Revue de chirurgie orthopedique et reparatrice de l'appareil moteur最新文献

{"title":"Réparation du cartilage articulaire par ingénierie tissulaire","authors":"D. Hannouche","doi":"10.1016/j.rco.2008.09.004","DOIUrl":"10.1016/j.rco.2008.09.004","url":null,"abstract":"<div><p>De nombreuses stratégies thérapeutiques sont apparues depuis une dizaine d’années dans le traitement des lésions chondrales localisées. Certaines visent à stimuler la réparation naturelle du cartilage par le recrutement de cellules progénitrices contenues dans la moelle (microfractures), d’autres ont pour objectif la réparation du défect par une greffe (<em>mosaicplasty</em>). Enfin, les techniques de thérapie cellulaire ont pour ambition la régénération complète de la lésion par l’implantation de cellules chondrogéniques ou de véritables tissus fonctionnels fabriqués au laboratoire à partir de cellules souches mésenchymateuses et de matériaux supports résorbables. Ces nouvelles thérapies ouvrent des perspectives exaltantes pour la prise en charge des lésions chondrales focales et permettent d’envisager une réparation tissulaire par des substituts autologues dont la composition et la structure reflètent celles du cartilage natif. Elles nécessitent cependant d’être évaluées par des études cliniques méthodiques dans le cadre d’un protocole de recherche permettant d’en préciser l’intérêt pour les patients.</p></div><div><p>The treatment of full thickness articular defects remains a challenging problem for the orthopaedic surgeon. Beside bone marrow stimulation techniques (microfractures) and autologous osteochondral mosaicplasty, a variety of procedures have been proposed to promote the healing of articular lesions by cultured competent cells. Tissue engineering is an emerging field, whose goal is to repair or replace tissues and organs by delivering the appropriate cells, biomaterials and signaling factors to diseased or damaged areas. In this article, we review the preclinical and clinical literature reported on the fabrication of implantable cartilage structures from chondrocytes and mesenchymal stem cells and discuss potential areas of development in the field of cartilage repair. Before routine use of engineered cartilage grafts in the clinic, the safety and efficacy of these therapies need to be validated in prospective human clinical trials.</p></div>","PeriodicalId":76468,"journal":{"name":"Revue de chirurgie orthopedique et reparatrice de l'appareil moteur","volume":"94 8","pages":"Pages 383-393"},"PeriodicalIF":0.0,"publicationDate":"2008-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rco.2008.09.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27871392","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":"Results of surgical treatment of congenital convex pes valgus (ten nonidiopathic feet)","authors":"K. Ayadi,&nbsp;M. Trigui,&nbsp;F. Gdoura,&nbsp;W. Zribi,&nbsp;M. Zribi,&nbsp;M.H. Elleuch,&nbsp;H. Keskes","doi":"10.1016/j.rco.2007.12.020","DOIUrl":"10.1016/j.rco.2007.12.020","url":null,"abstract":"<div><h3>Purpose of the study</h3><p>Congenital pes valgus is a rare and complex deformity of the foot raising serious diagnostic and therapeutic challenges. The purpose of our work was to present the surgical procedures used in our series and to analyze outcome.</p></div><div><h3>Material and methods</h3><p>Ten feet presenting congenital convex pes valgus treated surgically over a six-year period using the same operative technique were reviewed at minimum five years follow-up. Idiopathic deformities were excluded from this series. Deformities were secondary to arthrogryposis in five feet, multiple malformative syndrome in four, and diastematomyelia in one. The surgical technique used two approaches: a posteromedial incision to release the dorsal flexors, disinsert the tibialis posterior, open the talonavicular joint, release the Achilles tendon and release the posterior tibiotalar capsule; a lateral incision to lengthen the fibular tendons and perform an osteotomy of the anterior process of the calcaneum. A talonavicular pin and a calcaneocuboid pin maintained the correction. The tibialis posterior tendon was reinserted on the anterior aspect of the talonavicular capsule after incision of the dislocation chamber.</p></div><div><h3>Results</h3><p>Outcome was considered good in five cases and fair in five. Outcome was fair in the arthrogryposis feet. Undercorrection was observed in two feet and valgus flatfoot in three. Talar necrosis occurred in one foot and navicular necrosis in two.