscoelastic soft
tissue, unlike the bony fixation areas of BTB
grafts, that friction/compressive ''aperture''
fixation such as interference screws would
produce inferior results for HS grafts when
compared to cortical and screw-post type fixation.
METHODS: An extensive computerized medical
literature search was performed for all articles
dealing with anterior cruciate ligaments in
humans since 1990. All clinical series using
hamstring and/or bone-patellar tendon-bone
autograft were selected and analyzed. Inclusion
criteria included minimum twenty-four month
follow-up, stratified presentation of arthrometric
stability data (not just averages), and use of at
least 30lb arthrometric testing (including
maximum manual). The 11 DHS, 15 QHS, and 37
BTB series that met these criteria were then each