POSTER ABSTRACTS - ISAKOS

E-poster #621
Double Bundle Technique: Endoscopic
Posterior Cruciate Ligament Reconstruction
Using Tibialis Posterior Allograft
Sung-Jae Kim, Seoul, KOREA, Presenter
In-Seop Park, Seoul, KOREA
Sang-wook Ryu, Seoul, SOUTH KOREA
Dept. of Orthopaedic Surgery, Yonsei University,
Seoul, KOREA
Recently, attentions have been headed for double
bundle technique for posterior cruciate ligament
(PCL) deficient knee. We present an one incision
arthroscopic PCL reconstruction technique using
a double-bundle with 3-stranded tibialis posterior
(TP) allograft fixation sequence. The anterolateral
bundle of the PCL is reconstructed using 2-
stranded TP allograft and the posteromedial
bundle using 1-stranded TP allograft successfully.
3-stranded TP allograft will be an alternative graft
choice for PCL reconstruction.
E-poster #622
A Newly Arthroscopic Reduction and Fixation
Technique for the Avulsion Fracture of the
Tibial Attachment of the Posterior Cruciate
Ligament
Ginjiro Minami, Kyoto JAPAN, Presenter
Hara Kunio, Kyoto, JAPAN
Arai Yuji, Kyoto, JAPAN
UradeHidenori, Kyoto, JAPAN
Hirai Naofumi, Kyoto, JAPAN
Nakagawa Haruhiko, Kyoto, JAPAN
Ohta Mitsuhiko Kyoto, JAPAN
Kubo Toshikazu Kyoto, JAPAN
Dept of Orthop, Kyoto Prefectural Univ of
Medicine, Kyoto, JAPAN
We established a newly arthroscopic reduction
and fixation technique for the avulsion fracture of
the tibial attachment of the posterior cruciate
ligament (PCL) utilizing the posteromedial portal.
At surgery, the tibial bone tunnels on medial and
lateral sides of the avulsion fragment can be
created with the arthroscopic view via the
intercondylar notch and posteromedial portal.
This procedure is performed only in the
posteromedial compartment without perforation
of the posterior septum. The looped wires are
introduced into the posteromedial compartment
through the tibial tunnels. Fixation wires or nylon
threads are passed through the looped wires
using posteromedial portal, pulled into the tibial
tunnels, and pulled out on the tibial cortex. Our
procedure can be minimally invasive treatment for
the avulsion fracture of the tibial attachment of
PCL without special equipments.
E-poster #626
Quadriceps Contracture in Permanent or
Habitual Dislocation of the Patella
Yoshihiro Nagaosa, Fukushima, JAPAN, Presenter
Shinichi Kikuchi, Fukushima, JAPAN
Kenichi Ohtoshi, Fukushima, JAPAN
Gota Ohi, Fukushima City, Fukushima JAPAN
Fukushima Medical University School of Medicine,
Fukushima City, JAPAN
Purpose: Permanent dislocation of the patella
(PDP) and habitual dislocation of the patella
(HDP) are relatively rare conditions. The
pathological mechanisms of the diseases are
thought to be associated with laterally displaced
extensor mechanism and secondary bony changes
around the patella. In addition, several authors
indicated that the diseases might be associated
with shortening of the extensor mechanism, so
called quadriceps contracture. The objective of
the study was to assess the association between
the amount of quadriceps lengthening and
postoperative results in PDP and HDP.
Methods: Six patients, who had PDP or HDP in
their unilateral knee and underwent surgery of the
index joint, were enrolled in the study. PDP was
seen in 4 patients and HDP in 2. All patients were
women, and the age at operation ranged from 8 to
31 years,(average 15 years). Associated disease
was noted as follows: severe Down syndrome in
one patient, hydrocephalus with mental
retardation in one patient, none in 4 patients.
Post-operative follow-up period ranged from 7
months to 6 years,mean 31 months. Proximal tube
realignment was performed in one patient.
Modified Stanisavljevic’s extensive lateral release
combined with Insall’s medial imbrication was
performed in the other patients. Medialization of
the tibial tuberosity was performed only in
patients with a closed physis. Quadriceps
lengthening was additionally performed in a
prospective fashion if easy dislocation of the
patella still remained following the above
procedures.
Results: Three patients needed quadriceps
lengthening. The amount of the lengthening
raged from 2 to 4 cm, mean 2.7 cm. In this group
patellar tracking following the operation was good
without any dislocation of the patella, while an
extension lag was noted: within 10 degree in 2
patients and more than 40 degree in a patient who