POSTER ABSTRACTS - ISAKOS

performed an additional endobutton back up
fixation.
Follow-up objective IKDC evaluation distribution
was as follows: A, 8 knees; B, 29 knees; C, 13
knees; and D, 2 knees. Average final follow-up
IKDC subjective score was 80,2 (40-100).
Conclusion:
The first cases we performed demonstrated the
learning curve as it is immanent with every new
fixation device. The change of the fixation device
due to technical problems occurred within the
first twenty patients. Meanwhile a device to notch
the tibial aperture is available.
The retrograde aperture fixation of soft tissue
grafts in tibial cortical bone allows a safe and rigid
graft fixation. Till today there are no studies about
graft slippage under cyclic loading with the
Retroscrew. Screw diameter should be adapted to
bone stock quality as it is measured while drilling
the tibial tunnel. Recommendation is to choose
the same screw size as tunnel diameter for hard
bone quality and a one millimeter larger screw for
soft bone quality. Load to failure measurements
have to be performed for different srew sizes for
different bone stock qualities.
The Retrocrew is easy to apply and is possible to
combine with another distal tibial fixation (hybrid
fixation) like endobutton or another anterograd
back up screw.
E-poster #611
The Utility of Medial Patellofemoral Ligament
Reconstruction for Recurrent Patellar
Dislocation and Subdislocation.
Yoshinori Mikashima, JAPAN, Presenter
Zenshukai Gunma Sports Medicine Reserch
Center, Maebashi, JAPAN
Background; Although more than 100 different
surgical techniques for the treatment of patellar
instability have been described during the past
100 years, various problems continue to be raised.
Recently, the medial patellofemoral ligament
(MPFL) has been recognized as being an
important stabilizer of the patella, preventing
lateral dislocation.
Hypothesis: Reconstruction of the MPFL will
useful for the treatment of recurrent patellar
dislocation and subdislocation.
Study Design: Prospective randomized clinical
trial.
Methods: We reviewed 25 patients with recurrent
patellar dislocation and subdislocation who had
undergone realignment surgery from July 1999 to
December 2001. In these, there were 11 patients
who had undergone Elmslie-Trillat procedures
designated Group E. And there were 14 patients
who had received reconstructions of the MPFL
with the Elmslie-Trillat procedure designated
Group M. We investigated the postoperative
assessment of both groups, and compared them.
Results: At the 2-year follow up, the apprehension
sign remained positive in 4 knees in Group E, but
negative in all knees in Group M. And on stress
skyline view, stability in Group M was better than
that in Group E significantly.
Conclusions: We concluded that reconstruction of
the MPFL is useful for the treatment of recurrent
patellar dislocation and subdislocation.
E-poster #612
Periosteum-Enveloping Hamstring Tendon
Graft For Arthroscopic Anterior Cruciate
Ligament Reconstruction - Minimal Three Years
Clinical Outcome
Chih-Hwa Chen, Keelung, TAIWAN, Presenter
Chang Gung Memorial Hospital, Keelung, TAIWAN
Introduction: Tendon-bone incorporation of a
tendon graft within the bone tunnel is of priority
concern when using for anterior cruciate ligament
ligament reconstruction. Superior healing process
and stronger healing strength can be achieved
when periosteum is sutured on the tendon
inserted into a bone tunnel. We applied this idea
to ACL reconstruction to enhance tendon-bone
healing.
Materials and Methods: A 4-stranded hamstring
tendon graft was used. A piece of periosteum was
harvested from the anterior cortex of proximal
tibia, and split into two rectangular flaps. These
periosteum flaps are wrapped and sutured around
the tendon graft near the femoral and tibial tunnel
openings. From 2000, 104 patients with complete
final follow-up data for minimal 3 years were
analyzed. The average follow-up time was 27 (36
to 48) months.
Results: 96 (92%) patients achieved good or
excellent results by Lysholm knee rating. The
median Lysholm knee score was 56 (40 to 70) and
94 (58 to 100) points before and after surgery. 86
(83%) patients could return to moderate or
strenuous activity after reconstruction. 6 (6%)
patients were found to exhibit grade 2 or more
ligament laxity. Complete range of motion could
be achieved in 90% of patients. 5 patients (5%)
had positive pivot shift. Finally, 96 (92%) patients
were assessed as normal or nearly normal rating