Abstracts / Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilitation and Technology 9 (2017) 59e124
Conclusion: The medial rotatory with button locked irreducible knee
dislocation is a special knee dislocation, the MRBLIKD is emphasize the
injured structures at the medial, the situation of locked and irreduction of
KD. Prompt open reduction or reduction under the arthroscopy assist is the
treatment of choice.
Keywords: knee dislocation, button, medial rotatory, arthroscopy
Knee - Ligament > PCL/PLRI
EP-220
INCIDENCE OF POSTERIOR CRUCIATE LIGAMENT INJURY
Gang Chen, Tianfu Yang, Weili Fu, Xin Tang, Qi Li, Jian Li, Jian
Li. Department of Orthopaedics And Sports Medicine, West China Hospital,
Sichuan University, China
Purposes: We sought to determine: (1) patient-specific factors and
concomitant injuries of PCL in the general Chinese population; (2) the
differences between the two types of injury.
Methods: A total of 423 patients with PCL injury diagnosed between
January 2006 and December 2015 in a single center were retrospectively
studied. We enrolled 417 cases and excluded 6 cases due to incomplete
records. The patient-specific factors were analyzed, including gender,
side, onset age, duration and cause. We analyzed 11 types of concomitant
injury around the knee, including bone fractures, ligament injuries,
vascular damage, nerve injuries and meniscus tears, and compared the
gender differences. All the cases were divided into substance tear group
and avulsion fracture group. Finally, patients with isolated substance tear
or avulsion fracture were compared with respect to patient-specific
factors.
Results: (1) patient-specific factors and concomitant injuries of PCL in the
general Chinese population; Patients with PCL injury were mainly males
(404, 72.9%) with a peak onset age of 30 to 49 years (236, 56.6%). Traffic
injury was the predominant cause (225, 54%), followed by routine acci-
dental injury (137, 32.9%). Patient-specific factors were not significantly
different between the genders. Isolated PCL injuries accounted for about 1/
3 of all cases (145, 34.8%). Among the concomitant injuries, anterior cru-
ciate ligament (ACL) was the most frequently involved (191, 45.8%), fol-
lowed by medial collateral ligament (125, 30%) and posterolateral complex
(103, 24.7%). Except for lateral meniscus tear (LMT) (p ¼ 0.019) and tibial
nerve injury (TNI) (p ¼ 0.034), most of the concomitant injuries showed no
significant difference between genders.(2) the differences between the
two types of injury. PCL substance tear was more common than AF (299 vs.
118, 71.7% vs. 28.3%, respectively). Patient-specific factors including gender,
side and age of onset showed no significant difference between the two
groups, but duration and cause of injury showed significant difference (p ¼
0.010, p ¼ 0.004, respectively).The incidence of isolated AF was higher than
that of isolated substance tear (67.8% vs. 21.7%). Significant differences in
the duration and cause of injury were found between the 2 groups (p ¼
0.002, p ¼ 0.008, respectively).
Conclusions: Middle-aged males were mainly involved in traffic-related
PCL injuries. ACL injury was the most common injury. Substance tear was
the main injury type, often accompanied with concomitant injury. AF was
mainly isolated. The differences between the two injury patterns might be
related to the degree of violence. The treatment of concomitant injuries
should receive higher attention, especially in patients with LST.
Keywords: posterior cruciate ligament, avulsion fracture, ligament sub-
stance tear, patient-specific factor
Knee - Ligament > PCL/PLRI
EP-287
ARTHROSCOPIC POSTERIOR CRUCIATE LIGAMENT RECONSTRUCTION
WITH REMNANT-PRESERVATION
Chen Chongmin, Sun Yu. Department of Shenyang Hosptal of Orthopaedics,
Shenyang, China
Objective: To evaluate the clinical value of arthroscopic posterior cruciate
ligament(PCL)reconstruction with remnant preservation in enhancing the
85
stability, the revascularization of the graft, and preserving proprioceptive
function.
