{"title":"Cinématique articulaire du genou prothésé","authors":"P.-P. Casteleyn","doi":"10.1016/j.emcrho.2005.09.001","DOIUrl":"https://doi.org/10.1016/j.emcrho.2005.09.001","url":null,"abstract":"<div><p>Kinematics of normal knee show, in flexion, a rotation through a longitudinal axis located in the medial compartment, and a posterior displacement of the femorotibial contact point. Thorough in vivo kinematic studies became possible with the use of fluoroscopy combined with computerised imaging of knee implants. These studies demonstrate that only implants sparing both cruciate ligaments can reproduce normal knee kinematics. Posterior cruciate retaining prostheses often show paradoxal anterior translation in flexion. Posterior cruciate substituting prostheses and rotating platform mobile bearing prostheses get near to normal knee kinematics, without duplicating it totally.</p></div>","PeriodicalId":100448,"journal":{"name":"EMC - Rhumatologie-Orthopédie","volume":"2 6","pages":"Pages 573-581"},"PeriodicalIF":0.0,"publicationDate":"2005-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcrho.2005.09.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72280821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Index des mots clés","authors":"","doi":"10.1016/S1762-4207(05)00032-3","DOIUrl":"https://doi.org/10.1016/S1762-4207(05)00032-3","url":null,"abstract":"","PeriodicalId":100448,"journal":{"name":"EMC - Rhumatologie-Orthopédie","volume":"2 6","pages":"Pages 615-617"},"PeriodicalIF":0.0,"publicationDate":"2005-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1762-4207(05)00032-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72281126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Verdonk (Chef de service), F. Almqvist (Chef de clinique adjoint)
{"title":"Lésions traumatiques des ménisques du genou","authors":"R. Verdonk (Chef de service), F. Almqvist (Chef de clinique adjoint)","doi":"10.1016/j.emcrho.2005.08.001","DOIUrl":"10.1016/j.emcrho.2005.08.001","url":null,"abstract":"<div><p>Preserving the meniscal body after an injury to the meniscus is very important. Meniscal function is an integral part of the knee function and it is related to the integrity of ligaments and cartilage. The anatomy and physiology of the meniscus are reviewed, as well as the pathogenesis, symptomatology and current meniscal imaging. The authors focus on the treatment of meniscal lesions, addressing the conservative approach and the operative management, including proper meniscal resection and meniscal suture, and describe the current operative techniques. It would be interesting to know how meniscal lesions in a stable knee or associated with a ligamentous injury are treated. A discussion of potential complications related to the operative management of these lesions concludes this chapter.</p></div>","PeriodicalId":100448,"journal":{"name":"EMC - Rhumatologie-Orthopédie","volume":"2 6","pages":"Pages 592-613"},"PeriodicalIF":0.0,"publicationDate":"2005-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcrho.2005.08.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80128626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Sclérodermie systémique","authors":"E. Hachulla, D. Launay","doi":"10.1016/j.emcrho.2005.07.001","DOIUrl":"10.1016/j.emcrho.2005.07.001","url":null,"abstract":"<div><p>Systemic sclerosis is a rare auto-immune disease that involves immune cells, fibroblasts and endothelial cells. Depending on the cutaneous extend, the sclerosis may be either limited or diffuse. Whatever the form, all are associated with a high risk of visceral involvement, particularly digestive, pulmonary, cardiac and renal, resulting in an increased risk of mortality. Sclerodactily and digital ulcers alter considerably the patients' quality of live. Regular visceral check-up, adequate use of calcium channel blockers, ACE inhibitors and proton pump inhibitors, and the development these past 15 years of new drugs such as prostacyclins and analogues, endothelin receptor inhibitors, improve the patients survival.</p></div>","PeriodicalId":100448,"journal":{"name":"EMC - Rhumatologie-Orthopédie","volume":"2 5","pages":"Pages 479-500"},"PeriodicalIF":0.0,"publicationDate":"2005-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcrho.2005.07.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88161404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Syndromes des loges","authors":"J. Letenneur, G. Pietu","doi":"10.1016/j.emcrho.2005.05.001","DOIUrl":"10.1016/j.emcrho.2005.05.001","url":null,"abstract":"<div><p>The hallmark of any compartment syndrome, whether acute or chronic, is the elevation of soft tissue pressure within a closed space even if the primary event was different. Acute cases are most often trauma-related and can lead to irreversible neuromuscular dysfunction. They require immediate dermofasciotomy to decompress the soft tissue and avoid ischemia. The diagnosis should rely on physical examination and be confirmed by tissue pressure measurement. If not treated in time, they can result in major sequelae and even amputation. Chronic compartment syndromes are mostly exercise-induced and then mainly related to sport practice. Pressure measurements during provocative test are required to ascertain that exercise-related pain is due to a compartment syndrome. Percutaneous fasciotomy is necessary to alleviate symptoms.</p></div>","PeriodicalId":100448,"journal":{"name":"EMC - Rhumatologie-Orthopédie","volume":"2 5","pages":"Pages 518-535"},"PeriodicalIF":0.0,"publicationDate":"2005-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcrho.2005.05.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87198687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
