Femoral nerve inguinal approach versus proximal femoral triangle ap proach for continuous regional analgesia in active rehabilitation after total knee arthroplasty: A prospective, randomised study.

BACKGROUND: A catheter in femoral nerve block (F-Cath) is an effective regional analgesia technique in total knee arthroplasty (TKA) but results in significant quadriceps weakness. The femoral triangle catheter (FTB-Cath) seems to be an interesting alternative. In this study, we aim to demonstrate that the nerve block administration for analgesic purposes via an FTB-Cath results in less quadriceps weakness than via an F-Cath. METHODS: This study included patients scheduled for TKA performed under general anaesthesia. The patients were randomised to receive either an F-Cath or an FTB-Cath. A unique regimen of 0.2% ropivacaine was administrated for 72 h. The primary endpoint was quadriceps strength assessed clinically on postoperative day (POD) 2 by the Manual Muscle Test (MMT) using a motor grading scores (0-5). The secondary endpoints were quadriceps strength measured by a dynamometer, the Timed Up and Go (TUG) test, the 30-m walk test (30MWT) and pain scores. RESULTS: Forty-four patients were analysed (22 in each group). On POD 2, 77.3% of the patients in the FTB-Cath group had MMT scores ≥ 4 and 13.6% in the F-Cath group (p < 0.001). During the first four POD assessments, quadriceps strength evaluated with a dynamometer was less diminished in the FTB-Cath group (p < 0,001). There was no difference between groups regarding pain scores, TUG test results and 30MWT assessment. CONCLUSION: The FTB-Cath provided a better preservation of quadriceps strength than the F-Cath in TKA, with a similar pain relief.

Posterior cruciate ligament: Anatomy, femoral insertion and relationships with the anterior menisco-femoral ligament in 23 cadaver knees.

BACKGROUND: Abundant anatomic descriptions exist of the posterior cruciate ligament (PCL) and menisco-femoral ligaments (MFLs). There is broad agreement that the PCL is composed of two bundles and inserts on the femur near the distal cartilage. However, a different configuration with a single bundle and a complex femoral insertion has been reported. The main objective of our cadaver study was to determine the number of anatomical bundles forming the PCL. We also described the insertion of the PCL and its relationships with the anterior menisco-femoral ligament (AMFL). HYPOTHESIS: The PCL consists of a single ribbon-like bundle and inserts on the femur separately from the AMFL. MATERIAL AND METHODS: We used 23 knees of fresh unembalmed cadavers, which we dissected under a microsurgery loupe. Inclusion criteria for the knees were freedom from trauma and scars. No age limits were set. The features of the PCL were studied using the clock method. Measurements were taken using callipers with a precision of 0.01mm. RESULTS: No knees were excluded from the final analysis. Macroscopically, the PCL appeared as a single bundle forming a slender flat ribbon. With the knee flexed at 90°, the ligament footprint extended from 58min to 25min on the right and from 48min to 2min on the left. The femoral insertion of the AMFL started 2.07mm from the distal cartilage and masked the distal insertion of the PCL. After removal of the AMFL, the middle of the femoral insertion of the PCL started on average 5.99mm from the distal cartilaginous rim when the knee was flexed at 90°. DISCUSSION: Our study confirms descriptions of the PCL as a single bundle shaped as a flat ribbon. The presence of the AMFL gives the appearance of a double bundle and partially masks the femoral insertion of the PCL, which is located further back relative to the distal joint cartilage. LEVEL OF EVIDENCE IV: Experimental cadaver study.

Isolated Rupture of the Teres Major Muscle When Water Skiing: A Case Report and Literature Review.

Isolated lesions to the teres major muscle are rare. They generally occur in patients participating in sports such as baseball, tennis, or boxing. We report the case of a sports patient who suffered an isolated injury to the teres major while water skiing. The clinical presentation was confirmed by MRI. Conservative treatment was chosen and consisted of brief analgesic immobilization, followed by rehabilitative treatment. The rapid recovery of this patient with normal isokinetic strength evaluation at 6 months was interesting for objectifying full muscle recovery. Our results and the data from the literature suggest that functional rather than surgical treatment is preferable in isolated lesions to the teres major muscle.

Atmospheric Measurements by Ultra-Light SpEctrometer (AMULSE) Dedicated to Vertical Profile in Situ Measurements of Carbon Dioxide (CO2) Under Weather Balloons: Instrumental Development and Field Application.

The concentration of greenhouse gases in the atmosphere plays an important role in the radiative effects in the Earth's climate system. Therefore, it is crucial to increase the number of atmospheric observations in order to quantify the natural sinks and emission sources. We report in this paper the development of a new compact lightweight spectrometer (1.8 kg) called AMULSE based on near infrared laser technology at 2.04 µm coupled to a 6-m open-path multipass cell. The measurements were made using the Wavelength Modulation Spectroscopy (WMS) technique and the spectrometer is hence dedicated to in situ measuring the vertical profiles of the CO2 at high precision levels (σAllan = 0.96 ppm in 1 s integration time (1σ)) and with high temporal/spatial resolution (1 Hz/5 m) using meteorological balloons. The instrument is compact, robust, cost-effective, fully autonomous, has low-power consumption, a non-intrusive probe and is plug & play. It was first calibrated and validated in the laboratory and then used for 17 successful flights up to 10 km altitude in the region Champagne-Ardenne, France in 2014. A rate of 100% of instrument recovery was validated due to the pre-localization prediction of the Météo-France based on the flight simulation software.

Wavelet denoising for infrared laser spectroscopy and gas detection.

After a brief introduction to wavelet theory, this paper discusses the critical parameters to be considered in wavelet denoising for infrared laser spectroscopy. In particular, it is shown that measurement dispersion as well as sensibility can be dramatically improved when using wavelet denoising for gas detection by infrared laser absorption spectroscopy.

Self-induced pressure shift and temperature dependence measurements of CO2 at 2.05µm with a tunable diode laser spectrometer.

By using a high resolution tunable diode laser absorption spectrometer combined with a cryogenically cooled optical multi-pass cell, we have measured the self-induced pressure shift coefficients for 8 transitions in the R branch of the (20(0)1)(III)←(00(0)0)(I) band of carbon dioxide around 2.05µm. This spectral region is of particular interest for the monitoring of atmospheric CO(2) with Differential Absorption Lidars (DiAL). The measurement of these shift coefficients was realized at five different temperatures ranging from 218 to 292K in order to determine their temperature dependence. The results are thoroughly compared to previous values reported in the literature for the (20(0)1)(III)←(00(0)0)(I) band of CO(2). The temperature dependence of the self-induced pressure shifts are reported experimentally for the first time for this specific CO(2) band.

Diode laser spectroscopy of two acetylene isotopologues ((12)C2H2, (13)C(12)CH2) in the 1.533 microm region for the PHOBOS-Grunt space mission.

Several line intensities of the nu(1) + nu(3)(Sigma(u)(+)) - 0(Sigma(g)(+)) bands of (12)C(2)H(2) and (13)C(12)CH(2) at 1.533 microm have been revised at room temperature. These molecular transitions were selected to measure acetylene within the framework of the Martian space mission PHOBOS-Grunt. In the spectral region ranging from 6518 to 6530 cm(-1), 10 lines of both isotopologues have been analyzed using a high resolution tunable diode laser spectrometer. These transitions are well appropriate to the monitoring of C(2)H(2) by laser absorption spectroscopy with standard telecommunication laser diodes. Both the Voigt and the Rautian models are used to fit the molecular line shape and to provide accurate line strengths. Our data are thoroughly compared to existing database (including HITRAN08) and former experimental measurements.