Methods: From January 2009 to January 2012,82 cases of PCL rupture were
treated with single-bundle PCL reconstruction in which the ligament
remnants were preserved. The tibial remnant and the synovial shell were
preserved as much as possible. Grafts were pulled intra-articularly through
the tibial remnant under arthroscopic visualization. All patients were
followed up for more than one year as scheduled. Lysholm,Tegner and
International Knee Documentation Committee (IKDC)rating scale were
used to evaluate the curative effects at the last follow-up.
Results: At the last follow-up,64 patients(94.1%)had negative anti-Lach-
man results, and 62 patients had 1 degree positive posterior drawer test
results. All patients showed a negative pivot shift test and a normal range
of motion. The average Lysholm score was (61.2 ±7.6) before operation and
(91.7±3.7) at the last follow-up(t¼2.935, P¼0.002).The average Tegner
score was (3.7 ±1.4) before operation and (6.7±1.1) at the last follow-
up(t¼2.289, P¼0.012).The average IKDC score was (65.1±7.9) before
operation and (92.4±4.5)at the last follow-up (t¼3.186, P¼0.001).
Conclusion: Techniques combining remnant-preserving transtibial single-
bundle PCL reconstruction resulted in somewhat better stanblity out-
comes. It is beneficial for the graft revascularization and rehabilitation of
proprioceptive function.
Keywords: posterior cruciate ligament, reconstruction, remnant preser-
vation, arthroscopy
Knee - Osteotomy > High tibial osteotomy
EP-014
OUTCOME OF HIGH TIBIAL OBLIQUE ROTATIONAL OSTEOTOMY
Hitoshi Kanmura 1, Yuji Arai 2, Shuji Nakagawa 2, Hiroaki Inoue 2,
Shinichiro Nakamura 1, Toshikazu Kubo 2. 1 Department of Orthopaedics,
Fukuchiyama City Hospital, Japan; 2 Department of Orthopaedics, Kyoto
Prefectural University of Medicine, Japan
Backgrounds: The purpose of this study is to report clinical results of the
high tibial oblique rotational osteotomy (HTORO).
Materials and Methods: The subjects were 9cases (2men and 7women)
which performed HTORO from February 2005 to August 2009. Outcome
measures were pre-postoperatively femoral-tibial angle, patellofemoral
joint congruity, range of motion, Lysholm score, the time to complete bone
union.
Results: The Femoral-tibial angle was corrected from 183.4 degrees to
171.9 degrees. The patellaofemoral joint congruity was improved at 6
knees of 10 knees. Lysholm score improved from 72.1 points to 89 points.
All cases was provided bone union.
Discussion: One advantage of HTORO is that bone union is easy to be
provided to correct transformation. The other advantage is that the
osteotomy site is more strongly fixed because the lateral proximal and
distal bone cortex came in contact. The tibial tuberosity moved to the
medial side, and so there are possibilities to be effective for the osteoar-
thritis of the patellofemoral joint.
Conclusion: HTORO might let both the symptom of the patellofemoral
joint and medial knee osteoarthritis relieve.
Keywords: osteotomy, medial knee OA, patellofemoral joint OA
Knee - Osteotomy > High tibial osteotomy
EP-028
THE RESERCH OF SPORTS ACTIVITIES AFTER OPEN WEDGE HIGH TIBIAL
OSTEOTOMY
Katsunari Ohsawa, Ryouhei Takeuchi, Hiroyuki Ishikawa, Yuuichiro
Yamaguchi. Department of Joint Surgery, Yokosuka City Hospital, Japan
Background: Open wedge high tibial osteotomy (OWHTO) is a well-
established method for the treatment of medial unicompartmental oste-
oarthritis of the knee, which has shown good midterm results. It is indi-
cated for relatively young and high sports activity population. The purpose
of this study is whether elderly patients who underwent OWHTO can keep
doing their sports activities.