POSTER ABSTRACTS - ISAKOS

From 2000 to 2002, 67 patients with an isolated
complete ACL injury, who were amateur athletes
between 15 and 30 years old, were operated by bisocket
ACL reconstruction using multiplied
hamstring tendons. The average age at surgery
was 18.5 years old. The average follow up period
were 27 months (13~51). These patients were
separated into the following two groups. One is
high activity group (Hi-group) which is to return to
competitive sports after ACL reconstruction
almost 8 months. Another is low activity group
(Lo-group) which is not to return to competitive
sports until second-look arthroscopy. There was
no significant difference between two groups
about age and sex. The evaluation was performed
as follows: Tegner activity score, Lysholm knee
scoring scale, KT-1000 arthrometer side-to-side
difference, IKDC, graft in second-look arthroscopy.
We classified grafts into the following three
grades; Grade I: completely covered by synovium,
Grade II: incompletely covered by synovium and
no graft fibers ruptured, Grade III: graft fibers
ruptured partially.
Results
Clinical results at post-operative one year were
revealed in Table 1. Two patients in Hi-group
sustained revised ACL injury before second-look
arthroscopy.
Table 1
Tegner Lysholm KT-1000(mm)
IKDC
Hi-group (N=35) 7.5 98.1 0.4 A:21
B:10 C:4 D:0
Lo-group (N=30) 5.2 97.1 0.5 A:20
B:7 C:3 D:0
Grade of the graft in second-look arthroscopy were
revealed in Table 2.
Table 2
Grade I Grade II Grade III
Hi-group (N=35) 10 17 8
Lo-group (N=30) 24 4 2
Conclusions
These results suggested that sports activity level
influences the graft, though does not the clinical
outcome. Careful observations are necessary for
amateur athlete after ACL reconstruction,
especially high activity group, to avoid early graft
degeneration.
E-poster #333
2 To 5 Years Follow-Up Of Full Thickness
Quadriceps Tendon Graft For ACL
Reconstruction With Aggressive Rehabilitation.
Daniel Slullitel, Santa Fe, ARGENTINA, Presenter
Malier Sebastian, Santa Fe, ARGENTINA
Vaieretti Elisabet, Santa Fe, ARGENTINA
Federico Paquez, Santa Fe, ARGENTINA
Pablo Caas, Santa Fe, ARGENTINA
Instituto Dr. Jaime Slullitel, Rosario, Santa Fe,
ARGENTINA
Introduction
ACL reconstruccion has been used since 1998 with
a full thickness quadriceps tendon graft, opening
everytime the suprapatellar pouch to fasten
dissection and to improve fixation. We present
our medium term results.
Material and Methods
We dissect the full thickness of a tendon of 10 mm
width 8 cm long, including 2,5 cm bone block
opening deliberately the suprapatellar pouch.
Using #2 Ethibond sutures through the tendinous
side, we passed through the femoral ACL hole
retrieving and tying them on the opened pouch
also improving fixation with a bioabsorbable
screw on the femoral hole.
On the tibial side, bone block fixation is done with
standard interference screw. No splints are used
and full weight bearing with aggressive full ROM
movements are started on the first post-op day.
Normally patients progress to run at 45 days and
start practising contact sports as full muscle
balance is regained usually at 5 months. Between
december 1998 and june 2001, 150 patients were
operated and 92 of them came back to evaluation.
Results
In Tegner Sports Scale mean scored 7.9 (our
biggest sport population being Rugby players).
Using IKDC Score, 85 patiens (92,4 %) were rate
normal or nearly normal. KT1000 arthrometric
evaluation scored on 79 patients (85.86%)
between 1 to 3 mm on manual max. 10 patients
(10.87 %) between 3 and 5 mm, 3 patients (3,27%)
more than 5 mm.
On Lyshom Scale mean 90 points. Anterior knee
pain slight to moderate in 8 patients (8.7%) and
crepitus 20 patients (21.7% patients).
No difficulties due to lack of visualisation were
noted on surgery. We have 3 patellar linear
fractures, that required no treatment 1 septic
arthritis with full recovery, 1 case of retrieved
Ethibon sutures due to pain and effusion.
Conclusion
With this technique we achieved medium terms
results in line with best patellar tendon ones with
less anterior knee pain, so it is a suitable
alternative on ACL reconstruction, also with this
aggressive rehabilitation protocol.