POSTER ABSTRACTS - ISAKOS

had severe Down syndrome. On the other hand 3
patients who did not undergo quadriceps
lengthening during the operation showed
abnormal patellar tracking: patellar subluxation in
2 patients and recurrence of patellar dislocation in
one patient.
Summary: Six patients with PDP or HDP were
reviewed. Quadriceps lengthening was associated
with postoperative results. Quadriceps
contracture is considered to be one of the main
pathological mechanisms. Adequate operative
procedure should be based on the amount of
quadriceps contracture.
E-poster #627
Evolution of Patellar Luxation: Operative and
Non-operative Treatment
Sergio Mainine, Sao Paulo, BRAZIL, Presenter
IFOR Hospital, Sao Paulo, BRAZIL
The evolution of 84 patients is presented, 117
knees with at least one well characterized episode
of patella luxation, and a minimum of 5 years of
evolution. These are classified according to the
following criteria: operated: 60 patients, 70 knees
treated by proximal, distal realignment or both
associated through open surgery, follow-up time
5-31 years (mean 8.9); non operated: 41 patients,
47 knees, sickness time 5.8-64 years (mean 16.3)
contralateral knees without instability: 44 knees.
Seven cases excluded, 5 for being operated less
than 5 years before, and 2 for having started the
symptoms less than 5 years ago. Even though the
operated cases had a higher frequency of pre
operatory luxation and giving way, the clinical
results were better than those of the non operated
ones according to LYSHOLM score. However they
presented a higher grade III and IV rate by
SPERNER score than the non operated knees.
This means that in spite of being clinically better
the operated knees present higher seriousness in
arthrosis. The comparison of the pre-operative
and postoperative radiographic demonstrates that
operative treatment didn’t stop the evolution to
arthrosis. There wasn’t significant arthrosis
incidence between the non-operated knees and
the stable patelofemoral knees.
The chondral lesion seriousness found at surgery
was correlated with the clinical and radiographic
evolution. The frequency of pre-surgery giving
ways was not correlated with the clinical nor with
the radiographic results among the operated
knees. However, they were correlated with the
non-operated ones. The older the patients, the
worse the clinical and radiographic results were,
except the clinical evolution among the nonoperated
knees.
The pre-operative history time did not influence
the clinical results but the longer the waiting for
surgery decision, the higher the arthrosis
incidence in the present. The postoperative
follow-up was correlated with the clinical results
as well as with the evolution to arthrosis.
A correlation between the length of the disorder
and the clinical results was observed; however,
such correlation was not noted in the disease
evolution to arthrosis.
In addition, a group of 17 special patients who
presented bilateral instability but with only one
side operated was analyzed. It is important to
mention that the operated side was in general the
most critical one. The results were similar to the
analysis in general, that is, the operated side was
clinically better but more severe in relation to
arthrosis.
E-poster #628
Femoral Trochleoplasty: Surgical Procedure
and Indication
Elvire Servient, Caluire, FRANCE, Presenter
Simone Cerciello, Lyon, FRANCE
Tarik Ait Si Selmi, Lyon, FRANCE
Philippe Neyret, Lyon, FRANCE
Centre Livet, Lyon, FRANCE
Introduction
The trochlear dysplasia is the most fundamental
factor of patellar instability that is present in 96%.
Femoral trochleoplasty has been proposed in the
treatment of femoral trochlear dysplasia. The
interest of femoral trochleoplasty is to create a
trochlear groove. At the contrary of Albee or
Masse’s Trochleoplasty, this procedure does not
elevate the lateral facet of the trochleal and
respect the articular cartilage. The aim of this
study is to describe an original deepthening
trochleoplasty(1)with a special ancillary and to
precise the different surgical steps.
This operation was always associated with a tibial
tuberosity transfer and a proximal realignment.
Material and Methods
15 patients had undergone 17 deepthening
trochleoplasty with a mean follow-up of 73
months (6 -150). The mean age at time of surgery
was 22.6 years (15-46). CT-scan and x-rays allowed
to analyse the trochlear dysplasia according to the
David Dejour’s classification. There were 5
trochleas graded B, 2 C and 11 D. The trochlear