[The specificities of orthopedic trauma in the geriatric patient]. / Les particularités de la traumatologie de l'appareil locomoteur chez le sujet gériatrique.

Aging of the population represents an ubiquitous and ever-growing phenomenon in the developed countries. Geriatric traumatology is a constant-developping sub-speciality of orthopedics and traumatology; it deals with the specific medical problems developed by older patients when affected by muskuloskeletal trauma. The optimal treatment of this pathology as well as the age threshold used to define the "geriatric" patient are still subjects of debate. Chronological age cannot be used as the sole inclusion criteria; physiological age as defined by comorbidities seems to be more appropriate. The aim of this article is to provide a general overview of the problems that the orthopedic surgeons faces when dealing with geriatric trauma: timing of surgery and anesthesia, technical aspects of surgery and fractures, complications and problems with the postoperative management of geriatric patients. Geriatric trauma is already today an important problem; it will certainly become a great challenge in coming years. The solution must reside in a multidisciplinary approach backed up by a solid infra-structure and good management decisions.

[Are the concerns regarding metal-on-metal total hip arthroplasties founded in 2012?]. / Les inquiétudes liées au couple métal-métal dans les prothèses totales de hanche sont-elles fondées en 2012?

Metal-on-metal total hip arthroplasty (MOM THA) fuels debate in the orthopedic community after statistics showed higher-than-expected short-term failures in comparison with metal-on-polyethylene THA. The problem of early failure in the young, active patient with a metal-on-polyethylene implant has prompted the research of another couple. Multiple studies showed the advantages of MOM THA. The results of MOM resurfacing and MOM THA in our hospital did not show concerning results. Nonetheless, the data in the literature shows divergent opinions. The most recent statistics indicate that the results are disappointing, particularly with specific types of implants. Several institutions, in the USA and in Europe, are developing protocols for the follow-up of patients with MOM hip implants. Today, we are headed towards imposing a moratorium on using MOM THA.