POSTER ABSTRACTS - ISAKOS

with AC injuries can result in unexplained
operative failures and morbidity. There is a high
incidence of SLAP lesions in these surgically
treated patients. Therefore, we recommend the
use of shoulder arthroscopy in patients
undergoing operative treatment of
acromioclavicular injuries and careful
consideration for possible SLAP pathology in
patients with AC joint injuries, particularly those
which fail to improve with conservative care.
E-poster #917
Glenohumeral Arthrodesis. Functional Results
After 7.8 Years.
Sigbjorn Dimmen, Haslum, NORWAY, Presenter
Jan Erik Madsen, Oslo, NORWAY
Per Siewers, Baerum, NORWAY
Orthopedic Centre, Ullevaal University Hospital,
Oslo, NORWAY
Aims. The complications and functional long time
results after glenohumeral arthrodesis are
described.
Methods. 22 patients (9 men, 13 women) with a
median age of 64 (19 - 75) years were operated
with a glenohumoral arthrodesis between 1982
and 2000. The indications for surgery were fracture
sequelae (11), severe osteoarthritis (4), deltoid
dysfunction (3), failed revision arthroplasty (1),
chronic posterior dislocation (1), tuberculosis (1)
and gunshot wound (1). Standard AO surgical
technique with stable plating was used. 6 patients
are dead and 1 refused examination. The
remaining 15 patients were examined
retrospectively after a mean of 7.8 years. The
American Shoulder and Elbow Surgeons (ASES)
score and Oxford score were registered and
radiographs taken.
Results. 8 patients had intermittent or continuous
pain with a mean pain score (VAS) of 1.5 (0-8). 1
patient was reoperated after 4 months due to
excessive pain and one was operated due to a
humeral shaft fracture after 8 months. The
implants had been removed in 5 patients and 1
had a lateral clavicle resection after 3 years. No
patients had infections, but 1 had reflex
sympathetic dystrophy. Radiologically all but two
arthrodesis fused, the remaining 2 were painfree.
Mean Oxford score was 33 (20 - 49), mean ASES
score was 59 (15 - 95).
Conclusions. The functional results after
glenohumeral arthrodesis are comparable with
results reported after shoulder arthroplasty. The
arthrodesis has a wide range of indications and
the long time complications related to shoulder
prosthesis may be avoided.
E-poster #918
Bursoscopy Findings in Patients with
Symptomatic Acromio-clavicular Joints
Chris PaulRoberts, Ipswich, UNITED KINGDOM,
Presenter
Pol Huysmans, NETHERLANDS.
Karin van Rooyen, Cape Town, SOUTH AFRICA
Don F. du Toit, Tygerberg, SOUTH AFRICA
Joe F De Beer, Panorama, Cape Town, SOUTH
AFRICA
Cape Shoulder Institute, Cape Town, SOUTH
AFRICA
INTRODUCTION: The co-existence of
impingement syndrome and acromio-clavicular
joint disease is widely reported. It is
recommended by some that ACJ resection is
combined with subacromial decompression.
METHOD: During the period November 1998 to
November 2003 201 patients with symptomatic
ACJs were taken to theatre. Bursoscopy was
performed and recorded in 183 of these 201
patients. Exclusion criteria were patients that had
previous ipsilateral shoulder surgery and patients
with sonographically proven rotator cuff tears.
There were 129 males and 54 females with a mean
age of 41 (range 16 to 72 years). One hundred and
thirty-six of these patients had a pre-operative
diagnosis of isolated ACJ disease. Forty-seven had
a combined diagnosis of ACJ disease and
impingement.
RESULTS: No abnormal findings were present at
buroscopy in 124 of 136 patients diagnosed preoperatively
to have isolated ACJ disease. In two
minimal bursal fraying was noted but no
decompression performed. In 10 significant
impingement lesions were seen, all these patients
were over the age of 35. Our experience is
therefore that a symptomatic ACJ coexists with
impingement (lesion or signs) in only 31%
(57/183) of patients. Also, no patients under age
35 with a pre-operative diagnosis of isolated ACJ
disease had abnormal bursoscopy findings.
CONCLUSION: We recommend that with careful
pre-operative evaluation unnecessary surgical
violation can be avoided in patients with acromioclavicular
joint disease.