ABSTRACTS 329

plete disruption of the repair in one, and partial healing in four. In these four, the labrum appeared to be "spot welded" to the glenoid neck with per- sistence of a juxtaarticular sulcus between the re- paired soft tissue and bone. All three patients with recurrent instability had lax glenohumeral liga- ments.

In order to determine technical features of arthro- scopic Suretac repair that might contribute to in- complete healing of the labrum and repair, we ar- throscopically created and repaired a Bankart le- sion with this device in eight cadaver shoulders. An arthrotomy was performed, the repair was evalu- ated, and selected sagittal sections were made and inspected. We found that the lowest possible place- ment of the Suretac on the glenoid was at the 4 o'clock position. This resulted in a persistent sepa- ration of the soft tissue from bone below the lowest Suretac unless the inferior capsule was shifted su- periorly before tac placement. Placement of a tac medial to the edge of the glenoid also resulted in persistent labral separation, and the labrum was not well opposed to the bone between each tac. Based on the results of our clinical and laboratory studies, we recommend that the inferior glenohumeral liga- ment be shifted superiorly before placement of the first tac. This tac should be placed as inferiorly as possible, immediately adjacent to the articular car- tilage. We now use a minimum of three tacs in order to minimize soft tissue redundance and reduce the incidence of ajuxtaarticular sulcus. We also recom- mend that the glenoid rim be carefully prepared with a burr and rasp to promote soft tissue to bone healing. We do not recommend arthroscopic repair in cases with excessively lax or friable capsular tis- s h e .

Comparison of Endoscopicaily and Arthroscopically Assisted Anterior Cruciate Ligament Reconstruction. Nicholas A. Sgaglione and Robert E. Schwartz. Manhasset, New York, U.S.A.

The purpose of this study was to determine whether endoscopic reconstruction of the anterior cruciate ligament (ACL) offers any significant ad- vantages over arthroscopically assisted reconstruc- tion. A consecutive series of 90 athletically active patients (67 males, 23 females) who underwent re- construction for ACL deficiency using a patellar tendon autograft was retrospectively reviewed. The study group consisted of two treatment subgroups: group 1 [endoscopically assisted (EA) technique us-

ing no lateral femoral condylar incision] consisted of 45 patients with a mean age of 25 years (range 15--43); group 2 [arthroscopically assisted (AA) technique using both anterior and lateral femoral condylar incisions] consisted of 45 patients with a mean age of 25 years (range 16--37). The study groups were evaluated at specific postoperative in- tervals with a mean follow-up in group 1 of 24 months (range 18-31) and in group 2 of 41 months (range 24-77). Significant differences were noted in mean operative time, which was 66 rain longer in the group 2 (AA) patients (p < 0.0004), and mean duration of postoperative hospitalization stay, which was 2.1 days shorter in group 1 (EA) patients (p < 0.0003). No statistically significant differences were found between the groups in regard to prelim- inary stability outcome. Serial KT1000 results av- eraged 2 mm in both groups, with 79% of group 1 and 82% of group 2 patients noted to have <~3 mm side-to-side differences. Overall, good to excellent preliminary results were noted in 80% of the group 1 and 89% of the group 2 patients. No statistically significant differences were noted for complica- tions, including pateUofemoral pain, arthrofibrosis, harvest site pathology, or painful hardware. Shorter operative time and inpatient hospitalization stay length, as well as more rapid restoration of exten- sion in the endoscopic group may represent distinct early advantages to this surgical method. At ulti- mate follow-up, however, this study suggests that both methods may result in similar and reproducible satisfactory results.

Arthroscopically Assisted Combined Anterior and Posterior Cruciate Ligament Reconstruction in Trau- matic Knee Ligament Injuries. Gregory C. Fanelli, John Rich, Craig Edson, and John Foster. Depart- ments of Orthopaedic Surgery and Physical Ther- apy, Geisinger Medical Center, Danville, Pennsyl- vania, U.S.A.

We evaluate the results of 14 arthroscopically as- sisted combined anterior cruciate ligament (ACL)/ posterior cruciate ligament (PCL) reconstructions using Tegner, Lysholm, and Hospital for Special Surgery knee ligament evaluation forms, and the KT1000 arthrometer with a minimum 2-year follow- up.

Methods: Twenty-five arthroscopically assisted combined ACL/PCL reconstructions were per- formed by a single surgeon. Fourteen patients with a 24-month minimum follow-up (range 24-39) are

Arthroscopy, Vol. 10, No. 3, 1994