Is pre-operative block-test with lidocaine injection efficient in predicting the functional result of revision total hip arthroplasty?

Background: While performing a hip joint aspiration for culture, a lidocaine diagnostic injection called block test can be performed during the investigation of painful total hip arthroplasties (THA). This test was formerly applied to limited series in pre-operative and without assessing the predictive value on the results of THA revision. Therefore we investigated a consecutive series of THA revisions who underwent pre-operative aspiration-block test to determine if patients with pre-operative positive block test (disappearance of symptoms) have a better clinical improvement after revision.

Performance of the GeneXpert® MRSA/SA SSTI test in periprosthetic joint infections: rate of failure, outcomes and risk factors.

Background: The GeneXpert® MRSA/SA SSTI test allows early detection of methicillin-resistant staphylococci in intraoperative samples of prosthetic joint infections (PJI) in order to stop early broad-spectrum antibiotics.

Questions/purpose: (1) What is the rate of false-negative GeneXpert® MRSA/SA SSTI test results? (2) Does a false-negative GeneXpert® MRSA/SA SSTI test result increase the risk of treatment failure for the patient with a PJI? (3) What are the risk factors of a false-negative result?

Method: A retrospective study was carried out to compare all GeneXpert® assays to conventional cultures in prosthetic joint infections from April 1st, 2012 to October 1st, 2016. False-negative (FN) results (absence of methicillin-resistant staphylococci (MRS) with GeneXpert® test, but presence in the culture) were identified.

Acetabular revision for iliopsoas impingement: a study of 55 cases at 3 years of follow-up. Does the procedure achieve the Minimal Clinically Important Difference (MCID) in the Oxford-12 score in more than 80% of cases?

Introduction: Several surgical options can be offered to manage iliopsoas impingement. Research published on cup replacements often concerns a small population size or multicentre studies, suggesting a variety of indications. We conducted a retrospective single centre study screening according to a specific protocol of a population of patients who had a cup replacement for iliopsoas impingement.

Long-term results (after a mean 11.3years, and up to 22years, of follow-up) of the Legacy Constrained Condylar Knee (LCCK™) in primary total knee arthroplasty.

Introduction: The use of a sliding prosthesis in total knee arthroplasty (TKA) with increased stress is an intermediate solution in primary surgery, between posteriorly stabilized prostheses and hinged prostheses, in cases of ligamentous laxity and/or loss of bone substance. Favorable results have been reported in the medium term but to our knowledge, this type of prosthesis has not been evaluated in Europe beyond 10 years of follow-up. We therefore conducted a retrospective study in order to carry out: 1) the study of the survival of the Legacy Constrained Condylar Knee (LCCK™) prosthesis in primary surgery, 2) the analysis of complications, functional scores and radiographic data, 3) the analysis of the link between the diaphyseal filling rate and prosthetic loosening.

What role for short stems in 2023?

Current trends in total hip replacement aim at soft tissue and bone stock conservation. At the same time, mean patient age has been decreasing from decade to decade, raising the issue of iterative revision. Short stems seek to resolve the problem on the femoral side.

What happens in the medium-term to capsule-thickening plasties for iliopsoas impingement after total hip arthroplasty? Evaluation of 14 procedures at 4years' follow-up.

Introduction: In 2015, we described a capsule-thickening technique via an anterior approach for iliopsoas cup impingement. To our knowledge, medium-term results have not been reported. We therefore retrospectively analyzed all cases in the initial series and those since 2015, to assess this original technique over a longer follow-up: (1) to analyze complications, and (2) to assess functional outcome.

Should microbiological samples be taken routinely when performing revision surgery for post-surgical hematoma after hip or knee replacement? Retrospective study of 78 cases of surgically drained hematoma with a minimum follow-up of 2 years.

Introduction: The relationship between the occurrence of a periprosthetic hip or knee joint infection, a post-surgical hematoma and the time to surgical revision, along with the need to take samples for microbiology analysis has not been clearly defined. This led us to perform a retrospective study to: 1) define the rate of infected hematoma and subsequent infection after surgical revision for hematoma and 2) analyze in which time frame the hematoma was likely to be infected.

