Outcome at 3 to 5 years of a treatment algorithm for rotator cuff tears in an elderly population.

The purpose of this study is to evaluate the results of a conservative approach of rotator cuff tears in an elderly population at 3 to 5 years of follow-up. Prospective comparative study. All patients started with a program of exercises of at least 1 to 3 months.

Duocentric® reversed shoulder prosthesis and Personal Fit® templates: innovative strategies to optimize prosthesis positioning and prevent scapular notching.

We describe our experience with a new system of patient-specific template called Personal Fit(®), which is unique in shoulder surgery and used in combination with Duocentric(®) prosthesis. The reverse prosthesis's concept is the invention of Paul Grammont, developed with Grammont's team of Dijon University as from 1981, which led to the first reversed total shoulder prosthesis called Trumpet in 1985. The Duocentric(®) prosthesis developed in 2001 is the third-generation prosthesis, coming from the Trumpet and the second-generation prosthesis Delta(®) (DePuy).

Magnetic resonance arthrography of glenohumeral lesions: anatomy and arthroscopically confirmed pathology.

Interpretation of magnetic resonance (MR) arthrography images of the glenohumeral ligaments is made difficult by anatomical variations and by the lack of descriptions of signs of pathology of the ligaments. In this review, we describe the normal and pathologic appearance of the glenohumeral ligaments of the shoulder. These ligaments play an important role in stabilization of the shoulder.

Multicentre, prospective, open study to evaluate the safety and efficacy of hylan G-F 20 in knee osteoarthritis subjects presenting with pain following arthroscopic meniscectomy.

The aim of the study was to evaluate the safety and efficacy of viscosupplementation with hylan G-F 20 in patients with mild to moderate osteoarthritis (OA) presenting with persistent knee pain 4-12 weeks after arthroscopic meniscectomy. A prospective, multi-centre, open study was carried out in patients with pain due to OA of the knee, not resolved by simple analgesics, 4-12 weeks after undergoing arthroscopic meniscectomy. To be eligible, patients had to score > or =50 mm and < or =90 mm on both walking pain and patient global assessment visual analogue scales (VAS; 0-100 mm) at baseline and be radiologically diagnosed pre-operatively with OA grade I or II on the Kellgren-Lawrence scale, with <50% joint space narrowing.

Brucellar arthritis of the knee: a case report with delayed diagnosis.

Brucellar septic arthritis has become extremely rare in Western developed countries since bovine brucellosis has been successfully eradicated. Nevertheless, we should remain vigilant for this disease, as brucellosis is still endemic in many parts of the world. The authors present the rare manifestation of a brucellar septic arthritis of the knee joint, associated with a lytic lesion of the proximal tibia.

Characterized chondrocyte implantation results in better structural repair when treating symptomatic cartilage defects of the knee in a randomized controlled trial versus microfracture.

Background: As the natural healing capacity of damaged articular cartilage is poor, joint surface injuries are a prime target for regenerative medicine. Characterized chondrocyte implantation uses an autologous cartilage cell therapy product that has been optimized for its biological potency to form stable cartilage tissue in vivo.

Purpose: To determine whether, in symptomatic cartilage defects of the femoral condyle, structural regeneration with characterized chondrocyte implantation is superior to repair with microfracture.

Arthroscopic management of Mason type 2 radial head fractures.

During decennia the treatment of radial head fractures has been controversial. For Mason type II fractures, more recent studies agree that open reduction and internal fixation is the treatment of choice. It restores biomechanical properties, allows an early mobilisation of motion and results in better functional outcome compared with other treatments.

The Oxford unicompartmental knee prosthesis: an independent 10-year survival analysis.

One hundred forty-nine medial prostheses were implanted in 140 patients between 1988 and 1996. After a mean of 67 months 28 patients had died, without the need for revision. Seventeen prostheses were lost to follow-up.

Chemical basis for the affinity maturation of a camel single domain antibody.

Affinity maturation of classic antibodies supposedly proceeds through the pre-organization of the reactive germ line conformational isomer. It is less evident to foresee how this can be accomplished by camelid heavy-chain antibodies lacking light chains. Although these antibodies are subjected to somatic hypermutation, their antigen-binding fragment consists of a single domain with restricted flexibility in favor of binding energy.

The role of the Rolimeter in quantifying knee instability compared to the functional outcome of ACL-reconstructed versus conservatively-treated knees.

The purpose of this study is to correlate the measurement of anterior knee laxity using the Rolimeter with the functional outcome of anterior cruciate ligament (ACL) deficient knees. We tested 29 patients (12 males/17 females) with an average age of 33 years (range 19-47) that had been treated for ACL rupture, either by reconstruction or conservatively. The average follow-up at time of testing was 33 months (range 6-67).

Functional outcome after intramedullary nailing of humeral shaft fractures: comparison between retrograde Marchetti-Vicenzi and unreamed AO antegrade nailing.

Background: We compared anesthesia time, complications, fracture healing, as well as shoulder and elbow function after retrograde and antegrade nailing of humeral shaft fractures or impending fractures.

