352 ABSTRACTS

chor, and three Type II SLAP's were fixed with a 4 mm mini-Revo screw. One Type III and two Type IV SLAP lesions were debrided. A complex Type II/III SLAP lesion was treated with debridement and reat- tachment with Bio-Tak anchor.

Results: Eighteen patients regained full range of motion and were able to return to their same job fol- lowing surgery. Four patients were able to return but at a modified level, and one laborer was unable to return to his previous occupation. Fourteen patients were able to return to their same level of sporting activity, six to a modified level, and three were unable to return. Using the UCLA Shoulder Rating Scale, 17 (74%) patients had a good or excellent result. Three (13%) patients had a fair result and three (13%) pa- tients had a poor result. Using the Rowe Shoulder Rat- ing Scale, 19 patients had a good or excellent result, two had a fair result and two had a poor result.

Discussion and Conclusion: Operative treatment with secure anchor fixation of Type II SLAP lesions gives reliable results and allows patients to return to work and sporting activities. Debridement of Type I, III, and IV, and complex SLAP lesions also appears to give reliable results but are numbers too small to make any definitive statements.

Arthroscopic Repair of Rotator Cuff Tears. Joe W. Tippett. San Antonio, Texas, U.S.A.

Introduction: A method of arthroscopic repair of rotator cuff tears provides results equal to, or better, than previously used methods with advantages of early rehabilitation and decreased morbidity.

Method: In this study there were 103 patients with full thickness rotator cuff tears varying in size from 1 to 5 cm. Prior to repair of the rotator cuff, all shoulders had an intraarticular evaluation, subacromial decom- pression, and, if indicated, an arthroscopic Mumford procedure. The rotator cuff was debrided to viable tis- sue and, beginning at the lateral margin of the humeral articular surface, decortication was performed laterally through the concave portion of the greater tuberosity. The suture punch was placed through the anterior lat- eral portal (ALP) to place a #1 PDS suture in the cuff. Both limbs of the suture were retrieved through the ALP, placing the suture anchor on the intraarticular limb of the suture. The suture anchor was then passed through the ALP and inserted into the greater tuberos- ity. The first suture was placed anteriorly and suturing progressed posteriorly.

Results: All 103 patients were evaluated using UCLA shoulder rating. There were excellent, 72; good, 22; and fair, 3.

Discussion: Open repair of the rotator cuff tear, ei- ther conventional or mini-open, has been the accepted method. Arthroscopic repair of rotator cuff rear pro- vides an alternative method that is equal to, or better, based on results of UCLA grading. This method pro- vides precise, secure placement of the rotator cuff to the greater tuberosity by suture anchor. The integrity of the repair can be immediately evaluated by visual inspection in the internal rotation, external rotation, and adduction motions. Arthroscopic repair of the rota- tor cuff allows early shoulder exercises to regain range of motion and muscle strength. Since the deltoid mus- cle fibers are not violated as in open repair, and the rotator cuff is repaired anatomically, there is less mor- bidity.

Growth Factor Expression in Arthrofibrosis. John C. Richmond, Benjamin A. Alman, and M. Pajerski. Boston, Massachusetts, U.S.A.

Introduction: Arthrofibrosis is a significant compli- cation after anterior cruciate ligament reconstruction. It can lead to poor function, limited motion, repeated surgical procedures, and even osteoarthritis. Histologic evaluation of the arthrofibrotic tissue shows hypertro- phic proliferation of fibroblasts, with occasional carti- lage or bone formation. This is similar to the histologic picture of hypertrophic scar.

Several growth factors are expressed during the acute phases of normal wound healing (PDGF, TGH- beta, etc). Our hypothesis is that factors expressed during the acute phases of healing continue to be expressed in the hypertrophic scar that forms in arthrofibrosis. The purpose of this study is to determine the expres- sion of growth factors in arthrofibrotic tissue from pa- tients with this complication after anterior cruciate lig- ament reconstruction.

Methods: Eight patients underwent arthroscopic or open excision of arthrofibrotic tissue in the knee, which occurred following anterior cruciate ligament recon- struction. Control tissue consisted of normal mature scar from three additional patients, the MCR-5 normal fibroblast cell lone (negative control), the U-2 osteosar- coma cell line (positive control), and the A-172 glio- blastoma cell lone (positive control). RNA was ex- tracted by ultracentrifugation using a guanidinium isothiocyanate buffer loaded onto a cesium triflouride cushion, mRNA was converted to cDNA using Re- verse Transcriptase and a poly-T primer, cDNA was amplified with the polymerase chain reaction using specific oligonucleotide primers for PDF-GF-A, PDGF-B, IGF-I, IGF-II, EGF, TGF-betal, and bFGF.

Arthroscopy, Vol 12, No 3, 1996