Satisfactory mid- to long-term outcomes of TKA aligned using conventional instrumentation for flexion gap balancing with minimal soft tissue release.

Purpose: To describe a technique for flexion gap management in total knee arthroplasty (TKA) using conventional instrumentation with minimal soft tissue release, by aligning the femoral component to restore close-to-native posterior condylar angle (PCA). The hypothesis was that this technique renders consistent outcomes, regardless the preoperative deformity or intraoperative parameters.

Methods: In a consecutive series of 152 TKAs, the femoral component was rotated to restore anatomic PCA of 2° ± 2° and the flexion gap was balanced with a final lateral flexion laxity of 1-3 mm.

Does augmented core decompression decrease the rate of collapse and improve survival of femoral head avascular necrosis? Case-control study comparing 184 augmented core decompressions to 79 standard core decompressions with a minimum 2 years' follow-up.

Introduction: Avascular necrosis of the femoral head often progresses to femoral head collapse if not treated. Conservative treatment yields highly variable results and is not standardised, mainly because it is typically evaluated in small patient populations. This led us to conduct a large retrospective comparative study with the goals of 1) analysing survival and functional outcomes, 2) looking for differences in survival between core decompression techniques (standard versus augmented), and 3) studying the risk factors for femoral head collapse and revision by arthroplasty.

Short vs Standard-Length Femoral Stems Cemented According to the "French Paradox": A Matched Paired Prospective Study Using Ein Bild Roentgen Analyze Femoral Component at Two-Year Follow-Up.

Background: The purpose of this prospective matched paired study is to compare the in vivo migration patterns using Ein Bild Roentgen Analyze femoral component of shortened vs standard-length stems cemented line-to-line in primary total hip arthroplasty (THA) at 2-year follow-up.

Methods: We prospectively included the first 50 consecutive primary cemented THAs in 50 patients using a 12% shortened stem (AmisK group) of which design was derived from the original Charnley-Kerboull (CK) femoral components. These 50 patients were matched paired to 50 patients from a historical series of patients who underwent primary THAs using standard-length CK stems (CK group) with available long-term results, including Ein Bild Roentgen Analyze femoral component data at 2-year follow-up.

Acetabular reinforcement rings associated with allograft for severe acetabular defects.

Acetabular revisions with severe bone defects can be challenging procedures. Several grading systems have been set into place to help the surgeon adequately gauge the degree of bone loss within the acetabulum. Internationally innovative research in orthopedics and bio-engineering has helped with progression of successful techniques and rings to re-establish the normal anatomy of the hip.

Biomechanical behaviour of a French femoral component with thin cement mantle: The 'French paradox' may not be a paradox after all.

Objective: Cement thickness of at least 2 mm is generally associated with more favorable results for the femoral component in cemented hip arthroplasty. However, French-designed stems have shown favorable outcomes even with thin cement mantle. The biomechanical behaviors of a French stem, Charnley-Marcel-Kerboull (CMK) and cement were researched in this study.

Revision Total Hip Arthroplasty Using the Kerboull Acetabular Reinforcement Device and Structural Allograft for Severe Defects of the Acetabulum.

Background: The purpose of this study is to review our experience with Kerboull reinforcement device combined with bulk allograft for management of severe acetabular defects.

Methods: We investigated the results of revision total hip arthroplasty (THA) in 65 hips of 59 patients (10 male, 49 female) with Paprosky type 3A or 3B acetabular bone defects. Functional outcome was assessed using the Merle d'Aubigne hip score.

Selecting the surgical approach for revision total hip arthroplasty.

Selecting the approach for revision total hip arthroplasty is a crucial step in pre-operative planning. Whether the surgical objectives can be reached via a conventional approach or require a specific approach must be determined. The best approach depends on multiple factors including the reason for revision, patient's characteristics, implants requiring removal, previous approach, soft tissue and bone lesions, and surgeon's level of experience.

Comparison of the inter- and intra-observer reproducibility of the Crowe, Hartofilakidis and modified Cochin classification systems for the diagnosis of developmental dysplasia of the hip.

