POSTER ABSTRACTS - ISAKOS

Introduction: Based on the associated morbidity
with the open surgical excision of the olecranon
bursal sac when conservative treatment has failed,
since 2001 we have treated this pathology with
endoscopic bursal resection.
Material and Methods: We treated 8 patients with
olecranon bursitis refractary to conservative
treatment (aspiration and corticoids injection).
Through a two portal approach almost all the
inflamed areas of the bursa could be resected with
an angled 4.5 shaver. Technique is explained in
the presentation.
Results: After a minimum 1 year follow up we
found no recurrence, with 7 of the six patients
with no pain at all and one patient with pain for 3
months since a fall on the floor two weeks after
the surgery, but pain free after that. No
complications were observed.
Conclusions: Although not a big enough group for
an optimal statistical study or a comparative one,
our impression is that this endoscopic procedure
offers less morbidity, faster recovery and
avoidance of major complications if a careful
technique is achieved.
E-poster #212
Arthroscopic Treatment of Stiff Elbow
Jung Han Yoo, Seoul, KOREA,
Yung Khee Chung, Seoul, KOREA
Jin Soo Park, KOREA, Presenter
Kangnam Sacred Heart Hospital, Seoul, KOREA
The purpose of this study was to evaluate range of
motion and patient-related outcome after
complete arthroscopic release of elbow
contracture. sixteen consecutive patients who
underwent elbow arthroscopy and capsular
release were reviewed retrospectively at a
minimum follow-up of 1 year. Pain and range of
motion were measured. Patient outcome was
assessed with the American Shoulder and Elbow
Surgeons Elbow Assessment Form. Mean selfreported
satisfaction on a visual analog scale was
8.4 out of 10. Flexion increased from a mean of 79
deg. to 113 deg., and extension improved from a
mean of 35.4 deg. to 9.3 deg.. All patients had
improved function after the procedure, with a
mean self-reported functional ability score of 28.3
out of 30. There were two ulnar nerve palsies. The
improvement in range of motion and functional
outcome compares favorably with open-release
procedures. Combined with the potential benefits
of improved joint visualization and low surgical
morbidity, arthroscopic release of elbow
contracture appears to be a reasonable alternative
to open techniques.
E-poster #213
Arthroscopic Repair Of Combined TFCC Tears;
A New Clinical Entity
Michael R. Redler, Trumbull, CT, USA, Presenter
Steven P Fries, Trumbull, CT USA
Beth A Roros, Trumbull, CT USA
The OSM Center, Trumbull, CT, USA
In recent years, appreciation for the role of
triangular fibrocartilage complex tears in ulnar
sided wrist pain has significantly increased (TFCC
- triangular fibrocartilage complex). The TFCC
functions as the major stabilizer of the distal
radioulnar joint. It is the focal point that allows
the carpus to rotate with the radius around the
ulna. As a stabilizer of the ulnar carpus, the TFCC
transmits 20% of an axially applied load from the
ulnar carpus to the distal ulna. Severe twisting
and loading injuries of the wrist are commonly
responsible for tears of the TFCC. These patients
will not only present with ulnar sided wrist pain,
but pain with the extremes of supination and
pronation as well as repetitive activity. Injuries to
the TFCC have presented a challenge in regards to
treatment. We have previously reported on a
successful technique for arthroscopic repair of
peripheral TFCC tears. The technique involves the
use of spinal needles placed percutaneously
through the safe zone and the use of a Shuttle
relay (Linvatec) and
Panacryl suture to create a mattress type repair.
Follow up for a minimum of 24 months has
produced excellent results when evaluated using
the Mayo Modified wrist score. As our series of
patients has grown, we have noted an interesting
subset of patients that have had not only
peripheral TFCC tears, but central tears as well.
To the best of our knowledge, lesions of the TFCC
involving
both central and peripheral tears have not
previously been described. . Past studies have
demonstrated successful outcomes with
debridement of central lesions and repair of
peripheral lesions. Both arthroscopic as well as
open techniques have been described. However,
when we first encountered a TFCC tear with both a
central and a peripheral component; what we have
termed a Combined
TFCC lesion, we were perplexed as to how to
approach the problem. We ultimately did a
thorough debridement of the central component