POSTER ABSTRACTS - ISAKOS

OTHER
•E-poster #800
Extracorporeal Shockwave Therapy for Soft
Tissue Pathologies: Case Review
Paulo RobertoRockett, Porto Alegre, BRAZIL,
Presenter
Ana ClaudiaSouza, Rio de Janeiro, Rio de Janeiro
BRAZIL
Paulo RobertoSantos, Sao Paulo, BRAZIL
Ortosom, Cortrel and Orthomaster, Sao Paulo,
BRAZIL
Introduction: The aim of this retrospective study is
to demonstrate the experience of three BRAZILian
Centers of Extracorporeal Shockwave Therapy
using an electro hydraulic high-energy device
(REFLECTRON -HMT) to treat Soft Tissue
Pathologies.
Materials and Methods:
From March 2001 to May 2003, 260 consecutive
patients were treated in 6 different orthopaedic
practices: 60 tendinosis calcarea of the shoulder,
26 tendinosis of the shoulder, 42 epicondylitis; 24
hip bursities, 39 Achilles tendon calcifying (or not)
tendinosys; 69 plantar fasciitis.
Inclusion criteria was a minimum of 6 months of
unsuccessful conservative treatment.
One treatment was performed on 235 patients, 21
patients underwent a second treatment and 2
patients underwent a third treatment.
Depending on the localization 1200 to 1500 pulses
at E3 to E7 were applied as the parameters
suggested by HMT.
We used the analogical-visual scale of pain
intensity as subjective evaluation, considering
optimum/good values between 0-3, fair 4-6,
unsatisfactory 7-10.
We observed side effects such as local irritation,
petechia, hematomas, swelling and increase in
pain 24-36 hours after treatment. Through an
objective point of view, we matched x-rays and
ultrasound exams which had been performed
before treatment with those that were performed
90 and 180 days after treatment.
Results:
The Roles and Maudsley criteria were used for
outcome analysis:
Grade 1: excellent - no pain, full movement and
activity.
Grade 2: good - occasional pain, full movement
and activity.
Grade 3: acceptable - some discomfort after
prolonged activity.
Grade 4: poor - pain limiting activity.
Seven patients were excluded because of
inadequate follow-up. The remaining 253 patients
were included in the analysis with follow-up
ranged from 6 to 14 months.
We considered excellent and good (Grade 1 - 2):
46 cases (77.96%) of tendinosis calcarea of the
shoulder; 23 cases (88.46%) of tendinosis of the
shoulder; 32 cases (80%) of epicondylitis; 22 cases
(91.66) of hip bursitis; 24 cases (66.66%) of
Achilles tendon calcifying (or not) tendinosys and
52 (74.47%) of plantar fasciitis.
The improvement in pain score (VAS) was
statistically significant when a follow-up
examination was performed after 30, 90 and 180
days.
E-poster #801
Intra-Articular Synovial Lipoma of the Knee
Located in the Intercondylar Notch, between
ACL and PCL. A Case Report.
Harilaos S. Vasiliadis, Ioannina, GREECE,
Presenter
Efstathios Motsis, Ioannina, GREECE
Theodoros Xenakis, Ioannina, GREECE
Department of Orthopaedics, University of
Ioannina, Ioannina, GREECE
We report a case of a 16 year old girl Presenter
with persistent knee pain. No history of trauma or
any joint disorder or general disease was evident.
Pain sustained for the last two years, especially
after stressing activities, with no respond to
conservative treatment. Clinical evaluation
revealed no effusion of the knee joint which was
stable, with no signs of ACL or PCL laxity or other
ligament or meniscal injury. From the palpation of
the joint, a slight protrusion was felt at the
popliteal region. MRI showed an intraarticular
tumor arising from the posterior synovium
extending between the ACL and PCL. Characters
were completely compatible with lipoma.
Arthroscopy confirmed the presence of the tumor,
and the histological examination ensured the
diagnosis of synovial lipoma. Excision of the
lipoma led to immediate relief of the symptoms
postoperatively. Intra-articular synovial lipoma is
a very rare situation usually seen in adults, with
only a few references in the literature. One more
case found in an adolescent and also one more
have been described located in the intercondylar
notch. Intra-articular synovial lipoma although
rare, should be considered in the differential