POSTER ABSTRACTS - ISAKOS

malalignment. We recommend this procedure
according to our good results.
E-poster #645
Effects of Pretension in ACL Reconstruction
Ronald van Heerwaarden, Nijmegen,
NETHERLANDS,
Leendert Blankevoort, Amsterdam,
NETHERLANDS
D. Stellinga, Rotterdam, NETHERLANDS
Arjen Frudiger, Capelle a/d IJssel, NETHERLANDS
Sint Maartenskliniek, Nijmegen, NETHERLANDS
The mechanisms by which pretension affects the
results of ACL reconstructions were studied in
clinical, biomechanical and computer model
analyses.
Methods:
Pretensions of 60 N and 40 N applied to a Dacron
ligament prosthesis were compared in 2 groups of
13 patients by means of IKDC-, Lysholm-, and
Tegnerscores and isokinetic testing, in 4 fresh
knee specimens tested in a 6 DOF motion and
loading rig, and in a 3D computer model
simulation.
Results:
The higher pretension (60 N) resulted in a
decreased squatting ability in the patients at 4
years follow-up, in large tibial position errors and
abnormal graft forces in the biomechanical
analysis, and in significant changes in knee
kinematics and knee force balance as compared to
the 40 N pretensioned knee and the ACL intact
knee.
Conclusion:
The pretension exerts its effects on the knee
kinematics and the knee force balance by means
of the position of the tibia affecting the anterior
laxity and the tibiofemoral migration pattern and
by means of the graft force balanced by the PCL
and the joint cartilage surfaces. The working
mechanisms by which pretension variation results
in underconstrained, overconstrained or normal
reconstructed knees were established.
E-poster #646
Percutaneous Drilling for Painful Partite Patella
Keisuke Inoue, Yamato Koriyama City, JAPAN,
Presenter
Masao Ishimura, Ikoma, Nara, JAPAN
Yoshiyuki Fujisawa, Nara, JAPAN
Nishi-nara central Hospital, Nara city, JAPAN
Since 1984, we treated painful partite patella with
new operative technique that the painful patellar
fragment is drilled percutaneously to the main
portion of the patella. This technique is lower
invasive and more easy for post-operative
treatment than the other technique. Thirty
patients (mean age thirteen years) were treated by
percutaneous drilling for painful patella partite.
Drilling is performed with Kirschner wire (1.2~1.8
mm) at supra-lateral portion of patella(Saupe ?),
percutaneously. Radiological findings were
excellent in all patients except for 3 patients.
Clinical results were excellent in all patients
except for one patient. All patients except for one
patient, were returned to sports from 2 to 3
months. This technique is more effective than the
other technique for return to sports in children.
E-poster #647
Medial Collateral Ligament Release of the
Knee
Ronald M Selby, New York, NY, USA, Presenter
Stephen J O'Brien, New York, NY USA
Hospital for Special Surgery, New York, NY, USA
This paper describes a technique supplementing
arthroscopic surgery for improving access and
visualization of the posteromedial aspect of the
knee. Used extensively by the senioe author (SJO)
and recommended particularly for young
arthroscopists still honing their skills in gaining
mastery of tight places in the knee this technique
has proven useful in cases of meniscal repair,
partial menisectomies, and other cases requiring
better visualization and access to the
posteromedial sector than achievable by
conventional methods.
Under direct arthroscopic visualization, with the
knee held in extension and with valgus stress the
deep band of the MCL is palpated. Following this
a spinal needle is brought in percutaneously and
is brought through the fibers of the MCL just
inferior to the medial meniscus. The spinal needle
is then moved in and out in a sewing machine
type of motion, keeping it at all times under the
skin, until the MCL is felt to release. Improved
visualization and increased opening is thus
obtained. No added mobidity or increased postop
pain has been noted to result.