POSTER ABSTRACTS - ISAKOS

tunnel position even if they have excessive
hyperextension. Thus, it is appropriate to
determine the tibial bone tunnel position from
the intersection between the tibial plateau and
Blumensaat’s line in an accurate lateral view of
the uninjured knee in the majority of cases.
However, in the case of knees with excessive
hyperextension and a vertical intercondylar notch
roof, i.e., so-called unforgiving knees, it remains
to be determined how best to make the tibial
bone tunnel.
E-poster w/ Standard #419
Initial Tension of Reconstructed ACL on Clinical
Outcome Including MRI Findings
Masaki Sonoda, Chiba, JAPAN, Presenter
Takeyuki Okazaki, Chiba, JAPAN
Tsuguo Morikawa, Chiba, JAPAN
Kan Tsuchiya, Chiba, JAPAN
Hideshige Moriya, Chiba, JAPAN
Kawatetsu Hospital, Chiba, JAPAN
Introduction: Initial tension applied to the graft is
an important factor for successful anterior
cruciate ligament (ACL) reconstruction. Optimal
ranges for graft tension are advised and
recommended by several studies. The purpose of
this study was to analyze clinical outcome
including magnetic resonance image (MRI)
findings with two different set forces of initial graft
tension.
Materials and Methods: ACL reconstruction
through use of hamstring tendons and
endobutton technique were performed on 96
knees (42 male, 54 female, average age 26.9).
Distal part of the graft was connected to a
polyester tape and fixed to the proximal tibia
using double staples with two different set forces
(80N or 120N). Group I (80N) included 60 knees
and Group II (120N) 36 knees. Assessment was
performed at one year post surgery, including
Lysholm score, IKDC score, side-to-side difference
of KT-2000 (133N), and MRI findings. MRI
findings of reconstructed ACL were divided into
three grades; Grade I: low signal, Grade II: high
signal within 50%, and Grade III: high signal over
50%.
Results: No significant differences were observed
between two groups in Lysholm score. IKDC score
(Grade-number) was Group I (80N) (A-18, B-39, C-
3, D-0) and Group II (120N) (A-11, B-24, C-1, D-0)
with no significant difference. Anterior laxity side
to side difference was 1.9±1.7 mm in Group I and
1.9±1.4 mm in Group II with no significant
difference. MRI finding (Grade-number) was
Group I (I-54, II-6, III-0) and Group II (I-33, II-3, III-
0) with no significant difference.
Discussion and Conclusions: A previous study of
hamstring grafts reported that the patients with
initial tension of 80N have less laxity than those
with 20N and 40N. This study indicated no
significant difference in clinical outcome including
MRI findings between two groups (80N and 120N)
of initial tension. A relatively high initial tension
may subside to an adequate tension through
rehabilitation and possible clinical outcomes have
demonstrated no significant difference.
E-poster w/ Standard #420
Preemptive Analgesic Effect of Valdecoxib in
Arthroscopic Anterior Cruciate Ligament
Reconstruction: A Randomized Controlled Trial
Felicia Li-Sher Tan, Singapore, SINGAPORE,
Presenter
Pankaj Bajaj, Singapore, SINGAPORE
Amit Kanta Mitra, Singapore, SINGAPORE
Boon Keng Tay, Singapore, SINGAPORE
Cheng Shi Tham, Singapore, SINGAPORE
Paul Chang, SINGAPORE
Singapore General Hospital, Singapore,
SINGAPORE
Introduction: Postoperative pain control has
gained importance in the orthopaedic arena as
more procedures are being performed on an
outpatient basis. This study aims to assess the
effect of pre-operative versus post-operative
administration of a selective cyclo-oxygenase 2
(COX-2) inhibitor on pain scores and analgesia
consumption after arthroscopic anterior cruciate
ligament (ACL) reconstruction.
Method: Randomized, placebo-controlled,
double-blind trial conducted between January
2003 through January 2004, enrolling 40 patients
undergoing arthroscopic ACL reconstruction
with/without partial meniscectomy at a tertiary
hospital in Singapore. Patients were randomly
assigned to 2 groups. The first group received
Valdecoxib 40mg 2h before surgery and a placebo
15min after surgery (Preoperative group). The
second group received a placebo 2h before
surgery and Valdecoxib 40 mg 15min after surgery
(Postoperative group).
Main Outcome Measure: Post-operative pain
scores at rest and on movement using a visual
analogue scale (VAS) and analgesia requirements.
Results: There was significant difference in VAS at
rest between the two groups at 3 hours (p=0.02).