</p></div><div><h3>Discussion</h3><p>Simultaneous correction of the different anomalies observed in the congenital convex foot was achieved in this series. The anatomic and functional results were satisfactory. We recommend avoiding overly extensive release in order to decrease the risk of talar and navicular necrosis. It is also important to check the reduction radiographically during the operation. Patients should use an orthesis for several months postoperatively to avoid recurrence.</p></div><div><p>Le pied convexe congénital est une malformation rare du pied qui pose plusieurs problèmes d’ordre diagnostique et thérapeutique. De nombreuses techniques de correction chirurgicale ont été proposées. Nous rapportons dix cas de pied convexe congénital non idiopathique, traités chirurgicalement selon la même technique opératoire sur une période de six ans avec un recul minimal de cinq ans. La malformation était secondaire à une arthrogrypose dans cinq cas, à un syndrome polymalformatif dans quatre cas et à une diastématomyélie dans un cas. La technique chirurgicale comportait deux abords : un abord postéromédial permettant une libération des releveurs du pied, une désinsertion du tibial postérieur, une ouverture de l’articulation talo-naviculaire et une libération du tendon d’Achille et de la capsule tibiotalienne postérieure et un abord latéral permettant l’allongement des tendons fibulaires et une ostéotomie de l’apophyse antérieure du calcanéum. Les résultats ont été","PeriodicalId":76468,"journal":{"name":"Revue de chirurgie orthopedique et reparatrice de l'appareil moteur","volume":"94 8","pages":"Pages e28-e34"},"PeriodicalIF":0.0,"publicationDate":"2008-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rco.2007.12.020","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27890539","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":"Fractures of the lateral process of the talus. Retrospective study of 44 cases","authors":"E. Sariali,&nbsp;J.-F. Lelièvre,&nbsp;Y. Catonné","doi":"10.1016/j.rco.2008.04.009","DOIUrl":"10.1016/j.rco.2008.04.009","url":null,"abstract":"<div><h3>Purpose of the study</h3><p>Fractures of the lateral process of the talus often go undiagnosed. The cohorts reported in the literature are small. The aim of the study was to analyze these fractures with a large group of patients.</p></div><div><h3>Materials and methods</h3><p>Forty-four fractures in 43 patients were reviewed with a mean follow-up of 17 months. The diagnosis had been made immediately in 14 cases and secondarily in 30 cases with a delay of 46 months. Patients were evaluated with Kitaoka’s score and X-rays using Hawkins classification. Fractures occurred during sports in 19 cases. The most frequent mechanism was association of dorsal flexion and pronation. There were associated lesions in 44% of cases.</p></div><div><h3>Results</h3><p>In the delayed diagnosis group, we found 14 cases of associated pseudarthrosis<span> and subtalar osteoarthritis, two cases of isolated pseudarthrosis and two cases of isolated subtalar osteoarthritis. After treatment, the result at the last follow-up was excellent in 15 of these cases (50%), good in seven cases (23%), fair in seven cases (23%) and poor in one case (4%). In the immediate diagnosis group, five of 14 patients had at least one complication: 29% pseudarthrosis and 29% subtalar osteoarthritis. After treatment, the result at the last follow-up in this group was excellent in eight cases (58%), good in four cases (28%) and fair in two cases (14%). Immediate diagnosis was correlated with better results at the last follow-up. In the immediate diagnosis group, among patients who had orthopedic treatment, the rate of secondary surgery was 42%.</span></p></div><div><h3>Conclusion</h3><p>Fracture of the lateral process of the talus is quite frequent and occurs among young people. Spontaneous progression is severe, with two major complications: pseudarthrosis and subtalar osteoarthritis. Treatment is always required in case of displaced fracture.