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Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_III | Pages 115 - 115
1 Feb 2012
CLASSIC PERIOSTEAL-COVERAGE ACI VICE MATRIX-ASSISTED ACI IN HIGH-DEMAND PATIENTS: MODEST CLINICAL RESULTS AND DECREASED OVERALL PERFORMANCE AFTER 2 YEARS FOLLOW-UP
van Niekerk L Panagopoulos A Triantafyllopoulos I Kumar V
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Introduction

The purpose of this study is to evaluate the early functional outcome and activity level in athletes and soldiers with large full thickness cartilage defects of the knee that underwent either ‘classic’ autologous chondrocyte implantation using periosteal flap coverage (ACI-P) or 3-D matrix-assisted chondrocyte implantation (ACI-M).

Methods

Between April 2002 and January 2004, 19 patients (15 male, 4 female, average age 32.2 years) with 22 full-thickness cartilage defects in 19 knees were treated with ACI in our centre. The mean post-injury interval was 39.8 months whereas 17 (89.5%) patients had undergone at least one surgical procedure before ACI. The average defect size was 6.54 cm2 (located in MFC:7, LFC:7 or trochlear:2 while 3 patients had bifocal lesions in both LFC and TRC). Novocart¯ cultured chondrocytes with periosteal flap coverage were used in 11 patients and Novocart-3D¯ cell impregnated collagen patch in 8. The functional outcome was evaluated with IKDC form, Tegner activity scale and Lysholm score after a mean follow-up period of 26.5 months.

Orthopaedic Proceedings
Vol. 91-B, Issue SUPP_I | Pages 142 - 142
1 Mar 2009
CHRONIC LATERAL ANKLE INSTABILITY: COMPARISON OF STRESS VIEWS AND MRI WITH ARTHROSCOPY.
Kumar V Panagopoulos A Triantafyllopoulos I van Niekerk L
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Background: Stress radiography and more recently magnetic resonance imaging have been used to study the integrity of lateral ankle ligaments in chronic symptomatic instability after injury.

Aim: Our aim was to see if magnetic resonance imaging was as good as examination under anaesthesia and stress radiography, for diagnosing injury to the lateral ankle ligaments.

Study Design: Cross-over study.

Methods: Fifty eight patients, 47 men and 11 women, were included in the study. These were athletes or military personnel with symptomatic instability of the ankle after injury. This cohort of patients had MRI scans, stress radiographs and arthroscopic treatment of their ankle. Integrity of the calcaneo-fibular ligament (CFL) was recorded arthroscopically. The sensitivity, specificity, positive and negative predictive value of MRI and stress views, in assessing integrity of the CFL, were compared against the arthroscopic findings which was considered to be the gold standard.

Results: Stress radiography under anaesthesia and MRI has sensitivities of 94% and 47% and specificities of 98% and 83% for diagnosing injury to the CFL, respectively. Stress radiography has a higher accuracy in diagnosing CFL injuries as compared to MRI.

Conclusion: The results of this study casts doubt on the efficacy of MRI in the diagnosis of serious ankle ligament injuries.