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Orthopaedic Proceedings
Vol. 91-B, Issue SUPP_II | Pages 322 - 322
1 May 2009
Abad-Satorres R González-Lucena G Hinarejos-Gòmez P
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Introduction: Correct alignment of prosthetic components is considered one of the most important factors for TKR (total knee replacement) survival. It is our aim, in this study, to determine the degree of correlation between measurements made by 2 observers and the assistant navigator during prosthetic knee surgery.

Materials and methods: In a total of 55 non-selected patients, operated with navigator assistance, two resident physicians in our Department, using a computer system measured, during the preoperative period, the ipsilateral and contralateral femorotibial axis, the femoral and tibial axis, and the inclination of the tibial plateau. They also measured, during the postoperative period, the tibiofemoral axis by means of digitalized X-rays. These measurements were compared with those made by the navigator.

Results: The degree of correlation between measurements was variable. The greatest degree of correlation between values was that of the preoperative tibiofemoral axis, with an r of: 0.83 (0.68–0.91 CI 95%) and the lowest degree of correlation was that of the measurements of the posterior tibial inclination.

Conclusions: A large number of axes and useful measurements have been described for the planning of reconstructive knee surgery, but since the introduction of new technologies applicable in this field, it is necessary to determine the degree of reliability and reproducibility of these so they can be correctly used by the orthopedic surgeon in their everyday clinical practice.


Orthopaedic Proceedings
Vol. 91-B, Issue SUPP_II | Pages 320 - 320
1 May 2009
González G Cáceres E Monllau JC
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Introduction and purpose: One of the complications observed after meniscal transplant is allograft shrinkage. Amongst the proposed causes are both a subtle immunological rejection, and an alteration of meniscal permeability leading to nutritional deficit. The purpose of this study was to asses freezing, one of the most frequently used processes to preserve menisci, and provide evidence either in favor of those articles in the literature that claim that freezing does not affect the collagen network, or against it.

Materials and methods: Twenty-six lateral menisci were obtained during total knee replacement. Thirteen were frozen at −80° and the rest were used as a control group. The menisci were analyzed with Transmission Electronic Microscopy. According to the periodicity and degree of disruption of the collagen, loss of band pattern and intrafibrillar edema, each meniscus was scored from 0 to 7 points. Subsequently the menisci were classified by degrees from normal (grade I, 0 to 2 points) to severely altered (grade III, 5 to 7 points).

Results: Collagen fibers in longitudinal sections averaged 14.26 nm in previously frozen menisci and 17.28 in the control group (p=0.019), whereas in cross sections they averaged 13.14 nm. vs. 16.93 nm. respectively (p=0.003)..

Eight of the 13 frozen menisci were classified as grade III (61.54%) and 5 as grade II. In the control group 6 were classified as grade I (46.15%) and 7 as grade II (53.85%). Frozen menisci averaged 4.85 points and the control menisci 2.46 (p< 0.001).

Conclusions: The freezing process to −80°C seems to alter both each fiber of collagen as well as its spatial position. We have presented a new qualitative/quantitative assessment scale for meniscal status.