</p></div><div><p>Quarante-quatre fractures de l’apophyse latérale du talus chez 43 patients ont été revues avec un recul médian de 17 mois. Le diagnostic avait été posé en post-traumatique immédiat dans 14 cas et secondairement dans 30 cas avec un délai diagnostique moyen de 46 mois. L’évaluation a été clinique avec le score objectif de Kitaoka et radiologique avec la classification de Hawkins. Le mécanisme le plus fréquent était une hyperflexion dorsale associée à une pronation. Il existait des lésions associées dans 44 % des cas. Dans le groupe de diagnostic tardif 14 patients présentaient une pseudarthrose associée à une arthrose sous-talienne postérieure, deux patients une pseudarthrose isolée et deux une arthrose sous-talienne isolée. Après traitement, le résultat était très bon dans 15 cas (50 %), bon dans sept (23 %), moyen dans sept (23 %) et mauvais dans un cas (4 %). Dans le groupe de diagnostic précoce, cinq sur 14 patients ont présenté au moins une complication. Après traitement, le résultat était très bon dans huit cas (58 %), bon dans ","PeriodicalId":76468,"journal":{"name":"Revue de chirurgie orthopedique et reparatrice de l'appareil moteur","volume":"94 8","pages":"Pages e1-e7"},"PeriodicalIF":0.0,"publicationDate":"2008-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rco.2008.04.009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27890909","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":"Results of the Evora dual-mobility socket after a minimum follow-up of five years","authors":"S. Leclercq ,&nbsp;J.-Y. Benoit ,&nbsp;J.-P. de Rosa ,&nbsp;P. Euvrard ,&nbsp;C. Leteurtre ,&nbsp;P. Girardin","doi":"10.1016/j.rco.2007.10.015","DOIUrl":"10.1016/j.rco.2007.10.015","url":null,"abstract":"<div><h3>Purpose of the study</h3><p>Dislocation is a well-known complication of total hip arthroplasty. The risk can be reduced to one or two cases per thousand using a dual-mobility cup. The survival rate achieved with the Bousquet implant is 95% at 10 years. The complications with this implant are early mobilization and inguinal pain. An overly-large cup and insufficient primary and secondary fixation can be implicated. The design of the original implant was later modified to limit these early complications. The purpose of this study was to check the validity of these design changes.</p></div><div><h3>Patients and methods</h3><p>The chromium–cobalt moulded cementless cup was used. The outer surface of this cup presents large geometric striations and is coated with hydroxyapatite. The cup has the shape of a 180° half sphere and a posterior wall prolongation measuring 6.5<!--> <!-->mm. Three mechanisms were used for the primary fixation: an asymmetrical growth ring, four anchorage stems and a superior screw. Two hundred cementless cups were implanted in 194 patients. The femoral piece was a Charnley stainless-steel implant (<em>n</em> <!-->=<!--> <!-->139), a titanium SEM implant (<em>n</em> <!-->=<!--> <!-->59) or another implant (<em>n</em> <!-->=<!--> <!-->12). Cement was used for femoral fixation in 193 implantations. The series included 97 women and 103 men with osteoarthritis (<em>n</em> <!-->=<!--> <!-->180), necrosis (<em>n</em> <!-->=<!--> <!-->16) and surgery for fracture and primary arthroplasty (<em>n</em> <!-->=<!--> <!-->9). The Harris and Postel–Merle-d’Aubigné scores were noted. Eight radiographic criteria were analyzed to assess the position of the cup and the radiological course of the interface.</p></div><div><h3>Results</h3><p>The mean follow-up was six years and the minimum was five years. The mean age at surgery was 70 years (range, 32 to 91). At last follow-up, 17 patients had died, eight were lost to follow-up and five were bedridden. Three patients underwent revision surgery. Thus, this analysis included 170 prostheses followed for more than five years (mean, six years; range, five to seven years). The Harris score improved from 48 to 92 and the Postel–Merle-d’Aubigné score from 2/5/4 to 5.8/5.9/5.5 (range, 4 to 6/5 to 6/1 to 6). None of the patients complained of anterior pain during active hip flexion in supine position (related to ilio-psoas irritation). Cup inclination was 46° on average (range, 62 to 22°). Medialization, lateralization or ascension greater than 10<!--> <!-->mm from the center of rotation was not observed on the postoperative films. At the last follow-up, no measurable mobilization or migration could be identified on plain X-rays. Radiolucent lines, condensations and bony defects around the cup, when visible postoperatively, were not found on the last follow-up X-rays. There were two cemented femoral pieces that developed a radiolucent line in the nonspecific metaphyseal area. There were no cases of ","PeriodicalId":76468,"journal":{"name":"Revue de chirurgie orthopedique et reparatrice de l'appareil moteur","volume":"94 8","pages":"Pages e17-e22"},"PeriodicalIF":0.0,"publicationDate":"2008-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rco.2007.10.015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27890910","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":"Les