POSTER ABSTRACTS - ISAKOS

E-poster #520
Arthroscopic Evaluation and Management of
Unicompartmental Degenerative Disease of the
Knee
Rodica Marinescu, Voluntari, ROMANIA, Presenter
Dan Laptoiu, Bucharest, ROMANIA
Colentina Clinical Hospital, Bucharest, ROMANIA
Arthroscopy plays an important role in the
evaluation and management of degenerative
disease of the knee. The decision for
reconstructive surgery is taken during the
arthroscopy in numerous cases.
The study group we reviewed consists of 60 cases -
active, younger than 50 years old, with
symptomatic unicompartmental degenerative
disease who underwent arthroscopy - initial
procedures included lavage, meniscectomy,
chondrectomy of cartilage flaps, removal of free
bodies and removal of limited osteophytes.
Average follow-up is 36 months - the outcome
being related to improvement of pain, function
and need of further surgery; all patients followed
similar post-operative protocol with
rehabilitation, bracing and wedge insoles,
chondroprotective oral drugs. 16 cases (26.6%)
required subsequent surgery - 10 osteotomies and
6 unicompartmentals - at an average of 8 to 10
months.
Discussion
- due to discordant aspects found between clinic
and X-rays, arthroscopy may be the best guide for
therapeutic decision;
- history of mechanical symptoms, relatively acute
onset of symptoms may be related to a faster
clinical improvement and better outcome;
- osteotomy should be prepared at the time of
first arthroscopy ; it may be a valuable ''gaining
time'' intervention in well-selected cases;
- unicompartmental arthroplasty was a special,
age-limited indication; in our group, we used only
mobile bearing Oxford implants.
E-poster #521
Total Knee Replacement in the Young Patient:
A Prospective Study
Gareth Stables, Lymm, UNITED KINGDOM,
Presenter
James Edward Arbuthnot, Warrington, Cheshire
UNITED KINGDOM
Michael J McNicholas, Warrington, Cheshire
UNITED KINGDOM
North Cheshire NHS Trust, Warrington, UNITED
KINGDOM
We report our experience of younger patients with
a primary diagnosis of osteoarthritis undergoing
Total Knee Arthroplasty (TKA). Patients were
recruited prospectively and included if they were
65 years of age or younger at the time of operation
and had a primary diagnosis of osteoarthritis. In
the first part of this study we present the results
for 75 knees in patients 65 years of age or younger
with minimum 3 years follow-up. The mean
American Knee Society Scores improved from 34.5
to 84.0 for the knee score and from 48.6 to 75.8 for
the function score. Break-down of the scoring
system shows that predominantly, the knee score
increases as a result of pain relief and the function
score increases as a result of improved walking
ability.
Analysis of one-year results of TKA in a cohort of
1202 patients under 65 years of age divided into 5-
year age bands shows that there is a small but
significant difference in the results achieved by
surgery in this younger age group. Patients under
56 years of age had poorer knee scores at one year
in comparison to the older groups.
Our study shows that TKA remains a good,
reliable management strategy in the treatment of
younger patients with osteoarthritis affecting the
knee.
E-poster #522
Comparison of Anteroposterior Laxity in Mobile
Bearing Prostheses in vivo Using Two Different
Arthrometers
Yoshinori Ishii, Gyoda, Saitama, JAPAN,
Ryo ishii, Gyoda, Saitama, JAPAN
Hiroshi Kiga, Gyoda, JAPAN
Ishii Orthopaedic and Rehabilitation Clinic,
Gyoda, Saitama, JAPAN
A number of factors affect sagittal laxity in total
knee arthroplasty (TKA), including applied force,
soft tissue structures, and implant design. This
study compared the anteroposterior (AP)
displacement in a mobile bearing TKA system
using two different arthrometers between
posterior cruciate ligament (PCL) retaining (PCLR)
and PCL sacrificing (PCLS) prostheses and to
assess the role of the PCL in mobile bearing TKA
prostheses. Sixty LCS prostheses were analyzed.
Thirty knees had PCLR and 30 had PCLS
prostheses. The selected patients had successful
arthroplasty at 2 years postoperatively. The
greater AP laxity in PCLR versus PCLS showed the
influence of implant design, because only PCLR
allows AP excursion. The less effect of AP laxity on