POSTER ABSTRACTS - ISAKOS

E-poster w/ Standard #939
Arthroscopic Management of Partial Articular
Side Tear of the Rotator Cuff
Mario Larrain, Buenos Aires, ARGENTINA,
Presenter
Guillermo Botto, Buenos Aires, ARGENTINA
David M.Mauas, Buenos Aires, ARGENTINA
Cristian Collazo, Buenos Aires, ARGENTINA
Horacio E.Rivarola, Buenos Aires, ARGENTINA
Mansilla, Buenos Aires, ARGENTINA
PURPOSE: There is no consensus as regards the
pathogenesis and management of
partial articular side tears of the rotator cuff. The
purpose of this study was to evaluate the
incidence, associated injuries, treatment options
and results.
METHODS:We retrospectively analyzed our
shoulder arthroscopic procedures performed
between December 1998 and December 2002. Out
of 89 procedures performed due to symptoms in
the subacromial space-rotator cuff, we found 62
(71.95%) rotator cuff tears, 17(23.7%) were partial.
Ten of these lesions were located in the articular
side, 6 on the bursal side, and 1 on both sides
(7.9%). In 6 cases treated for internal impingement
syndrome, we found 3 partial articular lesions of
the rotator cuff; and of 208 patients with anterior
shoulder instability, 11 cases had rotator cuff
lesions and 6 (2.9%) of these were partial lesions
on the articular side. Of the 20 patients treated, 13
were male and 7 female. Average age at surgery
was 42 years. Twelfe of these patients were
athletes.
Neither physical examination nor MRI imaging
were diagnostic. Definite diagnosis was made
arthroscopically, settling the depth and extension
of the lesion after debridment, and if the lesion
was < 50% of the tendon thickness this was the
treatment (15 cases, 75%). If the lesion was > 50%,
arthroscopic repair depended on age and
functional demand. For good quality tissue we
performed transtendon repair (2 cases 10%), for
bad quality tissue repair by completing the lesion
(3 case, 15%). The most frequently associated
lesions were in relation to the biceps (50%): 6
SLAPS, 4 with tendon damage.
RESULTS: The incidence of partial articualr side
tears was 12,4% in arthroscopies perfomed for
subacromial space-rotator cuff symptoms, 50% for
internal impingement and 2.9% for instability.
The average follow up of our patients was 3.4
years with a high percentage of excellent and
good results using the Burkhart’s modified UCLA
scoring system.
CONCLUSION: The diagnosis of these lesions is
mainly arthroscopic, since MRI has low sensitivity.
Debridment allows us to identify, measure and
treat the lesion. The arthroscopic surgical
technique used and final prognosis depend on
tissue quality. The arthroscopy is an excellent
method for the management of partial articular
side tear.
E-poster w/ Standard #940
Arthroscopic Acromio-clavicular Joint Excision
via Superior Portals
Chris Paul Roberts, Ipswich, UNITED KINGDOM,
Presenter
Tim Cresswell, Cape Town, Western Cape, SOUTH
AFRICA
Hennie Bosch, Cape Town, Western Province,
SOUTH AFRICA
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
METHOD: During the period June 1994 to October
2003 155 isolated ACJ resections using the direct
superior approach were performed. Exclusion
criteria were previous ipsilateral shoulder surgery,
simultaneous arthroscopic procedures and
osteoarthritis.
We were able to contact 90 of these patients, 94
shoulders, who completed a telephone
questionnaire (Simple Shoulder Test). There were
72 males and 18 females with a median age of 38
(range 16 to 62 years). 54 were dominant
shoulders and 44 had a history of trauma, of
which 11 were rugby related.
RESULTS: The follow-up period had median of 29
months, with a range of 6 to 118. The postoperative
Simple Shoulder Test scores had a
median of 12 (mean 11.5) with a range from 6 to
12. Patients evaluated their outcomes as excellent
in 63, good in 22, moderate in 5 and poor in 4.
There was one portal infection that resolved with
debridement and antibiotics. Five patients
underwent revision surgery: four open revision
Mumford’s and one subacromial decompression.
CONCLUSION: The technique provides
consistently good or excellent results (90%) and
allows rapid return to normal function. There was
a complete resolution of pain in 73 of the 94