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Ollivier M.,Aix - Marseille University | Ollivier M.,Institute for Locomotion | Ollivier M.,Laboratoire Danatomie Of La Faculte Of Medecine Of Marseille | Ollivier M.,Institute Du Mouvement Et Of Lappareil Locomoteur | And 12 more authors.
Surgical and Radiologic Anatomy | Year: 2015

This study aimed to determine (1) whether: gender, morphotype, or etiology are correlated with the shape of the proximal femur in patients with advanced hip osteoarthritis and (2) is there any clinical predictive factors of potential abnormal anatomy of the hip at the time of total hip arthroplasty (THA)? We reviewed 689 European hips of patients who underwent THA for primary osteoarthritis (OA) or avascular necrosis (AVN), between 2000 and 2005. The patients were stratified according to their (1) Morphotype, (2) Gender, and (3) Etiology for undergoing THA. Two independent observers measured the following four anatomical parameters on preoperative CT-scans: neck shaft angle (NSA) and femoral neck version, femoral offset and lower-limb torsion. Our results showed that both morphotype and etiology, but not gender or body mass index, were correlated with femoral anatomical parameters. Two types of patients were identified as “at risk” for abnormal hip anatomy: (1) AVN-Endomorphic patients (2) OA-Ectomorphic patients. Etiology of the advanced hip osteoarthritis and patients’ morphotype may predict the proximal femur anatomy at the time of THA. © 2014, Springer-Verlag France. Source

Lunebourg A.,University of Lausanne | Lunebourg A.,Institute Du Mouvement Et Of Lappareil Locomoteur | Mouhsine E.,University of Lausanne | Cherix S.,University of Lausanne | And 3 more authors.
Orthopaedics and Traumatology: Surgery and Research | Year: 2015

Introduction: Periprosthetic femur fracture (PFF) is a serious complication after total hip arthroplasty that can be treated using different internal fixation devices. However, the outcomes with curved non-locking plates with eccentric holes in this indication have not been reported previously. The objectives of this study were to determine: (1) the union rate; (2) the complication rate; (3) autonomy in a group of patients with a Vancouver type B PFF who were treated with this plate. Hypothesis: Use of this plate results in a high union rate with minimal mechanical complications. Materials and methods: Forty-three patients with a mean age of 79 years. ±. 13 (41-98) who had undergone fixation of Vancouver type B PFF with this plate between 2002 and 2007 were included in the study. The time to union and Parker Mobility Score were evaluated. The revision-free survival (all causes) was calculated using Kaplan-Meier analysis. The average follow-up was 42 months. ±. 20 (16-90). Results: Union was obtained in all patients in a mean of 2.4 months. ±. 0.6 (2-4). One patient had varus malunion of the femur. The Parker Mobility Score decreased from 5.93. ±. 1.94 (2-9) to 4.93. ±. 1.8 (1-9) (P= 0.01). Two patients required a surgical revision: one for an infection after 4.5 years and one for stem loosening. The survival of the femoral stem 5 years after fracture fixation was 83.3%. ±. 12.6%. Conclusion: Use of a curved plate with eccentric holes for treating type B PFF led to a high union rate and a low number of fixation-related complications. However, PFF remains a serious complication of hip arthroplasty that is accompanied by high morbidity and mortality rates. Level of evidence: Retrospective study, level IV. © 2015 Elsevier Masson SAS. Source

Galland A.,Institute Du Mouvement Et Of Lappareil Locomoteur | Airaudi S.,Institute Of La Main Et Du Membre Superieur | Gravier R.,Institute Of La Main Et Du Membre Superieur | Le Cann S.,French National Center for Scientific Research | And 2 more authors.
International Orthopaedics | Year: 2013

