POSTER ABSTRACTS - ISAKOS

Osaka University Medical School, Suita, Osaka,
JAPAN
Treatment of the locked knee due to buckethandle
tear of the medial meniscus in stable
knees is controversial, while that with ACL
insufficiency could be successfully treated by
meniscal repair as well as ACL reconstruction. The
purpose of this study was to clarify the
effectiveness of one-stage treatment of reduction
of the displaced meniscus followed by its repair.
(Materials and Methods)
Of the more than 900 arthroscopic meniscal
surgeries during the past 10 years, as many as 17
cases (17 knees) were diagnosed isolated buckethandle
tear of the medial meniscus due to
athletics. They were 16 male and 1 female patients
with a mean age of 19 years (range 12-43). Eleven
knees (65 %) were injured during kicking, 3 (18 %)
were during twisting, 2 (12 %) were injured during
landing and 1 (6 %) was during contact maneuver.
All of them showed the knee locked. They were
treated with one- stage treatment of reduction of
the displaced meniscus followed by its repair.
(Results)
Sixteen menisci were repaired (average 12 sutures;
range 8-16) and the remaining irrepairable one
was partially excised. While inside-out technique
was applied using Henning instrumentation for
repairing the middle to posterior segment, the
zone specific cannula system and/or all-inside
technique with the suture hook were utilized for
the anterior segment tear. Postoperatively, all
repaired cases were returned to their preinjury
level at 4-5 months postsurgery. Second-look
arthroscopy at average 12 months postsurgery in
six knees revealed complete healing in 4 and
incomplete healing in 2.
(Conclusion)
The locked knee due to bucket-handle tear of the
medial meniscus in stable knees can be
successfully treated with reduction of the
displaced meniscus followed by its repair, while
as many as 12 sutures were needed for repair.
E-poster #772
Autologous Chondrocyte Transplantation: Two
Case Report
G. M. Reis Jr., Campinas, BRAZIL
Moises Cohen, Sao Paulo, BRAZIL, Presenter
UNIFESP-FEDERAL UNIVERSITY OF Sao PAULO-
GMREIS, Sao Paulo, BRAZIL
INTRODUCTION: The use of cultured cells to
regenerate cartilage lesions has been widely
applied in the Autologous Chondrocyte
Transplantation technique. Chondrocytes do not
proliferate in vivo and damaged cartilage has a
very limited capacity. Some surgical techniques,
such as drilling, and abrasion, induce the filling of
the damaged site with fibroblastic cells. The repair
tissue formed shows fibrous characteristics, with
distinct composition and biomechanics. The
biological option for cartilage treatment,
Autologous Chondrocyte Transplantation, results
in the formation of cartilage maintaining the
composition and function of the original tissue. In
the Latin America this treatment was firstly
applied in two patients with traumatic condyle
lesion.
METHODS: LK, woman, thirty-nine years old and
LSP, woman, thirty-nine years old showed
osteochondral lesion, troclhea femoral and
patellar chondromalacea. Previous surgeries and
conventional treatments were unsuccessful.
Autologous chondrocyte transplantation was
indicated. During arthroscopy procedure the
articular surfaces were regularized and cartilage
samples were obtained form a non-weigh bearing
area. The autologous chondrocyte transplantation
was made 20 days after the arthroscopy. The
follow up was made using MRI. A second
arthroscopy was made in both cases.
RESULTS AND DISCUSSION: The 10 months
follow-up of the two full chondral defect of the
femoral condyle treated with autologous
chondrocyte transplantation showed satisfactory
clinical results. The second arthroscopy made
showed periosteum integration and the
appearance of normal cartilage. The tissue formed
at the lesion site was soft, indicating
condromalacea, level I. The MRI showed a
cartilage formation at the site of the lesion.
CONCLUSION: The conclusion that the
autologous chondrocyte transplantation can be
safety carried on in BRAZIL came from the
satisfactory clinical evaluation of the patient, the
MRI images and the second arthroscopy showing
graft integration. Other clinical cases are in
progress to extend the data.