tendinopathies calcifiantes de l’épaule","authors":"P. Clavert ,&nbsp;F. Sirveaux ,&nbsp;la Société française d’arthroscopie","doi":"10.1016/j.rco.2008.09.010","DOIUrl":"10.1016/j.rco.2008.09.010","url":null,"abstract":"<div><p>La tendinopathie calcifiante de l’épaule est une affection fréquente dont les modalités du traitement restent débattues. Les auteurs de ce symposium ont revu rétrospectivement 450 patients opérés sous arthroscopies pour une tendinopathie calcifiante de l’épaule, avec une imagerie systématique de la coiffe des rotateurs. Le recul minimal était de cinq ans, sauf pour les calcifications du subscapulaire, de l’infra-épineux où il a été fixé à deux ans compte tenu de la rareté de ces localisations. Parallèlement, une étude prospective de prévalence a été menée sur 1276 épaules de patients asymptomatiques vus aux urgences. La prévalence des calcifications de la coiffe des rotateurs étaient de 7,3 % dans la population générale avec une prédominance féminine qui était plus marquée dans le groupe opéré. Cette étude a montré qu’il existait aussi des calcifications chez les patients de plus de 70 ans. L’analyse de la concordance inter- et intra-observateur a démontré que la classification A-B-C était peu reproductible avec une faible concordance pour différencier les types A des types B. L’évolution à long terme prouve que la tendinopathie calcifiante est une affection transitoire de l’épaule qui n’a pas de lien avec la rupture de coiffe. Aucune récidive n’est notée à long terme et le taux de rupture transfixiante à neuf ans de recul, pour un âge moyen de 56 ans, est de 3,9 %. Cette évolution permet d’affirmer qu’il n’est pas nécessaire de suturer les berges du cratère créé après exérèse de la calcification. L’état préopératoire de la coiffe a cependant une influence significative sur les résultats fonctionnels à long terme avec des résultats significativement moins bons quand il existe initialement une rupture partielle de coiffe ou un test de Jobe positif et avec un taux significativement plus élevé de rupture transfixiante à la révision. Les calcifications du subscapulaires sont rares (6 % des calcifications) et sont associées à des dépôts calciques sur d’autres tendons une fois sur deux. Les calcifications de l’infra-épineux sont plus fréquentes (20 %) et le plus souvent associées à d’autres localisation. À condition d’adapter la technique d’exérèse, le traitement arthroscopique est aussi efficace que pour les autres localisations. Le résultat clinique à long terme, après exérèse d’une calcification de type C, est significativement moins bon que pour les autres types de calcification. L’acromioplastie améliore les résultats si la calcification est associée à un acromion agressif ou à une rupture partielle de la coiffe.</p></div><div><p>Calcifying tendinitis is a frequent shoulder disease but the surgical treatment is still debatable. The authors of this symposium reviewed retrospectively 450 patients treated by arthroscopal excision for calcifying tendinitis. Imaging were used to assess the cuff status in every case. The minimum follow-up was five years except for subscapularis and infraspinatus calcification (minimum two years). At the same tim","PeriodicalId":76468,"journal":{"name":"Revue de chirurgie orthopedique et reparatrice de l'appareil moteur","volume":"94 8","pages":"Pages 336-355"},"PeriodicalIF":0.0,"publicationDate":"2008-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rco.2008.09.010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27870388","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":"Results of open reduction and cortico-cancellous autograft of intra-articular calcaneal fractures according to Palmer","authors":"M. Di Schino,&nbsp;M. Bensaïda,&nbsp;E. Vandenbussche,&nbsp;B. Augereau,&nbsp;C. Nich","doi":"10.1016/j.rco.2007.04.007","DOIUrl":"10.1016/j.rco.2007.04.007","url":null,"abstract":"<div><h3>Objective</h3><p>To assess the mid term patient outcome after operative treatment of a displaced intra-articular calcaneal fracture using the modified Palmer technique.