POSTER ABSTRACTS - ISAKOS

prosthesis. To prevent ulnar loosening we advise
to use an extended ulnar stem and fixate the ulnar
component with cement.
E-poster #204
Epicondylitis. Arthroscopic Treatment
Alberto Pienovi, San Isidro, ARGENTINA,
Presenter
Luciano Quevedo, San Isidro, Buenos Aires
ARGENTINA
Daniel Varela, San Isidro, ARGENTINA
CTO San Isidro, Buenos Aires, ARGENTINA
Introduction: Epicondylitits or tennis elbow is a
frequent pathology among the sports population.
Its medical-physical treatment not always solves
the problem and this pathology becomes chronic
and recurrent.
In this study, a series of 29 cases treated
arthroscopically and their results is presented.
Method: Eleven cases were evaluated, 9 women
and 20 men, who were treated arthroscopically for
chronic or recurrent epicondylitis. Previously, all
cases underwent a treatment consisting of antiinflammatory
drugs, physical therapy and in 16
cases a minimum of 3 infiltrations with corticoids.
Patients were classified in four grades for the
application of different arthroscopic techniques,
according to their clinical evaluation, the MRI and
the arthroscopic findings.
The methodology consisted on the bursectomy,
fasciotomy and release of the epicondyle muscles
in each case.
In 14 cases an intra-articular semeiology of the
elbow was performed, not finding a related
pathology attributable to this lesion.
Results: An average follow-up of 26,8
months (6 to 40) was carried out. Owens
classification in three arthroscopic types was
used, performing in type I (12 cases) bursectomy
and decompressive fasciotomy; in type II (13
cases) epicondyle muscles release, type III cases
with exostosis (4 cases ). Results were 75.8% of
the cases (22 patients) had excellent or very good
results, 20.7% (6 patients) regular results and 3.4%
(1 patient) poor results.
Discussion
The arthroscopic
treatment is considered a good election for
patients with chronic or recurrent epicondylitis,
and where non-surgical treatments are not
effective.
Decompression of the fascia, together with the
partial release of the epicondyle muscles is an
effective method for the treatment of this
pathology and has foreseeable results.
E-poster #205
Four Years Preliminary Experience with
Personal Technique for All Inside Arthroscopic
Repair of Triangular Fibrocartilage
Marco Conca, Milan, ITALY, Presenter
RiccardoConca, Milan, ITALY
Pierangelo Catalano, Milan, ITALY
Orthopedic & Arthroscopic Dep. - Clinica San
Carlo, Milan, ITALY
It's common habit to repair Triangular fibro
cartilage complex lesions by arthroscopy; the
most common techniques are the in-out or the
out - in, both of which have the disadvantage of
an extra incision in order to tie the suture.
We have developed a personal technique that
allows an all-inside repair for T.F.C.C. lesions with
a technique similar to the one used for cuff-repair
in the shoulder.
From May 2001 we have repaired 26 T.F.C.C.
lesions, 21 Palmer 1B, 1 patient with 1B & 1D
Palmer lesion contemporary, and 3 1D lesions
using anchor-screws of 2,0mm.
The middle average was 28, the younger 17 and
the older 45; 18 male and 8 female, 17 right hands
and 9 left. Every patient had clinical signs of
T.F.C.C. lesion and a pre-op. M.R.I. has been
performed to confirm that.
We usually perform 3 portals 3-4, 4-5 and 6R or 6U
with the scope in 3-4. A shaver is used to remove
the synovitis and to refresh the edges of the lesion
to obtain bleeding. We use a suture hook inserted
percutaneusly into the wrist perpendicular to the
lesion or inserted in the 6R or 6U portal, and we
catch both the sides of the lesion, as performed in
side to side cuff tears repair, assisted with a small
holder from 4-5 portal. Than a grasper or a crochet
through the 6R or 6U portal retrieves both the side
of the suture wire and a sliding knot is performed
to tie the suture. The patient is immobilized in a
long-arm plaster in complete supination for 4
weeks. After removal of the cast, the patient
performs an average of 4-6 weeks of physical
therapy. All patients report an improvement in the
strength of the wrist and absence of pain or
stiffness. To date, there has been only 1case of
lesion of the sensitive branch of ulnar nerve, and
no other complication at all. We consider that the
method we suggest has the advantages of not
requiring an additional skin incision, lower risk of
neuro-vascular damage, reduced post-op pain,