Learning and optimizing arthroscopic knot-tying by surgery residents using procedural simulation.

Introduction: Procedural training of orthopedic surgery residents includes learning arthroscopic knot-tying. The models used comprise arthroscopy training modules of increasing complexity, although there is no procedural training guide for the acquisition of arthroscopic knot-tying skills. Few studies have focused on how residents learn arthroscopic knot-tying.

Treatment of moderate hallux valgus by percutaneous, extra-articular reverse-L Chevron (PERC) osteotomy.

Aims: The aim of this study was to report a single surgeon series of consecutive patients with moderate hallux valgus managed with a percutaneous extra-articular reverse-L chevron (PERC) osteotomy.

Patients And Methods: A total of 38 patients underwent 45 procedures. There were 35 women and three men.

Acetabular component navigation in lateral decubitus based on EOS imaging: A preliminary study of 13 cases.

Introduction: Acetabular component navigation classically requires palpation of the bone landmarks defining the anterior pelvic plane (APP) (anterior superior iliac spine [ASIS] and pubis), the recording of which is not very reliable when performed in lateral decubitus. The objectives of the current experimental study were: (1) to assess the clinical feasibility of NAVEOS navigation (based on EOS imaging) in lateral decubitus; and (2) to compare precision versus classical APP-based navigation (NAVAPP).

Hypothesis: Iliac plane navigation using EOS is as reliable as APP navigation.

Percutaneous bunionette correction: results of a 49-case retrospective study at a mean 34 months' follow-up.

Introduction: Bunionette consists in a lateral prominence of the head of the fifth metatarsal (M5), inducing a callus. Toe malpositioning determines the varus, supraductus or infraductus form.

Hypothesis: A percutaneous method without osteosynthesis was assessed in 38 patients suffering from this pathology.

Preventing surgical-site infections: measures other than antibiotics.

Surgical-site infections (SSIs) due to intra-operative contamination are chiefly ascribable to airborne particles carrying microorganisms, mainly Staphylococcus aureus, which settle on the surgeon's hands and instruments. SSI prevention therefore rests on minimisation of airborne contaminated particle counts, although these have not been demonstrated to correlate significantly with SSI rates. Maintaining clear air in the operating room classically involves the use of ultra clean ventilation systems combining laminar airflow and high-efficiency particulate air filters to create a physical barrier around the surgical table; in addition to a stringent patient preparation protocol, appropriate equipment, and strict operating room discipline on the part of the surgeon and other staff members.

Tibiotalocalcaneal arthrodesis using a straight intramedullary nail.

Background: Tibiotalocalcaneal (TTC) arthrodesis is a proven solution for severe hindfoot arthropathy that reestablishes stability for plantigrade gait and alleviates pain, while correcting deformity. Intramedullary nailing is an effective option for fixation. The aim of this study was to determine clinical outcome, analyze the fusion rate, and determine final hindfoot alignment in a consecutive series of patients using a single-design straight intramedullary nail.

AKILE™ total ankle arthroplasty: Clinical and CT scan analysis of periprosthetic cysts.

Introduction: Despite good clinical results following total ankle replacement (TAR), the development of large periprosthetic cysts (>400 mm(2)) in the medium-term is a source of concern.

Objective: The primary objective of this study was to detect any large periprosthetic cysts in a cohort of AKILE™ patients using radiographs and CT scans, and then to compare these findings to published ones.

Material And Methods: A total of 127 TAR procedures were performed between June 1995 and January 2012.

Prognostic factors of calcaneal osteomyelitis.

Background: Calcaneal osteomyelitis is difficult to manage and requires a multidisciplinary approach. The aim of this study was to describe the characteristics and outcomes of calcaneal osteomyelitis, and to determine prognostic factors.

Methods: This was an observational and retrospective study including all patients presenting with calcaneal osteomyelitis referred to a tertiary referral centre between January 2005 and December 2010.

Viscosupplementation of the ankle: a prospective study with an average follow-up of 45.5 months.

Introduction: Providing pain relief for ankle osteoarthritis and delaying the need for a radical surgery procedure is difficult to achieve with analgesics that have limited efficacy or are not devoid of substantial side effects.

Hypothesis: The goals of this study were to evaluate the efficacy of viscosupplementation, explore which factors better predict Patient's response and propose an injection protocol.

Materials And Methods: Eighteen patients (26 ankles) with ankle osteoarthritis were included, with seven of them having received multiple series of injections.

Primary aseptic revision of the femoral component of a cemented total hip arthroplasty using a cemented technique without bone graft.

Background: Primary revisions using cement without bone graft reconstruction are less frequently used because of their supposed higher failure rate. The results, in fact, depend on multiple parameters: number of prior revisions, cementing technique quality, and residual bone stock; these intricate factors are rarely taken together into account when analyzing this treatment method.

Hypothesis: Femoral component fixation with cement can be a valid option in total hip arthroplasty primary revision.

