POSTER ABSTRACTS - ISAKOS

Background: Arthroscopy of the knee is
commonly performed as an outpatient surgical
procedure and effective post-operative pain
management continues to be a challenging
problem. Previous studies have addressed postoperative
management by examining use of intraarticular
analgesia and/or modification of
anesthesia techniques. No previous studies have
however, evaluated the relationship between
sleep deprivation and post-operative pain after
knee arthroscopy. The purpose of this doubleblinded
prospective placebo-controlled
randomized study was to evaluate the
effectiveness of a non-benzodiazepine hypnotic
sleep-aid (zolpidem) in improving post-operative
pain and fatigue in patients undergoing
outpatient knee arthroscopy.
Methods: Sixty-eight patients
undergoing outpatient knee arthroscopy for
treatment of meniscal tears and/or loose bodies
were randomized to three treatment groups
(ZOLPIDEM [24 patients], NONE [24 patients],
and PLACEBO [20 patients]). All groups received
post-operative hydrocodone and ibuprofen.
Patients in the ZOLPIDEM group received a single
dose of zolpidem for the first seven post-operative
nights. Patients in the PLACEBO group received a
gelatin capsule similar in appearance to zolpidem.
Patients in the NONE group received only
hydrocodone and ibuprofen.
Results: Patients in the NONE
group and PLACEBO group (no zolpidem
received) demonstrated significantly worse mean
daily post-operative pain scores on a visual
analog scale when compared with the ZOLPIDEM
group (p = 0.01 and p =0.04, respectively).
Patients in the NONE group consumed
significantly higher quantities of
hydrocodone/acetaminophen post-operatively (p
= 0.04) and had significantly more daily postoperative
fatigue (p = 0.02) than the ZOLPIDEM
group. Patients in the PLACEBO group also
consumed higher quantities of
hydrocodone/acetaminophen and had more daily
postoperative fatigue although these differences
did not reach statistical significance (p = 0.4 and p
= 0.1, respectively).
Conclusion: This study
demonstrates that sleep and fatigue may be an
important factor in the effective management of
pain after outpatient knee arthroscopy. Future
post-operative treatment regimens should
address sleep and fatigue in order to maximize
analgesic effects in these patients.
E-poster w/ Standard #759
Functional Outcome of the Arthroscopic
Meniscal Transplantation Compared with the
Open Meniscal Transplantation
Herman Kaptijn, Leiden, NETHERLANDS,
Ewoud Van Arkel, Den Haag, CK NETHERLANDS
Presenter
Westeinde Hospital, Den Haag,
introduction:
from 1998 on, 79 patients had a meniscal
transplantation with a cryopreserved meniscal
allograft. The first group of 63 consecutive
meniscal allografts ( 57 patients) were
transplanted through an open technique. The
second group of 22 consecutive patients were
operated through an arthroscopic assited
technique. The purpose was to assess the
arthroscopic technique on decreasing the
rehabilitation period.
Materials and methods:
A retrospective cohort investigation in which the
open technique of meniscal transplantation was
compared to the arthroscopic assisted technique.
Both groups were scored according to the
Lysholm score pre-operative and at 6 months and
12 months postoperative. The failures were
analysed. To compare the groups a student-t test
was used (p