ABSTRACTS 149

cent were rated good or excellent, and 87% were satisfied with their surgery. Twenty-eight of these 54 patients underwent subsequent surgery for hard- ware removal, manipulation, or removal of adhe- sions. All 28 had an arthroscopy and evaluation of ligamentous tissue and articular cartilage.

The graft resembled a normal ACL in 18 patients. The graft was slightly lax in two of these patients, but their clinical examination revealed normal sta- bility. In six patients the intercondylar notch was covered by a sheath of dense fibrous tissue, but the knees were stable. In two cases there was slight fraying of the lateral aspect of the graft from im- pingement on the lateral femoral condyle. In two cases the graft failed.

The condition of the articular cartilage was doc- umented and compared with the condition of the articular cartilage at the time of cruciate reconstruc- tion. In 19 cases the articular cartilage had been normal and remained normal at the time of reeval- uation. There were two instances of deterioration of the articular cartilage of the patella and one instance of deterioration of the trochlear groove. There were six instances of deterioration of the articular carti- lage in the medial compartment. In four of these cases a partial medial meniscectomy had been per- formed prior to or at the time of ACL reconstruc- tion. The articular cartilage in the lateral compart- ment remained normal in all cases.

We are encouraged by the clinical and arthro- scopic findings using this technique. The instance of articular cartilage deterioration is markedly de- creased using an arthroscopic technique for recon- struction and early motion. Partial medial menis- cectomy appears to correlate with subsequent de- generative changes in the medial compartment.

The Effect of Irrigating Fluids on the Ultrastructure of Articular Cartilage. Jack M. Bert, Zoltun Pos- alaky, Dennis McGinley, and Cay Chock. St. Paul, Minnesota. Stephen Snyder. Van Nuys, California, U.S.A.

Over a l-year period, 25 biopsies of articular car- tilage were obtained in patients between the ages of 2&25 years when performing routine arthroscopic surgery of the knee. A minimum of 30 min of ini- gation utilizing Synovisol, 1.5% glycine, normal sterile saline solution, Ringer’s lactate, or water was performed. Each fluid was utilized in five dif- ferent cases. The biopsies were obtained in a non- weight-bearing portion of the intercondylar notch.

Samples of articular cartilage were immediately placed in a paraformaldehyde/glutaraIdehyde and cacodylate buffer at pH 7.4. Specimens were then dehydrated in a graded series of alcohol and Freon. Critical point drying was then performed in Freon 13 in a Bomar critical point drying device. The spec- imens were reviewed in a Hitachi S450 scanning electron microscope.

The cartilaginous surface was viewed with a scanning electron microscope. The specimens irri- gated with water showed the most striking changes. The surface was generally uneven in appearance and exhibited different surface features including wrinkling and splitting and generally had a rough- ened fibrous texture. The specimens treated with Ringer’s lactate had an alternating fibrillar and smooth appearance. At higher magnifications, a smooth surface could be seen alternating with a hill- ocky appearance. The saline solution-treated spec- imen showed smooth areas containing elevated ridges arranged in a geometric pattern.

The specimens irrigated with 1.5% glycine showed a generally smooth, sometimes slightly un- even surface appearance with surface cracking. Specimens irrigated with Synovisol showed a more consistently smooth appearance than those irri- gated with glycine. Saline solution- or Ringer’s lac- tate-irrigated specimens showed areas similar to the glycine-treated ones but were not as consistent in a single specimen or between specimens. Water- treated specimens showed the most inconsistent re- sults.

Specimens treated with Synovisol resulted in the least amount of ultrastructural damage to articular cartilage and were qualitatively superior to the gly- tine-treated ones. Specimens irrigated with Ring- er’s lactate, saline solution, and water showed in- creased amounts of ultrastructural damage.

Arthroscopic Treatment of Calcific Tendonitis of the Shoulder; a Preliminary Report. Louis U. Bigliani, Jon W. Ark, Timothy J. Flock, and Evan L. Flatow. New York, New York, U.S.A.

We reviewed the cases of 13 patients who under- went shoulder arthroscopy for persistent calcific tendonitis of the shoulder to determine the useful- ness of the procedure. The indication for surgery was continued pain for more than 1 year despite conservative treatment including injections, nonste- roidal anti-inflammatory medications, and physical therapy. All patients had calcium deposits evident

Arthroscopy, Vol. 6, No. 2, 1990