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1.
Orthop Traumatol Surg Res ; 101(6 Suppl): S233-40, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26249539

RESUMO

BACKGROUND: Patient-specific cutting guides were recently introduced to facilitate total knee arthroplasty (TKA). Their accuracy in achieving optimal implant alignment remains controversial. The objective of this study was to evaluate postoperative radiographic outcomes of 50 TKA procedures with special attention to posterior tibial slope (PTS), which is difficult to control intraoperatively. We hypothesized that patient-specific cutting guides failed to consistently produce the planned PTS. MATERIAL AND METHODS: The Signature™ patient-specific cutting guides (Biomet) developed from magnetic resonance imaging data were used in a prospective case-series of 50 TKAs. The target PTS was 2°. Standardised digitised radiographs were obtained postoperatively and evaluated by an independent reader. Reproducibility of the radiographic measurements was assessed on 20 cases. The posterior cortical line of the proximal tibia was chosen as the reference for PTS measurement. Inaccuracy was defined as an at least 2° difference in either direction compared to the target. RESULTS: The implant PTS was within 2° of the target in 72% of knees. In the remaining 28%, PTS was either excessive (n=10; maximum, 9°) or reversed (n=4; maximum, -6°). The postoperative hip-knee-ankle angle was 0° ± 3° in 88% of knees, and the greatest deviation was 9° of varus. CONCLUSION: These findings support our hypothesis that patient-specific instrumentation decreases PTS accuracy. They are consistent with recently published data. In contrast, patient-specific instrumentation provided accurate alignment in the coronal plane.


Assuntos
Artroplastia do Joelho/métodos , Articulação do Joelho/cirurgia , Osteoartrite do Joelho/cirurgia , Tíbia/cirurgia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Articulação do Joelho/patologia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Osteoartrite do Joelho/diagnóstico , Estudos Prospectivos , Reprodutibilidade dos Testes
2.
Orthop Traumatol Surg Res ; 100(4): 433-6, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24794497

RESUMO

Long second-toe syndrome, although frequent and disabling, has been little described. Current surgical techniques often lead to loss of function. Based on anatomical and biomechanical observations, the present study reports a second phalanx shortening osteotomy technique. The procedure is relatively non-invasive, involving self-stabilizing segment resection osteotomy of the second phalanx. Results for the first 23 feet undergoing the procedure were analyzed retrospectively. Assessment comprised clinical examination, radiography and AOFAS and FAAM scores. Mean follow-up was 19±9.9 months. Second phalanx shortening osteotomy proved reliable, respecting the biomechanics of the toe.


Assuntos
Osteotomia/métodos , Falanges dos Dedos do Pé/cirurgia , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia , Falanges dos Dedos do Pé/anormalidades , Falanges dos Dedos do Pé/diagnóstico por imagem
3.
Chir Main ; 25S1: S108-S113, 2006 Nov.
Artigo em Francês | MEDLINE | ID: mdl-17349385

RESUMO

Elbow stifness has diverse etiologies, the most common being post-trauma. It appears that both arthroscopic and open techniques can achieve satisfactory results when employed properly. Their use is dictated both by the surgeon's level of expertise and an accurate preoperative assessment. When the release is done arthroscopically, collateral ligament stability is not compromised and morbidity from surgical dissection is minimized. The technique of arthroscopic release is described with all steps and difficulties. Arthroscopic capsular release is a technically demanding procedure that requires meticulous attention to detail and should only be attempted by surgeons with extensive experience in elbow arthroscopy.

4.
Chir Main ; 25 Suppl 1: S96-9, 2006 Nov.
Artigo em Francês | MEDLINE | ID: mdl-17361878

RESUMO

Elbow arthroscopy was known as a risky procedure regarding the literature. A symposium of the French Arthroscopic Society in 2005 focused on up to date technics and indications. An overall joint exploration can performed through five precise portals.


Assuntos
Artroscopia/métodos , Articulação do Cotovelo/cirurgia , Humanos
5.
Chir Main ; 25 Suppl 1: S108-13, 2006 Nov.
Artigo em Francês | MEDLINE | ID: mdl-17361880

RESUMO

Elbow stifness has diverse etiologies, the most common being post-trauma. It appears that both arthroscopic and open techniques can achieve satisfactory results when employed properly. Their use is dictated both by the surgeon's level of expertise and an accurate preoperative assessment. When the release is done arthroscopically, collateral ligament stability is not compromised and morbidity from surgical dissection is minimized. The technique of arthroscopic release is described with all steps and difficulties. Arthroscopic capsular release is a technically demanding procedure that requires meticulous attention to detail and should only be attempted by surgeons with extensive experience in elbow arthroscopy.


Assuntos
Artroscopia , Articulação do Cotovelo/cirurgia , Artropatias/cirurgia , Humanos
6.
Ann Cardiol Angeiol (Paris) ; 44(9): 477-85, 1995 Nov.
Artigo em Francês | MEDLINE | ID: mdl-8745657

RESUMO

Doppler ultrasound investigation of cervical and aorto-iliac arteries, performed in 248 patients investigated by coronary angiography (including 80% with coronary heart disease: 23% single-vessel, 23% two-vessel and 34% three-vessel disease) confirmed the frequency of dissemination of the atheromatous process (in the cervical vessels: non-stenotic atheroma: 45%, significant single- or multi-vessel stenoses: 16%, in the aorto-iliac vessels: non-stenotic atheroma: 32.8%, significant stenoses: 17.2%), which has been known for a long time. The unreliability of clinical examination, the reliability, safety and low cost of ultrasound, the discovery of a considerable number of critical, potentially dangerous arterial lesions, some of which may require a surgical procedure or angioplasty (3.4%), the value of assessing, either before coronary angiography or before cardiac surgery, certain specific arterial territories such as the aortic bifurcation and subclavian vessels, justify systematic use of this examination in coronary patients, particularly before coronary angiography and always before coronary surgery.


Assuntos
Aorta/diagnóstico por imagem , Arteriosclerose/diagnóstico por imagem , Doença da Artéria Coronariana/diagnóstico por imagem , Ecocardiografia Doppler , Artéria Ilíaca/diagnóstico por imagem , Pescoço/irrigação sanguínea , Adulto , Idoso , Idoso de 80 Anos ou mais , Arteriosclerose/etiologia , Doença da Artéria Coronariana/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pescoço/diagnóstico por imagem , Estudos Prospectivos , Reprodutibilidade dos Testes , Estudos Retrospectivos
7.
Ann Cardiol Angeiol (Paris) ; 39(7): 423-6, 1990 Sep.
Artigo em Francês | MEDLINE | ID: mdl-2264707

RESUMO

Post-infarction interventricular fistula (IVF) is a complication with a poor prognosis, particularly when it occurs very early after myocardial necrosis, when it is wide in diameter and even more so if it is at a posterior site, and if there are associated lesions which require surgery. An operation is often considered as contraindicated in cases where the patient is elderly. The authors report on the case of an 81-year-old diabetic patient operated for a wide post-infarctus posterior IVF and aorto-coronary artery bypass surgery. The operation is still a clinical success after 23 months of follow-up, showing that old age is not an absolute contraindication for surgery in cases of post-infarction IVF.


Assuntos
Ruptura Cardíaca Pós-Infarto/cirurgia , Idoso , Idoso de 80 Anos ou mais , Humanos , Masculino , Prognóstico
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