</p></div><div><h3>Materials and methods</h3><p>Eighteen operatively treated intra-articular fractures of the calcaneus in 16 patients (nine males, seven females) were retrospectively reviewed. The mean age at surgery was 35 years (range, 17–61 years). Two patients had a bilateral fracture. Following Utheza, five fractures (28%) were classified as vertical, three as horizontal (17%) and 10 (55%) as combined. Mean preoperative Böhler angle was −4° (range, −42 to 26°). An extended lateral approach to the calcaneus was used in each case. A cortical bone autograft was firmly impacted in the subthalamic void after reduction. Stabilization was achieved by two or three axial Kirschner wires and one or two screws inserted in a transverse position. Patients were evaluated at the last follow-up by physical examination and by the functional score described by Kitaoka. Böhler's angle was measured on the immediate postoperative radiographs and at the last follow-up, and compared when possible with the noninjured side.</p></div><div><h3>Results</h3><p>Follow-up ranged from 12 to 38 months (mean, 23 months). One patient required a subtalar arthrodesis for advanced osteoarthritis. One patient experienced reflex sympathetic dystrophy. No skin complication was noted. At the last follow-up evaluation, the mean Kitaoka score was 74 (range, 34–98). The functional score was considered good or excellent in 11 cases (64.7%), fair in three (17.6%), and poor in three (17.6%). The mean Böhler angle was 23.4° (range, 5–40°) postoperatively and 22.7° (range, 0–38°) at the last follow-up. A modest loss of correction was observed in four cases. The final Böhler angle was at least 85% compared to the healthy side in 10 cases out of 14 unilateral fractures. The functional score correlated well with restoration of Böhler's angle.</p></div><div><h3>Discussion and conclusion</h3><p>Operative treatment of intra-articular calcaneal fractures following a modified Palmer technique provided encouraging results, since restoration of Böhler's angle was obtained. The main advantages include an absence of hardware prominence, resulting in an absence of skin complications, and a stable fixation.</p></div><div><p>L’utilisation d’une greffe osseuse systématique dans le traitement des fractures articulaires déplacées du calcanéus est discutée. Les auteurs ont évalué rétrospectivement les résultats des relèvements associés à une greffe d’après Palmer. La technique a été employée dans 18 fractures articulaires du calcanéus, chez 16 patients (neuf hommes, sept femmes), âgés en moyenne de 35<!--> <!-->ans (17–61<!--> <!-->ans). La fracture était bilatérale chez deux patients. La fracture était classée verticale dans cinq cas (28 %), horizontale dans trois cas (17 %) et mixte dans dix cas (55 %). L’angle de Böhler initial moy","PeriodicalId":76468,"journal":{"name":"Revue de chirurgie orthopedique et reparatrice de l'appareil moteur","volume":"94 8","pages":"Pages e8-e16"},"PeriodicalIF":0.0,"publicationDate":"2008-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rco.2007.04.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27890542","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":"Analyses clinique, radiologique et arthroscopique de la rupture du LCA. Étude prospective de 418 cas","authors":"J.-C. Panisset ,&nbsp;H. Duraffour ,&nbsp;W. Vasconcelos ,&nbsp;P. Colombet ,&nbsp;C. Javois ,&nbsp;J.-F. Potel ,&nbsp;D. Dejour ,&nbsp;la Société française d’arthroscopie","doi":"10.1016/j.rco.2008.09.009","DOIUrl":"10.1016/j.rco.2008.09.009","url":null,"abstract":"<div><p>Cette étude multicentrique prospective sur 418 ruptures du ligament croisé antérieur avait pour but de rechercher les corrélations existantes entre les différents aspects du ligament croisé antérieur constatés au moment de l’intervention chirurgicale et les données de l’examen clinique, de l’examen radiographique standard et en tiroir antérieur et de l’IRM. Quatre types de lésions du LCA ont été identifies : disparu totalement, conservation du faisceau postérolatéral, cicatrisation sur le ligament croisé postérieur et cicatrisation dans l’échancrure. Les différentes corrélations ont montré une plus grande laxité dans le groupe disparu totalement avec une plus grande fréquence de tests de Lachman mou et de ressauts franc et explosif. Une plus grande incidence de lésions du ménisque médial a été retrouvée. Toutes ces constatations étant corrélées aussi avec le délai « accident–chirurgie » plus élevé dans le groupe disparu totalement par rapport aux groupes conservation du faisceau postérolatéral et cicatriciel échancrure. Cette étude a montré les différents critères des aspects cicatriciels du LCA et cela peut aider le chirurgien à faire le meilleur choix chirurgical.