The level of the joint line after cruciate-retaining total knee replacement: a new coordinate system.

This study assessed joint line changes after knee replacement surgery. Sixty consecutive cruciate-retaining total knee replacements were followed up. The height of the femorotibial joint line in extension and in 90 degrees flexion were analysed. A new coordinate system was used. It is based on two perpendicular axes applied to a lateral X-ray: one axis is drawn along the anterior cortex of the distal femur and the other axis overlies the intersection of the inter-condylar roof and the posterior femoral condyles. In patients with non-posterior stabilised implants, the landmarks chosen appear to be reliable and useful. In this study, the femorotibial joint line was displaced distally, and the surgical instrumentation was changed accordingly.

[Critical analysis of the laparoscopic approach in colorectal surgery based on the personal experience of 613 interventions]. / Analyse critique de la voie laparoscopique en chirurgie colo-rectale basée sur une expérience personnelle de 613 interventions.

Initial experience of colo-rectal laparoscopic surgery, after a period of enthusiasm tempered by anticipated technical difficulties, was held back due to reservations made in the case of operations for cancer, following the publication warning surgeons concerning the danger of the development of port-site metastasis. Nevertheless, this type of surgery continued to be developed for benign diseases of the colon, enabling acquiring of the necessary surgical skill. This skill could then applied by experienced surgical teams for the treatment of cancer, that do not seem to show negative aspects, in connection with local recurrences or 5 years survival rates. These reports need to be confirmed by ongoing multi-center trials currently being undertaken in several countries. The advantages of laparoscopic surgery in terms of post-operative comfort having been widely demonstrated, it seems that as applied strictly to colo-rectal pathologies, morbidity and mortality of this surgical procedure are at least equal to those of conventional "open" surgery. These good results require, however, a relatively long period of training. Based on the experience of 613 patients operated by laparoscopic surgery, the authors highlight the special characteristics of this surgical technique whose future expansion can be expected and is justified.