POSTER ABSTRACTS - ISAKOS

North Cheshire NHS Trust, Warrington, UNITED
KINGDOM
Introduction
Arthroscopically assisted anterior cruciate
ligament (ACL) reconstruction has become the
technique of choice for the majority of surgeons.
There are different operative techniques to
implant the graft especially concerning the
method of femoral tunnel placement. Tunnel
misplacement is the most common technical error
which leads to graft failure. Tunnel placement is
probably the single most important variable that
the surgeon can influence in achieving a
successful outcome
The purpose of this study was to compare two
techniques of determining the site of the femoral
tunnel. The first utilising fluoroscopic intraoperative
image guidance(IG) to aid in positioning
of the tunnel , the second without any IG.
Acceptable position for tunnel placement was
decided on review of the literature and the postoperative
radiographs of both groups were
assessed using the method described by Amis et
al (ESSKA Scientific Workshop).
Patients and Methods
From June 2001 two consecutive series of 12
patients with chronic ACL injuries had
reconstruction operations by the same surgeon
(the senior author). We included only patients
with unilateral ACL rupture who had no previous
intra-articular graft surgery. In the first group the
femoral tunnel placement was image guided , in
the second no guidance was used. The post
operative radiographs were evaluated and the
position of the femoral tunnel noted on the lateral
radiograph.
The results were recorded onto a database
(microsoft excel) and analysed.
Results and discussion
No significant difference in the position of the
femoral tunnel was noted between the two
groups. There was no signifiicant difference in
their clinical outcome scores.
The use of IG does not significantly improve the
positioning of the femoral tunnel and therefore
the outcome of the surgery. The authors do not
recomend its use for this purpose.
E-poster #351
Spur-like lesion on the Lateral Tibial Condyle:
A Sign of Chronic Anterior Cruciate Ligament
Tear
Sung Do Cho, Ulsan, KOREA, Presenter
Jong Ken Woo, Ulsan, KOREA
Chae Chil Lee, Ulsan, KOREA
Dept. of Ortho. Surg., Ulsan University Hospital,
Ulsan, KOREA
Introduction: Authors have found that some
patients with chronic anterior cruciate ligament
(ACL) tear had spur-like lesion on the lateral tibial
condyle which was different from lateral capsular
sign or degenerative spur. The purpose of this
study is to evaluate the spur-like lesion and its
significance in relation with chronic ACL tear.
Material and Method: Six patients had spur-like
lesion on the lateral tibial condyle in simple
roentgenogram. The location, shape, and size of
the lesions were studied using anteroposterior
roentgenogram and magnetic resonance imaging.
The cause of primary injury, chronicity of the ACL
tear and associated injury were also analyzed. All
6 patients were male and mean age was 33.8(17 -
46) years
Results: The spur-like lesions were located from
the level of 3.8 mm in average below the articular
surface of the lateral tibial condyle to the apex of
the fibular head and were protruded laterally or
inferolaterally from just posterior to the Gerdy’s
tubercle. Their shapes were triangular with either
round or sharp ends. Average length of the lesion
was 6.0 mm and average width of the base, 9.2
mm. The causes of primary injury were sports
trauma in 5 cases and traffic accident in one. The
chronicity of the ACL tear was from 8 months to
23 years. Medial meniscus tear was associated in
all cases and lateral meniscus tear, in three.
Conclusion: We suggest that a patient who has a
history of trauma with the spur-like lesion on the
lateral tibial condyle of the knee is expected to
have chronic ACL tear and the spur-like lesion is
thought to be a healed Segond’s fracture (lateral
capsular sign).
E-poster #352
Tibial Interference Screw Position in Soft
Tissue ACL Graft Fixation: Biomechanical
Considerations
David A. Hayes, Brisbane, QLD AUSTRALIA,
Presenter
Mark C Watts, Brisbane, QLD AUSTRALIA
Gregory A Tevelen, Brisbane, QLD AUSTRALIA
Ross W Crawford, Brisbane, QLD AUSTRALIA
Brisbane Orthopaedic and Sports Medicine
Centre, Brisbane, QLD, AUSTRALIA