</p></div><div><p>This prospective multicentric study concerns 418 anterior cruciate ligament tears. It correlates the arthroscopic data's and the clinical and radiological data's. Four types of anterior cruciate ligament tears were identified. Complete tears, postero lateral bundle preserved, healing on the posterior cruciate ligament and healing in the notch. The statistical correlations had shown a highest laxity in the complete tear group with a highest rate of soft Lachman and gross pivot shift, a highest incidence of medial meniscus tears was also noted and a longer delay between injury and surgery, 24 months for the complete tear group and seven months for the postero lateral bundle group. The mean medial compartment laxity, side to side, in the postero lateral bundle group was 4.93<!--> <!-->mm and 7.93<!--> <!-->mm in the complete tear group. These data could help the surgeon in his surgical planning especially in case of partial tears.</p></div>","PeriodicalId":76468,"journal":{"name":"Revue de chirurgie orthopedique et reparatrice de l'appareil moteur","volume":"94 8","pages":"Pages 362-368"},"PeriodicalIF":0.0,"publicationDate":"2008-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rco.2008.09.009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27870390","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":"Résection fémorale supérieure chez l’enfant polyhandicapé grabataire","authors":"J. Yankeum ,&nbsp;S. Bourelle ,&nbsp;G. Lefort ,&nbsp;V. Gautheron ,&nbsp;B. Al Bitar ,&nbsp;J. Cottalorda","doi":"10.1016/j.rco.2008.05.006","DOIUrl":"10.1016/j.rco.2008.05.006","url":null,"abstract":"<div><p>Il s’agit d’une étude rétrospective issue des services de chirurgie pédiatrique rémois et stéphanois rapportant l’expérience de 21 résections fémorales supérieures tête et col (RFS). Ces patients, tous polyhandicapés et la plupart infirmes moteurs cérébraux (IMC) grabataires étaient au nombre de 16, et avaient au moins une hanche luxée irréductible et douloureuse, ce qui représente 21 hanches opérées par résection, 13 fois sous le petit trochanter et huit fois en zone basicervicale. Au moment de l’intervention, ils étaient âgés en moyenne de 12 ans (huit à 18 ans). Toutes les hanches opérées présentaient des signes macroscopiques de destruction de l’encroûtement cartilagineux des têtes fémorales. La libération concomitante des parties molles a été associée dans 69 % des résections diaphysaires et dans 33 % des résections basicervicales. Les soins postopératoires ont été soit une traction, soit un plâtre pelvipédieux pour une durée moyenne de quatre semaines. Trois reprises chirurgicales à moyen terme ont été nécessaires, pour cause de déformation avec rétraction douloureuse des parties molles. On a noté cinq cas de calcifications hétérotopiques. Les hanches initialement douloureuses ont été soulagées dans 86 % des cas, avec une nette facilitation pour l’installation en position assise, dans les changements de position, et pour les soins du périnée.</p></div><div><h3>Introduction</h3><p>Hip dislocation in nonambulatory multiply handicapped children (particularly in cerebral palsy [CP]) is a common and severe problem involving painful transportation and uneasy positioning, usually resulting from major anatomical osteoarticular and soft tissue disorders. Therefore, proximal femoral resection is seen as a salvage procedure whose primary purpose is to provide children and their caregivers with better comfort during activities of daily living thus allowing improved sitting tolerance in the wheelchair and painless nursing care.</p></div><div><h3>Materials and methods</h3><p>A series of 21 proximal femoral resections performed on 16 patients with a mean age at surgery of 12 years, and a follow-up period of 21 years (from 1984 to 2005) were retrospectively reviewed. All patients suffered from painful dislocation of the hip. Sixteen of the hips (76%) had been managed previously with bony and soft tissue surgery. Femoral resection was performed in the basicervical region in eight hips and distal to the lesser trochanter in 13 hips.</p></div><div><h3>Results</h3><p>At a mean follow-up of five years and eight months, 18 of the 21 painful hips reported to be painless (86%). All preoperative stiffness and deformity of the hip joints was corrected, resulting in floppy, mobile hips with an increased range of motion after surgery. Femoral stump, regarding the acetabulum was above in three hips, at the same level in 18 and never below. The proximal end of the femoral shaft could often been palpated but did not reveal any skin irritation. The formation of he","PeriodicalId":76468,"journal":{"name":"Revue de chirurgie orthopedique et reparatrice de l'appareil moteur","volume":"94 8","pages":"Pages 753-757"},"PeriodicalIF":0.0,"publicationDate":"2008-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rco.2008.05.