POSTER ABSTRACTS - ISAKOS

with the conventional single-bundle isometric
reconstruction. These two bands reproduce more
precisely the natural behavior of the PCL in all the
mobility range.
The purpose of this study is to describe a
modification of an endoscopic PCL reconstruction
technique using a double-bundle tendon allograft
creating 2 femoral tunnel and 2 tibial tunnel.
Surgical Technique: The tunnels in the tibia are
arthroscopically viewed through the
posteromedial portal. A pin is introduced through
a tibial guide entered by the anteromedial portal,
Previously, neurovascular structures in the
posterior area of the joint are protected with a
curette. After that, an 8mm- canulated drill is
passed. It is advisable to perform the most distal
tunnel first and later the most proximal one. In
general, it is necessary to carry out an
arthroscopic desinsertion of the posterior capsule
in order to gain more space and avoid the two
tunnels meeting. The graft passage is performed
independently. First the posteromedial band and
then the anterolateral band. They are first fixed in
the femur and then in the tibia. The main
anterolateral band is fixed first at 90 of flexion
performing an anterior knee displacement, and
then the posteromedial band at 20 flexion. Finally
the graft tension is verified.
The use of the allograft does not produce
morbidity in the patient, decreases the surgical
time and the rehabilitation is faster and painless.
It also maintains the propioception of the knee
and keeps the dynamic stabilizers as the
structures surrounding the knee are not touched.
The difference in performing two tunnels in the
tibia enables the graft passage and its fixation in
an independent way. The disadvantage is that
increases the risk of vascularnervous lesions
associated to the tunnels (being technically more
demandable). Our preliminary results with this
technique are satisfactory, however, it is necessary
a higher number of patients and follow-up in
order to finally evaluate this procedure.
E-poster #633
Epidemiologic Research of Patella Fractures -
6 Year Review
Fabiano Kupczik, Curitiba, BRAZIL, Presenter
Daniel Tenius, Curitiba, Parana, BRAZIL
Marcio Hiroaki Kume, Curitiba, Parana, BRAZIL
Lucio Sergio Ernlund, Curitiba, Parana, BRAZIL
Cajuru University Hospital - Pontific Catholic Uni,
Curitiba, BRAZIL
Introduction: patelar fractures represent 1% of all
the skeleton fractures, considered a rupture of the
extensor device. The surgical treatment is praised
for fractures dislocated more than 3 mm of interfragmentary
fracture or with bigger displacement
that 2 mm in the articular surface. Objective: To
evaluate the results of the surgical and
conservative treatment of patelar fractures in our
institution. Material and Method: 156 patients
had been studied during the period of January of
1998 to January of 2004 and had been chosen 127
patients who had filled the inclusion criteria.
Results: The majority was men (68%), the average
of age was 46,1 years. Average time of follow-up
was of 28,1 months. More frequent trauma
mechanism was the direct trauma with 52%. The
injury was isolated in 89,5%. In the anatomical
classification, the more prevalent type of fracture
was transverse (51,8%). The conservative
treatment was instituted in 29% of the patients.
The surgical treatment in 78% of the patients was
the AO tension band method. Dislocated fractures
was observed in 9 patients. Using the Mcnab
criteria, good and regular results were achieved in
87.8% . Only 18 patients had been submitted to
new surgical intervations. Conclusions:
Satisfactory results can be achieved with the Ao
treatment method, promoting not only an
anatomical reduction of the articular surface, as
well as a restoration of the extensor mechanism.
•E-poster #634
Tibial Tubercle Osteotomy Arthroscopically
Assisted
Victor N Henriquez, CHILE, Presenter
Clinica Tabancura, Santiago, CHILE
We present the results of a new arthroscopic
technique designed to perform tibial tubercle
osteotomies , assisted by arthroscopy, using the
normal arthroscopic portals. We reviewed the
results of 40 patients, with 43 knees, that were
operated on between November 2000 and
September 2003. In 26 knees we did an
anteriorization, in 11 we did a medialization and
in 6 a combined procedure was done(
Anteromedialization). All of them except the last 9
cases, were fixated using one 4.0 mm. cancellous
screw. In the most recent cases we used a newly
designed screw, developed by the author,that
permits to advance the tubercle and fixate it at the
same time, thus saving time. This, so called
Distraction -Fixation Screw ( TDF in spanish )is
describe in detail.