146 ABSTRACTS

ical examination. Sixty-five percent of the subjects with a Lachman and pivot shift of plus-one returned to their previous activity level without limitation. Seventy percent of the patients with a K-T 1000 compliance index of I mm also returned to the same athletic level. However, only 20% of the patients with a clinical instability greater than the + 1 or a compliance index of 2 mm were able to perform without limitation. The location of the meniscal tear did not correlate with the functional outcome. Six patients required anterior cruciate ligament recon- struction.

Arthroscopic Repair of the Acutely Injured Ante- rior Cruciate Ligament Using Intra-Articular Staple, David Shneider, M.D., East Lansing Med- ical Plaza, East Lansing, MI.

Availability of the intra-articular staple that can be used arthroscopically has allowed the study of 25 patients who had acute injuries to the anterior cruciate ligament and underwent acute repairs ar- throscopically. The patients have been followed for an average of 13 months. The post-operative results in all patients indicate a significant reduction in an- terior drawer and Lachman sign and a very signif- icant reduction in pivot shift. Details of the series will include the pre-operative evaluations of ante- rior drawer, Lachman, and pivot shift signs, asso- ciated injuries to the menisci and articular cartilage. The operative procedures will be summarized in terms of types of procedures and repairs. The post- operative evaluation will include ligamentous testing for anterior drawer, Lachman sign, and pivot shift. The presence of hyperextension will be noted in both the operated and normal knee. Vi- deotape documentation of the technique of surgery will be presented along with the pre-operative and post-operative follow-ups on several patients in the series. To date, no patient has required further re- constructive procedures.

Re-Operation Rate for Arthroscopic Menisectomies in 300 Knees at Three-Year Review, Daniel M. Silver, M.D., Westwood Medical Plaza, Los An- geles, CA.

Arthroscopic microsurgery of the knee is used for a variety of conditions, one of which is for the torn meniscus. This paper reviews 276 patients that had arthroscopic surgery from April of 1979 through June of 1981 by one surgeon. A 21/2-year follow up of 319 meniscus tears were analyzed in detail.

Seven types of meniscal tears were categorized in- traoperatively. Other coincident conditions such as chondromalacia of the articular surfaces, plicae, pa- tellar malalignment, and loose bodies were all noted. Meniscal treatment included partial, subtotal or total menisectomies via the arthroscope. All cases were performed using television monitoring with videotape documentation of both initial find- ings and post-resection results. The primary ques- tion in this study was the number of re-operations required for retained meniscus due to further soft- ening and degeneration or missed secondary tears. This study demonstrates that in the early cases, re- operation was required to remove further meniscus and overall approximately 3% of patients required further surgery for this problem. In 5% of the cases additional surgery was required for conditions other than retained meniscus. These conditions included removal of loose body, patellar realignment or shave procedure, ligament reconstruction and total joint replacement procedures. It is concluded that aggressive reprobing and removal of softened ques- tionable meniscus rim will give a far better result with lower re-operation rate. Certainly partial men- isectomy is more desirable, if possible, however, in many cases, subtotal and total menisectomy via the arthroscope will probably be required to solve the patient's problem. No long term follow-up conclu- sions could be made for post-traumatic arthritis as this was only a 21/z-year follow-up. Other compli- cations such as infections, phlebitis, and anesthetic problems were negligible in this series of ambula- tory knee patients.

An Arthroscopic Review of Incomplete Rotator Cuff Tears, A. M. Wiley, F.R.C.S., F.R.C.S.(C), Toronto Western Hospital, Toronto, Canada.

Many authorities (Codman, DePalma) have found apparently symptom-less incomplete tears of the rotator cuff in one-third of all elderly cadavers. During the course of diagnostic shoulder arthros- copy we frequently encountered incomplete tears of the rotator cuff. Arthrograms are unlikely to readily demonstrate this particular lesion. In some patients plain x-rays showed humeral or acromial sclerosis and suggested an occult tear.

The files of 33 patients thus encountered have been reviewed and the outcome of the cases has been traced by personal review. All patients were initially treated conservatively. Incomplete tears of the rotator cuff were found in seven patients under

Arthroscopy, Vol. 1, No. 2, 1985