ABSTRACTS 143

transverse tear in the midportion of the lateral me- niscus is the predominant pathologic lesion. (2) Par- tial or subtotal arthroscopic menisectomy with preservation of a rim of the meniscus led to allevia- tion of knee pain and disappearance of the cyst.

Arthroscopic Meniscal Repair--Neurovascular Concepts, Marc J. Friedman, M.D., Orrin Sher- man, M.D., James M. Fox, M.D., Wilson Del Pizzo, M.D., Stephen J. Snyder, M.D., and Richard D. Ferkel, M.D., Southern California Sports Medicine and Orthopedic Medical Group, Van Nuys, CA.

Arthroscopic meniscal repair is becoming a more common procedure. The precise limitations of ar- throscopic repair regarding neurovascular struc- tures about the knee have not been delineated. A careful attempt has been made on multiple cadaver specimens with various arthroscopic portals, pic- tures, and diagrams to represent areas of potential danger in arthroscopic repair regarding the popliteal artery and vein centrally, the peroneal nerve later- ally, and the saphenous nerve medially. Angles of attack, degree of rotation, straight and curved nee- dles and variability of neurovascular structures are discussed.

Intra-operative arthroscopic views are correlated with open dissection, both diagramically repre- sented.

Treatment of Osteochondral Defect of Distal Femur With Fresh Osteochondral Allografts, John C. Garrett, M.D., Peachtree Orthopaedic Clinic, Atlanta, GA.

Arthroscopic technique sometimes is inadequate in the treatment of chondral defects of the femoral condyles especially when they are large. In this study 17 patients, ages 17to 47 with osteochondral defects of the distal femur, who had failed to re- spond to routine arthroscopic chondroplasty were treated with fresh osteochondral allografts. Results at 1 to 3 years demonstrate universal incorporation of the grafts. Clinically the patients noted diminu- tion in pain and swelling and improvement in func- tion. Arthroscopy was undertaken in three cases and revealed the grafts to be indistinguishable from the neighboring joint surface.

Overall good results were compromised by the presence of chondromalacia or degenerative changes elsewhere within the knee. The absence of a meniscus within the effected compartment also affected the end results. Prior to grafting, arthros-

copy was indispensable in selection of cases, win- nowing out those in which joint destruction was al- ready too advanced or widespread. The best results occurred when the entire defect could be grafted leaving no marginal irregularities, when the donor and recipient were matched closely in terms of age and size, and when a precise fit was obtained. The procedure requires sophisticated technology.

Arthroscopic Debridement of the Knee for Adult Hematogenous Pyarthrosis, Marty Ivey, M.D., and Ron Clark, B.M.S., The University of Texas Med- ical Branch, Department of Surgery, Division of Or- thopaedic Surgery, Galveston, TX.

Eighteen adult patients with 23 affected knees were treated with arthroscopic debridement for he- matogenous pyarthrosis. Large bore arthroscopes and inflow cannulas were used along with motor- ized instruments to irrigate and debride the joint. Suction drainage tubes were inserted under arthros- copic control and the knee was splinted in exten- sion. Intravenous antibiotics in doses appropriate for the organism(s) cultured were given for an av- erage of three weeks. Muscle strengthening exer- cises were instituted on the day of surgery and range of motion was started at 48 hours post-oper- ative when the drains were removed. Weightbearing was protected for 6 weeks with crutches. One pa- tient was lost to follow-up. Two patients died from unrelated causes free from infection. Fifteen pa- tients with 17 knees were evaluated at an average of 29 months after arthroscopic treatment. One pa- tient with chronic renal failure required arthrotomy and synovectomy of each knee to control recurrent infection. The other 14 patients were evaluated sub- jectively, functionally, objectively and had standing roentgenograms a n d Cybex muscle testing. All were found to have excellent results. Arthroscopic debridement of the knee for pyarthrosis is a safe, efficient method of knee joint decompression and is an acceptable alternative to arthrotomy in hematog- enous joint sepsis.

Infrapatella Fat Pad and Associated Synovial Im- pingement Lesions, Jerome E. Jennings, M.D., Winston-Salem, NC.

A frequent complaint to orthopaedic surgeons is anterior knee pain. There has been much said and written about the etiology of this pain with new in- terest generated since the common use of arthros- copy in diagnosis and treatment of knee disorders. Patella malalignment, chondromalacia, medial plica

Arthroscopy, Vot. I, No. 2, 1985