POSTER ABSTRACTS - ISAKOS

Outerbridge classification. 34 patients were
bilateral. The minimum follow-up was 12 months,
and the maximum was 14, 4 years (173 months),
which means an average of 35, 89 months or 2, 99
years. The abrasion arthroplasty was performed
with an abrader, combined with multiple micro
picks. The osteotomy was a closing-wedge
osteotomy, with proximal fibular joint lysis and
internal fixation.
Results: The mean knee score for patients treated
by abrasion arthroplasty plus micro picking and
osteotomy was 38, 10 ± 8, 04. Overall 83% of the
patients reported no or mild pain, with 14,2%
moderate and only 2,7% with significant pain.
60,8% were able to walk more than 1 hour, 29,7
%betwenn 16 and 60 minutes, 5% short distances
and only 4,4% reported real difficulty walking.
84,8% of the patients had no difficulties climbing
or descending stairs, 10,5% had moderate and
only 4,7% had found this activity really difficult.
Only 2.5 percent of the patients went on to have
their knee replaced by either TKR or UKR.
Conclusions:
We feel that it is time to have a new and
unprejudiced look at abrasion arthroplasty and
osteotomy as an alternative to knee replacement
surgery. The vast majority of patients treated that
way are very satisfied over a period of up to 15
years and only 2.5 percent of the patients received
a total knee replacement. When compared to
results for TKR and UKR, our results are better,
with fewer and less severe complications. This
treatment modality is particularly interesting for
youg patients and for patients who refuse joint
replacement surgery. In addition, with this
technique one is ''not burning any bridges'' and, if
necessary, the knee can still be replaced.
Key Words: Abrasion Arthroplasty; Micro fractures;
Osteotomie; Osteoarthritis; Knee replacement,
Oxford Knee Score .
E-poster #506
A Comparative Study of the Surgical Incision
Scar Following Primary Total Knee Arthroplasty
Using Midline and Medial Parapatellar
Incisions
Rathnam Obli Sundaram, Warrington, UNITED
KINGDOM, Presenter
Muthukrishnan Ramakrishnan, Upton, Wirral,
Cheshire UNITED KINGDOM
Robert Harvey, Upton, Wirral, Cheshire UNITED
KINGDOM
Richard W Parkinson, Neston, Cheshire UNITED
KINGDOM
Arrowe Park Hospital, Upton, Wirral, UNITED
KINGDOM
Aim: To determine the patient satisfaction of
their surgical incision scar following primary total
knee arthroplasty (TKA) using the validated
Manchester Scar Proforma (MSP) and Visual
Analogue Scales (VAS)
Methods: 2 Groups of patients who underwent
primary TKA were consecutively reviewed. Group
1 consisted of patients who underwent their
primary TKA through a medial parapatellar
incision. Group 2 consisted of patients who
underwent their primary TKA using a midline
incision. The surgical incision scar was assessed
using the validated MSP and VAS to determine
patient satisfaction, functional affect of the scar,
pain and resulting sensory loss.
Results: The mean follow-up period for patient
assessment was 2.67 years. Group 1:- There were
91 patients with a mean age of 71.8 years. The
mean scar length was 19.8cm, the mean MSP
score was 11.73. The mean VAS scores for;
functional affect of the scar was 9.96, scar pain
was 9.97 and sensory loss was 9.56. 5 patients
had superficial wound infections, and 56 patients
noticed significant sensory loss around the knee.
Group 2:- There were 76 patients with a mean age
of 69.9 years. The mean scar length was 19.57 cm,
the mean MSP score was 11.92. The mean VAS
scores for; functional affect of the scar was 9.99,
scar pain was 9.81 and sensory loss was 9.82. 3
patients had superficial wound infections, and 44
patients noticed significant sensory loss around
the knee.
Conclusion: There was no statistical significance
in any of the parameters measured between
midline and medial parapatellar incisions for
primary TKA (p>0.08). Mean incision scars of
19.8cm and 19.57cm for medial parapatellar and
midline incision produced excellent cosmetic
results and the resulting sensory loss is not
significantly distressing. It remains to be seen
whether smaller incisions for TKA will result in
significantly improved cosmetic outcomes in this
age group of patients.