POSTER ABSTRACTS - ISAKOS

E-poster #919
The Treatment of Glenohumeral Osteoarthritis
in the Young and Active Patient with the
GraftJacket®: Pre-Liminary Results
Chris Paul Roberts, Ipswich, UNITED KINGDOM
Karin van Rooyen, Cape Town, SOUTH AFRICA
Don F. du Toit, Tygerberg, SOUTH AFRICA
Joe F De Beer, Panorama, Cape Town SOUTH
AFRICA
Pol Huysmans,NETHERLANDS, Presenter
Cape Shoulder Institute, Cape Town, SOUTH
AFRICA
INTRODUCTION:
Treatment of osteoarthritis of the shoulder in
young active patients is a difficult and unsolved
problem.
Present treatment options are debridement,
microfracturing, arthrodesis or shoulder
replacement.
We report the preliminary results of soft-tissue
interposition arthroplasty with an acellular
allograft skin-derived collagen matrix (Graft
Jacket®, Wright Medical).
MATERIAL AND METHODS:
Between July and December 2003 6 patients (5
men, 1 woman) with severe glenohumeral
osteoarthritis had a soft-tissue interposition
arthroplasty of the shoulder.
The average age of the patients was 47 years (34-
58).
The operative procedure was done
arthroscopically in 4 patients.
The Graft Jacket® was sutured to the labrum with
a minimum of 5 sutures.
Average duration of post-operative follow-up was
6,2 months.
RESULTS:
Four patients had significant pain relief after the
operation. The average pre-operative VAS-score
was 7,2 and 2,6 post-operatively.
1 patient had no improvement, but wants to wait
with further treatment, 1 patient was not
successful and had a hemi-arthroplasty.
The range of motion improved only in 1 patient.
The average Constant score improved 14 points
(from 45 to 59).
There were no complications per- or postoperatively.
CONCLUSION:
Soft-tissue interposition arthroplasty with the
Graft Jacket® shows promising results in the
treatment of osteoarthritis in the young and active
patient especially for pain relief.
When the procedure is performed arthroscopically
the morbidity for the patient is very low.
Long term results of this new treatment are still
unknown.
E-poster #920
Clinical Results of Ultrasound Guided Needling
of Calcific Tendinitis of the Shoulder
Chris Paul Roberts, Ipswich, UNITED KINGDOM,
Karin van Rooyen, Cape Town, SOUTH AFRICA
Don F. du Toit, Tygerberg, SOUTH AFRICA
Christo J.F. Muller, Tygerberg, Western Cape,
SOUTH AFRICA
Joe F De Beer, Panorama, Cape Town, SOUTH
AFRICA
Pol Huysmans, NETHERLANDS, Presenter
Cape Shoulder Institute, Cape Town, SOUTH
AFRICA
INTRODUCTION:
Calcific tendinitis of the shoulder is a common
cause for shoulder pain.
Conservative treatment is the the first method of
choice.
In this study we evaluate the ultrasound guided
needling procedure for calcium deposits in the
rotator cuff.
MATERIAL AND METHODS:
Between sept 2002 and September 2003 26
patients (8 men, 18 women) with calcific tendinitis
of the shoulder were treated with an US-guided
needling procedure.
The mean age was 49 and the mean duration of
symptoms was 29 months.
Before the procedure started the skin and
subacromialbursa were infiltrated with a local
anaesthetic.
The calcium deposit was perforated and aspirated
when possible.
With saline a lavage was done to wash-out the
calcium.
RESULTS:
Complete dissolution of the calcium deposit on
the X-ray was seen in 3 patients (11, 4%).
In 11 patients the calcium was partially dissolved
and in 8 patients it was unchanged.
11 patients (42,3%) had significantly improvement
of the pain and did not need any further
treatment.
4 patients required a re-needling procedure and 4
patients needed repeated subacromial injections
during the absorption phase of the calcium.
For 6 patients an arthroscopic calcium removal
was needed.