POSTER ABSTRACTS - ISAKOS

E-poster w/ Standard #643
Semitendinosus Tenodesis for Chronic Medial
Instability of the Knee
Sung-Jae Kim, Seoul, KOREA, Presenter
Nam-Hong Choi, Seoul, KOREA
Yong-Min Cheon, Seoul, SOUTH KOREA
In-Seop Park, Seoul, KOREA
Sang-wook Ryu, Seoul, SOUTH KOREA
Andri MTLubis, Jakarta, INDONESIA
Dae-Ya Kim Seoul KOREA
Dept. of Orthopaedic Surgery, Yonsei University,
Seoul, KOREA
Background: The results of treatment for chronic
medial instability of the knee have been rarely
reported. The purpose of this study was to present
the operative technique and analyze clinical
results of semitendinosus tenodesis for the
chronic medial instability of the knee.
Methods: Thirty-eight patients underwent
semitendinosus tenodesis. The average of preoperative
side-to-side difference of the medial
opening on stress radiographs was 8.2 mm. For
reconstructing the medial collateral ligament
(MCL), the semitendinosus tendon was sectioned
at the musculotendinous junction and was
overlapped and parallel with MCL by dissecting
the accessory insertion of the semitendinosus
tendon. An isometric point for replacing MCL was
located on the medial epicondyle. A 6.5-mm
cancellous screw with a 18-mm washer was placed
in the drill hole 9 mm above the isometric point.
An inverted V-shaped bony trough was made. The
graft tendon was hooked around the screw, and
the screw with a washer was tightened to hold the
tendon on isometric point. The free end of the
tendon was pulled diagonally and passed through
the insertion of the direct head of the
semimembranosus tendon to reconstruct the
posterior oblique ligament. The average follow-up
period was 5 years and 4 months.
Results: The average of Lysholm and Gillquist
score was 89.1. The average of HSS score was 89.5.
The IKDC score was A for thirteen patients, B for
twenty, C for four and one patient got D score. The
average of side-to-side difference of the medial
opening was 1.2 mm in stress radiographs.
Complications were superficial wound infection,
loosening of the screw, saphenous nerve
irritation, stiff knee and degenerative changes.
Conclusion: The semitendinosus tenodesis
provided clinically reliable technique in patients
with chronic medial instability of the knee.
E-poster #644
Arthroscopic Patellofemoral Realignment in the
Treatment of Recurrent Dislocation-
Subluxation of the Patella
Mohammad Razi, Tehran, IRAN, Presenter
Hossein Vahid Tari, Tehran, IRAN
Rasoul Akram University Hospital, Tehran, IRAN
Introduction: Recurrent dislocation and
subluxation of patella is more common in the 2nd
decade of life and is caused by different
anatomical and functional abnormalities.
Different conservative and surgical procedures are
described by many authors in the treatment of
this abnormality.
Materials and methods: In this before and after
study, 19 patients with documented recurrent
dislocation and subluxation of the patella
underwent arthroscopic realignment procedure
including lateral release and medial reefing by the
main author. From 1998 to 2002, just patients with
severe valgus, varus, and rotational deformities
excluded from this procedure. Loose body and
chondral lesion type III were seen in ten cases and
type IV in the other nines. Neoprene patellar
support or patellar bandage was used
postoperatively for the average of 2 weeks. The
average follow up period was 28.5 months and a
designed questionnaire and Lysholm score was
used for evaluation of patients pre and
postoperatively.
Results: Full ROM achieved in all cases and
functional ability improved significantly in all
patients. Limping, swelling, stepping, squatting,
locking, using knee support and instability were
evaluated pre and postoperatively and improved
significantly. Preoperative average Lysholm score
was 48.5 and improved to 88.5 postoperatively.
Average Lysholm pain score was 5.8
preoperatively which improved to 20.5. In this
study there was no relation between severity of
chondral lesion and final functional ability of the
patients.
Conclusion: Many authors have recommended
diagnostic arthroscopy and treatment of
combined lesions including loose bodies and
chondral lesions before open surgical intervention
of this problem. As there is no doubt that
arthroscopic patellofemoral realignment has less
morbidity, we tried to limit the number and
intensity of the operations by using this technique
in patients suffering from patellofemoral
instability but mild to moderate knee