Purpose: We evaluated the biomechanical strength of two all suture anchors (ASA) of reduced diameter (1.4 mm) and compared them with the standard screw anchor (SA) with larger diameter (5.5 mm) used in rotator cuff tears. Methods: We conducted 30 uniaxial vertical pullout tests using Material Testing System Instron 5566A until failure of the anchorage defined as rupture of the threads or anchor or detachment of the anchor. Anchor fixation was on tuberosities of fresh bovine humerus bone. ASAs were spaced four millimetres apart and were compared with a control SA implanted on the same greater tubercle at two centimetres. The tests were all performed at room temperature in a dry environment. Tensile loads (10 mm/min) were applied parallel to the axis of insertion. A preloading of 10 N was used to overcome loading artifacts of the test sample at the beginning of the test. Results: Student's t test showed no statistically significant difference between anchors in terms of load to failure (ASA: force 265.06 ± 87.25 N versus SA: 325.35 ± 113.46 N; p = 0.09) and mean elongation at rupture (ASA: 23 ± 7 mm versus SA: 21 ± 6 mm; p = 0.46). Conclusions: In vitro, this experimental study showed no statistically significant difference in pullout strength and displacement between ASA and SA at a chosen level of significance (p < 0.05). © 2013 Springer-Verlag Berlin Heidelberg. Source

Maurel B.,Service de Radiologie Interventionnelle Non Vasculaire | Maurel B.,Institute Du Mouvement Et Of Lappareil Locomoteur | Le Corroller T.,Institute Du Mouvement Et Of Lappareil Locomoteur | Bierry G.,Service de Radiologie Interventionnelle Non Vasculaire | And 3 more authors.
Skeletal Radiology | Year: 2013

Purpose: To describe the technique and clinical outcome of percutaneous injection of bone cement in the treatment of symptomatic para-articular intraosseous cysts. Materials and methods: Five patients (three men, two women; mean age 35 years) with painful para-articular intraosseous cysts were treated by percutaneous injection of bone cement under combined fluoroscopic and computed tomography (CT) guidance. The lesions were all located in weight-bearing bones, involving the acetabulum, proximal tibia, distal tibia, talus, and calcaneus, respectively. Results: The average amount of bone cement injected was 2.1 ml (range, 0.6-3.5 ml). Calcium phosphate cement was used in four cases and acrylic cement in one case. There were no immediate or delayed complications. Full pain relief was obtained between 1 and 4 weeks after treatment. All patients made a complete recovery and were pain-free at their last visit. Conclusions: Percutaneous injection of bone cement was a safe and efficient technique in the management of symptomatic para-articular intraosseous cysts in our population. © 2012 ISS. Source

Ollivier M.,Institute Du Mouvement Et Of Lappareil Locomoteur | Ollivier M.,Aix - Marseille University | Turati M.,Institute Du Mouvement Et Of Lappareil Locomoteur | Turati M.,Aix - Marseille University | And 8 more authors.
International Orthopaedics | Year: 2015

Purpose: In vitro studies have shown promising results for balloon-guided inflation tibioplasty. It was our hypothesis that this technique may be safe and effective for use in depressed lateral tibial plateau fracture. Methods: We performed a prospective study of all patients suffering from a depressed lateral tibial plateau fracture, managed in our institution with inflation tibioplasty and a resorbable calcium phosphate bone substitute injection, between January 2012 and December 2013. Twenty patients, mean age 54.3 ± 12. 8 years, suffering from a depressed lateral tibial plateau fracture (Schatzker type II and III) were included. We then aimed to evaluate at a minimum follow-up of one year: (1) the rate of complications, (2) the clinical outcome (Knee Injury and Osteoarthritis Outcome (KOO) and 12-Item Short Form Health Survey (SF-12) scores); and (3) the radiographic outcome (evaluated by CT-scan). Results: No peri-operative complications occurred. In one patient, calcium phosphate substitute was found in the infrapatellar fat pad on post-operative radiography with no clinical or radiographic consequences at one year. At one year after surgery, the KOO subscores were: Pain 80 (range 64—93), other symptoms 81.3 (69–93), daily living activities 81.9 (46–99), sport 65.83 (20–100), and quality of life 67.04 (31–100). The SF-12 activity component was 40.4 (28.6—52.2) and SF-12 mental component 47.71 (28 – 67.1). The mean depressed step-off of the lateral joint decreased from 10.7 ± 4.8 mm pre-operatively to 2.7 ± 1.7 mm post-operatively (p < 0.0001). Conclusion: Our observations suggest that the use of balloon-guided inflation tibioplasty with injection of a resorbable bone substitute is safe, and results in a high rate of anatomic reduction and good clinical outcomes in patients with depressed tibial plateau fractures. Level of Evidence: Therapeutic Level IV. © 2015 SICOT aisbl Source

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