POSTER ABSTRACTS - ISAKOS

The double incision technique is easy, has low
morbility, reproduce and allow early
rehabilitation.
E-poster w/ Standard #414
Ten Year Follow-up of PBTB ACLreconstruction
with Emphasis of Occurrence of
Osteoarthritis
Thomas Patt, Huizen, NETHERLANDS, Presenter
Maikel Bruin, Amsterdam, NETHERLANDS
Miguel E Sewnath, Amsterdam, NETHERLANDS
Cor P van der Hart, Amsterdam, NETHERLANDS
OLVG, Amsterdam, NETHERLANDS
The Hypothesis - What is the question?
The purpose of this study was to evaluate the
incidence of osteoarthritis ten years after aclreconstruction.
Does acl reconstruction have an
influence on osteoarthritis of the knee ?
Method - How was the question investigated?
Between March 1993 and January 1994 53 patients
with acl instability were operated arthroscopically
using the central third bone-patellar-tendonbone.
At minimum 10 year follow up 58% (n=31)
of the patients (11 female / 20 male, 41 (26-53)
years of age at follow-up, matched the including
criteria (no knee ligament surgery at the
contralateral side, no ipsilateral revision) and
could be reached for follow-up. All patients were
operated upon by one surgeon (CPvdH). Followup
was 10 years (118-128 months) after the initial
reconstruction and was done by one independent
examiner. Evaluation included a patient
satisfaction evaluation using a Visual Analog
Scale (VAS), clinical examination (IKDC score,
Tegner score, Lysholm score, KT-1000
stabilometry) and a radiological evaluation (knee
AP standing, lateral and patella in 30 of flexion).
X-ray evaluation, according to the classifications
of Kellgren and Fairbanks, was performed by two
independent examiners.
Results - What are the results?
The overall IKDC score at the 10 year follow-up
demonstrated 32% IKDC A , 52% B and 16% C
results. The KT 1000 arthrometer revealed 55% A (-
1-2mm), 29% B (3-5mm) and 16% C (6-10 mm)
stability. The Lysholm score showed satisfactory
results with a mean of 91 points (range 56-100),
which was also seen in the VAS (1-10) with a mean
of 8.5 (range 4-10). According to the Tegner score
(mean pre-op 6.8 / post-op 6.0) 52% of the
patients were able to perform at the same activity
level as pre-operatively, 6% could improve one
level. 16% decreased one level, 13% two levels and
another 13% three levels (the last group due to
non-knee-related reasons).
Looking at the osteoarthritis rate 55 % decreased
one grade according to the Kellgren classification,
32% two or more grades. In 13 % there was no
change, compared to the contralateral side. The
Fairbank classification showed increase in
osteoarthritis in 52% grade 1, 35% grade 2 and 3%
grade 3. 10 % had no changes 10 years after
follow-up.
Conclusions
10 years after acl-reconstruction more than 60% of
the patients showed only a slight increase
concerning osteoarthritis. 52% could keep up the
level of activity and 6% could even improve it.
There was no correlation between the level of
activity and occurrence of OA. The long term
clinical results of acl-reconstruction are
satisfactory, the occurrence of arthritis only minor
to moderate based on radiographic criteria and
minor based on Visual Analog Scale
E-poster w/ Standard #415
Reduction of Post Operative Pain Following
ACL Reconstruction Using Low Temperature
Irrigation Fluid
Hayden Morris, Melbourne, AUSTRALIA,
Presenter
Jon Borrill, Manchester, UNITED KINGDOM
Andrew Porteus, Bristol, UNITED KINGDOM
Jon Seddon-porteus, Bristol, UNITED KINGDOM
University of Melbourne, Melbourne, Victoria,
AUSTRALIA
Introduction
Cold therapy is known to reduce pain and swelling
after surgical procedures
on the knee. We hypothesised that if cold therapy
is started earlier, then
there would be a reduction in pain and swelling in
patients undergoing
arthroscopic anterior cruciate ligament (ACL)
reconstruction
Methods
We prospectively randomised 40 patients
undergoing arthroscopic ACL
reconstruction with hamstring autograft, to
receive either room temperature
(19ºC) or cold (4ºC) arthroscopy irrigation fluid.
Patients were then
assessed over the following 7 days, with regard to
pain (measured on a
visual analogue scale), and swelling (measured
with limb girth at 4 points