Hypothesis: The more time elapsed before the postoperative hematoma is drained surgically after hip or knee replacement, the higher the hematoma infection rate and the late infection rate.

Hip resurfacing for small-sized osteonecrosis: 73 cases at a median 8years' follow-up.

Introduction: Total hip resurfacing arthroplasty (THRA) is an alternative to conventional total hip replacement (THR) in young patients with osteonecrosis of the femoral head. Series have been small, without criteria regarding extent of necrosis, thus vitiating results. We therefore conducted a retrospective assessment of THRA for small necrosis, to determine (1) implant survival, (2) functional scores, and (3) systemic chromium, cobalt and titanium ion concentrations.

Cementless metal-on-metal versus ceramic-on-polyethylene hip arthroplasty in under-50 year-olds with 20 to 22 years' follow-up: Was it a good idea to abandon the small-diameter metal-on-metal bearing?

In 2005 and 2011, we reported results for a comparative study of two types of 28-mm bearing (metal-on-metal (MoM) and ceramic-on-polyethylene (CoP) in active patients with respectively 5 and 12 years' follow-up. The present report is an update at a mean 20 years' follow-up, addressing 2 issues: (1) implant survival at a mean 20 years; and (2) long-term complications with the metal-on-metal bearing. Twenty-eight millimeters MoM bearings show good survival at 20 years in young active subjects.

Tibiofemoral lift-off and resulting laxity following total knee arthroplasty: Frequency in a series of 906 continuous cases and functional consequences at 4 years' follow-up in a case-control study.

Background: Tibiofemoral instability is one reason for early revision of total knee arthroplasty. It can be the consequence of tibiofemoral laxity, especially in the coronal plane with tibiofemoral lift-off. But does femoral condyle lift-off on conventional postoperative radiographs suggest the presence of laxity or potential instability? To our knowledge, this question has not yet been answered.

Are CPR (Contact Patch to Rim) distance anomalies associated with the occurrence of abnormal noises from ceramic-on-ceramic THA?

Introduction: The ceramic-on-ceramic couple in total hip arthroplasties (THA) has the advantage of excellent wear resistance and the bioinert nature of its debris. Noise occurring from this friction torque is a common complication, the contributing factors of which are debated. The noise is caused by a lack of lubrication, due in most part to the positioning of the acetabular cup.

Debridement, antibiotics and implant retention for prosthetic joint infection: comparison of outcomes between total hip arthroplasty and hip resurfacing.

Introduction: The management of prosthetic joint infection (PJI) has been widely studied in the context of total hip arthroplasty (THA). However, the outcomes of debridement, antibiotics and implant retention (DAIR) for PJI have never been compared between hip resurfacing arthroplasty (HRA) and THA. This led us to carry out a retrospective case-control study comparing the surgical treatment of post-operative infections between HRA and THA to determine the infection remission rate and the medium-term functional outcomes.

Influence of shelf acetabuloplasty on the outcomes of total hip arthroplasty in hips with dysplasia: a case-control study.

Introduction: Total hip arthroplasty (THA) in young adults, especially in those with hip dysplasia, is affected by wear and acetabular fixation problems. Shelf acetabuloplasty is performed to delay THA in patients with acetabular dysplasia. Thus, we conducted a retrospective, continuous case-control study at a single healthcare facility to analyze (1) the influence of prior shelf acetabuloplasty on the survival of a subsequent THA and (2) the functional outcomes.

French Hip & Knee Society classification of short-stem hip prostheses: Inter- and intra-observer reproducibility.

Introduction: In total hip replacement (THR), a short stem theoretically provides more physiological force transfer to the proximal femur, conserves bone stock and facilitates minimally invasive surgery. On the other hand, such implants involve a learning curve and incur risk of malpositioning or fracture and of secondary mobilization. There are several types of short stem, and classification is needed.

French hip resurfacing registry: A study of 1650 cases.

Background: Hip resurfacing has been the focus of many evaluations based on international registries but, to date, no prospective studies have evaluated this procedure in France. In 2015, the French Society for Orthopaedics and Traumatology (SoFCOT) and the French Hip and Knee Society concluded an agreement with the French Medicines Agency (ANSM) and French National Health Authority (HAS) to establish an exhaustive observational hip resurfacing registry. The primary objective of this study was to evaluate the hip resurfacing survival rate since the creation of the registry 5 years ago.