O. Gille (Praticien hospitalier), C. Soderlünd (Assistant hospitalier universitaire), J.-M. Vital (Professeur des Universités, praticien hospitalier, chef de service)
{"title":"Hernie discale thoracique","authors":"O. Gille (Praticien hospitalier), C. Soderlünd (Assistant hospitalier universitaire), J.-M. Vital (Professeur des Universités, praticien hospitalier, chef de service)","doi":"10.1016/j.emcrho.2005.03.004","DOIUrl":"10.1016/j.emcrho.2005.03.004","url":null,"abstract":"<div><p>The techniques of modern imaging, particularly magnetic resonance (MRI), have shown the high frequency of thoracic herniated discs (THD). One or more THD have been reported in 11% to 37% of asymptomatic subjects. In contrast, symptomatic forms are rare: less than 0.5% of surgical procedures for herniated discs involve a THD. Clinical signs vary widely from spinal pain, nerve root pain to spinal-cord compression. Among symptomatic THD, some are soft and the others hard, impinging on the anterior aspect of the thecal sac. In such cases, the discs are often voluminous and adherent to the thecal sac, and even intradural, making their surgical resection particularly difficult. Information regarding the nature of the lesions and the interface between the herniated disc and the thecal sac are analyzed in the MRI T1-weighted and T2-weighted sequences, respectively. A hypointense lesion on T1 corresponds to a calcified herniated disc. In the midst of a hypointense lesion on T1-weighted sequence, the presence of hyperintense signal that is no longer visible on fat-suppression sequences corresponds to the presence of fatty marrow. This MRI sign indicates that an ossified hernia is involved. The interface between herniated discs and the dura is more visible on T2-weighted sequences. If preoperative T2-weighted sequences do not show a band of hypointense signal between the THD and the thecal sac or if the connecting angles between the PLL and the THD are acute, complete resection of the lesion cannot be achieved without a dural tear. Instead, we recommend preserving a bony chip adhering to the anterior aspect of the dural sheath to prevent a postoperative cerebrospinal fluid fistula. Anterolateral exposure of these lesions by thoracotomy or thoracoscopy is recommended, because posterolateral approach does not provide sufficient exposure to remove this “rock” embedded in the anterior aspect of the spinal cord.</p></div>","PeriodicalId":100448,"journal":{"name":"EMC - Rhumatologie-Orthopédie","volume":"2 5","pages":"Pages 510-517"},"PeriodicalIF":0.0,"publicationDate":"2005-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcrho.2005.03.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76491072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H. Thomazeau , M. Ropars , N. Belot , J. Lasbleiz , F. Langlais
{"title":"Tumeurs bénignes épiphysométaphysaires","authors":"H. Thomazeau , M. Ropars , N. Belot , J. Lasbleiz , F. Langlais","doi":"10.1016/j.emcrho.2005.07.003","DOIUrl":"https://doi.org/10.1016/j.emcrho.2005.07.003","url":null,"abstract":"<div><p>The treatment of epiphyso-metaphyseal benign tumours of bone is not univocal and is based on tumour's identification and evolution. These tumours are classified according to the type of the proliferating tissue (osseous, cartilaginous or fibrous), but none of them demonstrate histological and cytological characteristic of malignant tumours. There is no concern about vital prognosis and the therapist must not use extensive procedures in case of mildly aggressive tumours. The treatment is often limited to simple follow-up or radio-guided excision. Conversely, local aggressiveness may need rapid excision, mostly by intralesional excision and rarely by wide excision with reconstruction. Although benign, these tumours need meticulousness at each step of the diagnosis and the therapeutic management. A well-informed orthopaedic surgeon may manage most of these tumours but any doubt must be verified by a consultation in a specialized orthopaedic department.</p></div>","PeriodicalId":100448,"journal":{"name":"EMC - Rhumatologie-Orthopédie","volume":"2 5","pages":"Pages 536-551"},"PeriodicalIF":0.0,"publicationDate":"2005-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcrho.2005.07.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136602922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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