Methods: Thirty retrograde Marchetti-Vicenzi nails (MVN) and 22 antegrade locked AO unreamed humeral nails (AO-UHN) were inserted in 52 patients. Forty-three fractures were followed up until healing, and three required reoperation for nonunion (two MVN, one AO-UHN).

Treatment options in full thickness rotator cuff tears.

Increasing interest in shoulder pathology during the last decades has considerably diversified the possible treatment options of full thickness rotator cuff tears. This review of the recent literature combined with information gathered during recent European shoulder meetings attempts to summarize present trends. Every full thickness cuff tear, except for the acute traumatic tear in younger patients, should always benefit first from a conservative rehabilitation program.

CT and MR arthrography of the normal and pathologic anterosuperior labrum and labral-bicipital complex.

Interpretation of computed tomographic and magnetic resonance arthrograms of the shoulder is complicated by normal variants of the labrum and glenohumeral ligaments. A superior sublabral recess is located at the 12 o'clock position and represents a normal recess between the superior labrum and the cartilage of the glenoid cavity. A sublabral foramen is located at the 2 o'clock position and represents localized detachment of the labrum from the glenoid rim.

Medium-term results of percutaneous, arthroscopically-assisted osteosynthesis of fractures of the tibial plateau.

We carried out percutaneous, arthroscopically- and fluoroscopically-assisted osteosynthesis of fractures of the tibial plateau in 52 patients, of whom 38 were assessed using the HSS knee score and standing radiographs. We reviewed 31 AO type-B fractures and seven type-C fractures after a mean follow-up of five years (1 to 14). Fixation was achieved using percutaneous screws and/or an external frame; 33 associated intra-articular injuries, diagnosed in 21 out of the 38 patients, were treated arthroscopically.

SLAP lesions: a retrospective multicenter study.

A retrospective analysis of 530 glenohumeral arthroscopies performed by three independent Belgian arthroscopists revealed the presence of 32 SLAP lesions, which represents an incidence of 6%. Since this is exactly the same percentage as found by Snyder et al., we report our data in this article.

Static and dynamic roentgenographic analysis of ankle stability in braced and nonbraced stable and functionally unstable ankles.

Patients suffering from functional ankle instability were selected based on a structured interview. Talar tilt was measured using supine ankle stress roentgenographs and standing talar tilt was measured using erect ankle stress roentgenographs. A digital roentgenocinematographic analysis of a 50 degrees ankle sprain simulation was performed to measure dynamic talar tilt and inversion distance between two video images (inversion speed).

Objective roentgenologic measurements of the influence of ankle braces on pathologic joint mobility. A comparison of 9 braces.

The stabilizing effect of external support (taping and nine different ankle braces) was tested in a total of 220 functionally unstable ankles. A standard surface EMG controlled stress Roentgen test protocol was used, measuring talar tilt (TT) without support and with tape bandage or brace. Different levels of TT restraining by external support could be identified.

Glenoid dysplasia: radiographic and CT arthrographic findings.

A 60-year-old man with dysplasia of the glenoid and a rotator cuff tear is reported on. Because of the tear, CT arthrography was performed, offering an opportunity to evaluate the various soft tissue abnormalities accompanying glenoid dysplasia. Marked thickening of the glenoid cartilage and labrum was apparent, as well as an abnormal posterolateral orientation of the glenoid cavity.

Unusual evolution of a benign-looking cortical defect of the proximal humerus. A case of intracortical osteosarcoma?

A case of an osteosarcoma following a pathological fracture through a small benign-looking cortical lesion of the proximal humerus is described. The unusual evolution from a small cortical lesion to a malignant lesion raises the question whether this is a case of an intracortical osteosarcoma that has some distinct features from those of previously reported cases.

Imaging in sports-medicine--knee.

Since the last decade, the introduction of Magnetic Resonance Imaging has provided a powerful new tool for the clinician to diagnose sports-related knee injuries. The main objective of this paper is to familiarise the relevant specialists with the proven clinical indications and semiology of MRI of the knee. At the present time, the knee joint is the area in which the advantages of MRI are most spectacularly apparent.

Non-operative management of anterior cruciate ligament injuries in the general population.

The operative treatment of lesions of the anterior cruciate ligament (ACL) in athletes has been widely advocated and performed. We have investigated the outcome of non-operative management in a lower-demand, general population. We reviewed a consecutive group of 228 patients, which excluded professional and high-level athletes, for two to 12 years after an ACL lesion had been diagnosed by arthroscopy.

Treatment of isolated distal ulnar shaft fractures with below-elbow plaster cast. A prospective study.

In a prospective study 52 patients with an isolated fracture of the distal ulna were treated with a below-elbow plaster cast. The histories of 46 patients were reviewed after a mean follow-up of 3.5 years (ranging from 10 months to 7 years).

Distraction for ankle arthroscopy.

Distraction has proven to be usefull for arthroscopic visualisation and instrumental access to some ankle pathology. A distraction technique using a single calcaneal pin combined with the installation of the patient on a fracture table is described. The method has already been used by the authors in more than 100 ankle arthroscopy procedures without distraction-related complications.