Mapping and Crosswalk of the Oxford Hip Score and Different Versions of the Hip Disability and Osteoarthritis Outcome Score.

Background: Patient-reported outcome measures such as the Oxford-12 Hip Score and Hip Disability and Osteoarthritis Outcome Score (HOOS) are used in daily orthopaedic practice to evaluate patients. Because different studies use different scores, it would be important to build conversion tables between scores (crosswalk) to compare the results of one study with those of another study. Various mapping methods can be used to develop crosswalk tables that convert Oxford-12 scores to the HOOS (and its derivatives, including the HOOS physical function short form, HOOS joint replacement, and HOOS-12) and vice versa.

Does the alpha-defensin lateral flow test conserve its diagnostic properties in a larger population of chronic complex periprosthetic infections? Enlargement to 112 tests, from 42 tests in a preliminary study, in a reference center.

Background: Diagnosis of periprosthetic infection (PPI) is crucial for management of bone and joint infection. The preoperative gold-standard is joint aspiration, providing results after 2-14 days' culture, with non-negligible false negative rates due to the fragility of certain micro-organisms and/or prior antibiotic treatment. The Synovasure™ alpha-defensin lateral flow test (Zimmer, Warsaw, IN, USA) contributes within minutes to joint fluid diagnosis of almost all infectious agents, including in case of concomitant antibiotic therapy.

Can the minimal clinically important difference be determined in a French-speaking population with primary hip replacement using one PROM item and the Anchor strategy?

Background: The impact of surgery on the patient is classically assessed on pre- and post-treatment scores. However, it is increasingly recommended to rank these results according to the minimal clinically important difference (MCID), using either the data distribution method or the anchor method, latter consisting in an extra question specifically targeting the patient's improvement. MCIDs vary between populations and, to the best of our knowledge; there have been no investigations in France regarding this in the context of total hip replacement (THR).

Muscular Hernia of the Leg After Anterior Cruciate Ligament Reconstruction with Hamstring Autograft: A Case Report.

Case: A 20-year-old woman presented with symptomatic instability secondary to traumatic anterior cruciate ligament (ACL) rupture. Arthroscopic ACL reconstruction was performed using a 4-strand semitendinosus autograft harvested using a posterior approach. At her 2-month follow-up, a painful mass was palpable, and a hernia of the medial gastrocnemius was confirmed by ultrasound.

Does change in language change the properties of a shortened score previously validated in its complete version? Validation of the French versions of the HOOS-12 and KOOS-12 scores in primary knee and hip arthroplasties.

Background: The HOOS and KOOS scoring questionnaires comprise respectively 40 and 42 items; a shorter 12-item version was recently developed, but remains to be validated in a French-speaking population. We therefore conducted a prospective study: 1) to determine whether the new 12-item versions in French are equivalent to the longer HOOS and KOOS versions, and 2) to validate the French-language HOOS-12 and KOOS-12 patient-reported outcome measures in a population of primary total hip and knee arthroplasty: validity, reliability, and responsiveness.

Hypothesis: The change in language in a score already validated in its long version does not alter its properties in the short version.

Hip arthroscopy in France: An epidemiological study of postoperative care and outcomes involving 3699 patients.

Background: Hip arthroscopy is a surgical procedure that is becoming more and more prevalent in France. Even though indications are now well-established little is still known about patient outcomes. Therefore, the purpose of our retrospective study was to: (1) describe the circumstances in which hip arthroscopies are being performed; (2) study arthroscopy and arthroplasty reoperation rates; (3) assess the incidence of readmissions for complications.

Does hip or knee joint replacement decrease chances to complete an ultra-trail race? Study in participants at the Ultra-Trail du Mont Blanc®.

Introduction: The number of patients with hip or knee joint replacements is increasing. Some of these patients want to practice sport, including in high-impact sports such as ultra-trails. Is the proportion of drop-out higher among runners after a hip or knee replacement? What are the symptoms of these patients?

Hypothesis: Hip or knee joint replacements are associated with a higher drop-out rate during an ultra-trail.