[Evaluation of an articulated spacer for two-stage reimplantation for infected total knee arthroplasty: 28 cases].

Purpose Of The Study: Two-stage reimplantation remains the most popular solution for infected total knee arthroplasty. We have used articulated spacers since their introduction in 2000. We evaluated tolerance, joint motion under general anesthesia before reimplantation and also the infectious and functional long-term outcome.

[Filling of a lateral pre-malleolar soft tissue defect with the extensor digitorum brevis flap and the abductor digiti minimi flap].

The authors report the filling of a lateral pre-malleolar soft tissue defect after sub-talar arthrodesis. Four months after surgery the loss of substance measured 2,5 cm in depth, 3 cm diameter at the skin level and 5 cm diameter at the bone level. An autologous tricortical bone graft impacted in the sinus tarsi was also exposed.

Anterolateral compartment of the ankle in the lateral impingement syndrome: appearance on CT arthrography.

Objective: This article describes the appearance of the anterolateral recess of the posttraumatic ankle on CT arthrography and clearly shows the benefit of this technique in the diagnosis of soft-tissue impingement.

Materials And Methods: The study was carried out on 44 patients examined by CT arthrography and arthroscopy for chronic, posttraumatic ankle pain. The analysis principally concerned the lateral compartment--in particular, the synovial regularity and the cartilage of the talar dome.

[Postoperative radiotherapy of a benign tumor of the ankle].

Pigmented villonodular synovitis is a rare benign tumor. The high rate or recurrence after surgery exposes the risk of non-conservative or non-functional treatment. External irradiation of post-surgical residual disease seems to be useful for the prevention of relapse and conservation with a good functional result.

Primary angiosarcoma of bone in Paget's disease.

We report here a case of a primitive angiosarcoma of the bone occurring in Paget's disease. Only one case has been previously described in the literature. We review other types of tumours occurring in Pagetic bone and discuss medical and surgical management.

Tri-calcium phosphate ceramics and allografts as bone substitutes for spinal fusion in idiopathic scoliosis as bone substitutes for spinal fusion in idiopathic scoliosis: comparative clinical results at four years.

The authors present the results of a comparative study of two series of posterolateral arthrodeses for scoliosis performed using COTREL DUBOUSSET instrumentation. Fifty-four consecutive patients underwent surgery for idiopathic scoliosis using the same technique. Thirty received a graft consisting of a mixture of corticocancellous autologous and allogenic bone frozen at -80 degrees, and 24 patients were grafted with a mixture of cortico-cancellous autologous bone and sticks of tricalcium phosphate (TCP, Biosorb, SBM, Lourdes, France).

Distal rupture of the tendon of biceps brachii. Evaluation by MRI and the results of repair.

We report ten cases of rupture of the distal part of the tendon of biceps brachii in patients aged from 27 to 58 years. MRI allowed assessment of the degree of retraction of the tendon which was related to the integrity of the bicipital expansion. When the retraction exceeded 8 cm the expansion was always ruptured.

[Acromio-clavicular joint cyst. Surgical treatment].

A chronic cyst of the acromioclavicular joint was treated in 3 patients who were followed up for an average period of 26 months. All three were over 60 years old and presented with a massive rupture of the rotator cuff with a subnormal range of passive motion; active motion was variably affected and was painful. The patients underwent resection of one cm of the lateral end of the clavicle, together with resection of the cyst and synovectomy of the upper part of the pathologic humero-acromial joint; the coraco-acromial ligament was left in place.

[Results of a series of deltoid flaps for the treatment of massive rotator cuff tears with an average follow-up of 3.5 years].

Purpose Of The Study: We report a series of 14 patients with a massive rotator cuff tear operated on with a deltoid flap according to Augereau's technique. The aim of this study was to evaluate the benefits of this technique using Constant's scoring system. The follow up is 40 months.

Epicondylitis after treatment with fluoroquinolone antibiotics.

We report two cases of epicondylitis of the elbow occurring after treatment with fluoroquinolone antibiotics. Both patients had intense pain which appeared very shortly after the first dose of the drug and was not relieved by conservative treatment. Ultrasonography revealed extensive inflammatory lesions with pseudonecrotic areas.

A study of the fasciocutaneous vascularisation of the arm. Surgical applications.

The data on the fasciocutaneous vascularisation of the medial aspect of the arm are incomplete in the literature. This study presents the methodology and results of an anatomic study on 19 upper limbs with arterial injection. The vascularisation of the upper part of this region is provided in 68% of cases by the superficial fasciocutaneous branch (SFCB) of the superior ulnar collateral artery (SUC), that of the middle and lower part by 3-4 fasciocutaneous pedicles originating from the SUC which are prolonged distally by the recurrent posterior ulnar artery.

[Epicondylitis induced by fluoroquinolones in athletes. Apropos of 2 cases].

Epicondylitis occurred in two leisure athletes who were taking fluoroquinolones. No similar cases have been reported in the literature. In both cases, pain occurred early after initiating drug therapy.