POSTER ABSTRACTS - ISAKOS

Result : The mean Lysholm knee score was 72.9
points (range 48 to 99) at the latest follow-up. No
statistically significant difference was found in
Lysholm knee scores among the groups.
Radiographic development of osteoarthritis was
seen in 9.1% of the patients in Group 1, in 14.0%
of Group II, in 25.0% of Group III, and in 28.2% of
Group IV after 5 years. After 7 years, osteoarthritis
increased to 18.2% of Group I patients, 29.1% of
Group II, 46.4 % of Group III, and 54.5% of Group
IV. There was statistically significant difference in
radiographic evaluation among the groups.
Conclusion : The development of osteoarthritis
after total menisectomy was highly observed in
cases involving the medial meniscus with ACL
injury. To a lesser extent it was also seen, in order
of incidence, in cases involving the discoid
meniscus, the lateral meniscus, and the medial
meniscus.
E-poster #745
Clinical Results and MRI Findings After
Collagen Meniscus Implant (CMI)
Paolo Bulgheroni, Varese, ITALY, Presenter
Mario Ronga, Varese, ITALY
Federico A. Grassi, Varese, ITALY
Eugenio Genovese, Varese, ITALY
Paolo Cherubino, Varese, ITALY
Dipartimento di Ortopedia e Traumatologia,
Varese, ITALY
Aim: To report clinical results and MRI findings
observed in 50 patients, who underwent collagen
meniscus implant (CMI) between March 2001 and
June 2003.
Methods and materials: Fifty patients, who were
affected by irreparable meniscal lesions or had
previously undergone partial medial
meniscectomy, were arthroscopically treated with
CMI, a tissue engineering technique designed to
promote meniscal regeneration. Average age at
the time of surgery was 38.4 years. The average
size of the lesion/defect was 4.3 cm. Additional
procedures included 16 ACL reconstruction, 8
high tibial osteotomy and 2 autologous
chondrocyte implantation. All knees were
evaluated according to the Lysholm II and Tegner
activity scales. MRI (FSE Fat-Sat T2, SE T1, GRE
T2) was performed 6, 12 and 24 months
postoperatively. Six arthroscopic examinations of
the implant were performed at different times (6
to 16 months postoperatively).
Results: Postoperative complications included
saphenus neuroapraxia in 3 patients and CMI
rupture in 1 patient who presented persistent
knee swelling. Follow up averaged 15.7 months,
with a minimum of 6 months. At most recent
evaluation, 46 patients showed improvement of
the clinical scores. MRI was useful to document
healing of CMI to the meniscal stump and
parameniscus, followed by tissue invasion and
ingrowth inside the scaffold. A progression toward
a more homogeneous signal was detected in the
implants with a two-year follow-up. At second
arthroscopic look, free fragments of the implant
were observed in the knee of the patient, who
suffered CMI rupture. In another patient, partial
resorption of CMI was observed at the posterior
horn. The remaining four arthroscopic
examinations demonstrated regeneration of
meniscal-like tissue with healing of the implants
to the parameniscus and to the residual meniscal
stump; good consistency and stability was
detected by probing.
Conclusions: Clinical results achieved with CMI
are promising, once correct indications are
respected and patients are compliant with
rehabilitation program. MRI demonstrated to be
an effective tool for monitoring the evolution of
the implant and showed good correlation with
clinical outcomes and arthroscopic findings at
follow up.
E-poster #746
All-Inside Meniscus Suture: A New Technique
Graeme Campbell Brown, AUSTRALIA, Presenter
St John of God Hospital, Geelong, Victoria,
AUSTRALIA
The indications for meniscal tears have become
better defined over recent years. The surgical
options for a meniscal repair include open, insideout,
outside-in and all-inside repair using various
implants.
Materials & Methods: Four cases of meniscal
repair using a posterior portal to perform an allinside
suture have been performed. Three
involved the medial meniscus and all were
associated with an ACL reconstruction. The
technique will be described. Results:Three have
been adequately reviewed at an average follow-up
is 6 months and all are clinically healed. No MRI
or second-look arthroscopies have been
performed. There have been no complications
attributable to the posteromedial portal or the
technique. Discussion:The perceived advantages
of this technique are that repairs are anatomical
and performed under direct vision. There is less