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27890038","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":"Survival of cementless dual mobility socket with a mean 17 years follow-up","authors":"R. Philippot ,&nbsp;F. Farizon ,&nbsp;J.-P. Camilleri ,&nbsp;B. Boyer ,&nbsp;G. Derhi ,&nbsp;J. Bonnan ,&nbsp;M.-H. Fessy ,&nbsp;F. Lecuire","doi":"10.1016/j.rco.2007.10.013","DOIUrl":"10.1016/j.rco.2007.10.013","url":null,"abstract":"<div><h3>Purpose of the study</h3><p>As part of the 2006 symposium of the French Hip and Knee Society devoted to the dual mobility socket, we report a retrospective multicentric series of 438 first-intention total hip prostheses with a dual mobility socket at a mean 17 years follow-up. The purpose of our report was to ascertain the 15-year survival of this socket and analyze failures.</p></div><div><h3>Material and methods</h3><p>The series included 438 primary replacements. This was a homogeneous multicentric series. The cementless sockets were 80 Novae-1^® titanium Serf cups and 358 Novae-1^® stainless steel Serf cups. All stems were inserted without cement: 185 Pf^® stainless steel screwed Serf stems, 228 PRO^® titanium screwed Serf stems, and 25 Corail^®<span> stems. The mobile polyethylene insert was retaining. All of the heads were 22.2-mm chromium-cobalt heads. Degenerative hip disease was the main etiology and mean follow-up was 17 years (range, 12–20). Mean age at implantation was 54.8 years (range, 23–87). The actuarial method with a 95% confidence interval was used to determine the 15-year cup survival rate.</span></p></div><div><h3>Results</h3><p><span>At the last follow-up, none of the patients had presented an episode of early or late instability. Analysis of the socket at last follow-up showed 13 aseptic loosenings, 23 intraprosthetic dislocations, and seven replacements of the polyethylene insert for wear. The overall 15-year prosthesis survival rate was 89.2</span> <!-->±<!--> <!-->8.7%. The overall 15-year socket survival rate was 96.3<!--> <!-->±<!--> <!-->3.7%.</p></div><div><h3>Discussion</h3><p><span>The fact that, at last follow-up, none of the implants had shown instability confirms the long-term stability of the dual mobility socket. The results in terms of 15-year survival confirm earlier reports. The main cause of failure was cup fixation, which is the weak point of this technique with the initial Novae cup design, which did not have hydroxyapatite coating. The second leading cause was intraprosthetic dislocation, which can be divided into three main categories. The first is intraprosthetic dislocation in a context of pure wear with normal function of the dual mobility socket; the retaining feature of the insert loses its efficacy due to wear. The second category is intraprosthetic dislocation in a context of cup loosening with a third-body effect and increased retention wear, in which case we consider that cup loosening is the primary event leading to rapid secondary wear and subsequent intraprosthetic dislocation. The third category is intraprosthetic dislocation caused by a blockage in a context of fibrosis or impingement involving severe </span>heterotopic ossifications. We had only two femoral failures related to aseptic loosening, most certainly related to use of noncemented implants, which limits the extension of granulomas to the polyethylene. Studying the three ","PeriodicalId":76468,"journal":{"name":"Revue de chirurgie orthopedique et reparatrice de l'appareil moteur","volume":"94 8","pages":"Pages e23-e27"},"PeriodicalIF":0.0,"publicationDate":"2008-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rco.2007.10.013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27890538","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":"Prise en charge thérapeutique des lésions méniscales et des lésions isolées du ligament croisé antérieur du genou chez l’adulte","authors":"","doi":"10.1016/j.rco.2008.09.001","DOIUrl":"https://doi.org/10.1016/j.rco.2008.09.001","url":null,"abstract":"","PeriodicalId":76468,"journal":{"name":"Revue de chirurgie orthopedique et reparatrice de l'appareil moteur","volume":"94 8","pages":"Pages 787-791"},"PeriodicalIF":0.0,"publicationDate":"2008-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rco.2008.09.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91599032","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}