Introduction: Developmental dysplasia of the hip (DDH) leads to multiple treatment challenges during adulthood. Surgical treatment is mainly based on radiographic evaluation of the anatomical alterations. Several classification systems have been described in the published English scientific literature, but the French Cochin classification has not been used very much.

Length of clinically proven cemented hip stems: state of the art or subject to improvement?

Purpose: The purpose of this study was to identify the shortest possible length of an established cemented hip stem in order to reduce stress shielding and optimise its bending behaviour.

Methods: Twenty-five prototypes from the same batch (five for each stem length) were included. Lengths resulted from the original length (100 %) and four distal shortenings to 94, 88, 83 and 78 % of original length.

Is the so-called 'French paradox' a reality?: long-term survival and migration of the Charnley-Kerboull stem cemented line-to-line.

We have evaluated the in vivo migration patterns of 164 primary consecutive Charnley-Kerboull total hip replacements which were undertaken in 155 patients. The femoral preparation included removal of diaphyseal cancellous bone to obtain primary rotational stability of the stem before line-to-line cementing. We used the Ein Bild Roentgen Analyse femoral component method to assess the subsidence of the femoral component.

Impaction grafting in association with the Charnley-Kerboull cemented femoral component: operative technique and two- to 16-year follow-up results.

We describe 129 consecutive revision total hip replacements using a Charnley-Kerboull femoral component of standard length with impaction allografting. The mean follow-up was 8.2 years (2 to 16).

[Early femoral osteolysis following Charnley-Kerboull total hip arthroplasty combining a 22-mm zirconia head on polyethylene].

Purpose Of The Study: New bearings have been developed to reduce polyethylene wear. Zirconia ceramic is one proposal with attractive tribologic properties. The purpose of this prospective study was to evaluate the clinical and radiological results at least two years after implantation in a continuous series of total hip arthroplasties combining a zirconia head with polyethylene socket.

Positive effect of patient education for hip surgery: a randomized trial.

The current trial compared patient education before total hip arthroplasty with the usual verbal information. A randomized, controlled 24-month prospective single-center study was done. Patients scheduled for a first elective total hip arthroplasty for primary hip osteoarthritis were enrolled.

Total hip arthroplasty for the treatment of ankylosed hips : a five to twenty-one-year follow-up study.

Background: The purpose of the present retrospective study was to report the long-term results of total hip arthroplasty following a hip fusion. Special attention was paid to the resulting function of both the involved joint and the neighboring joints, as pain in the lower back or knee was the usual indication for conversion. The factors that were likely to influence the functional outcome were analyzed.

Immunohistological study of entheses in spondyloarthropathies: comparison in rheumatoid arthritis and osteoarthritis.

Objective: To determine which inflammatory cell types are present in entheses from patients with spondyloarthropathy (SpA) compared with patients with rheumatoid arthritis (RA) or osteoarthritis (OA).

Methods: Enthesis specimens were obtained during orthopaedic procedures in eight patients with SpA, four with RA, and three with OA. After decalcification, the lymphocyte subsets (CD3, CD4, CD8, CD20) in the bone marrow component of each enthesis were measured by an immunohistochemical technique.

[Femoral reconstruction with massive allograft implanted in a split femur. Mid-term results of 18 reconstructions].

Purpose Of The Study: Extensive loss of femoral bone subsequent to implant loosening raises an unsolved problem. The purpose of this work was to examine mid-term results of 18 iterative total hip arthroplasties with femoral reconstruction using massive allografts performed between 1986 and 1997.

Materials And Methods: Using the Vives classification, the femoral bone lesions were grade 3 (n =2) and grade 4 (n =16).

The Kerboull acetabular reinforcement device in major acetabular reconstructions.

Sixty consecutive revision total hip arthroplasties were performed with bulk allograft bone supported by the Kerboull reinforcement acetabular device in 53 patients from 1980 to 1987. The average age of the patients at the time of hip revision was 57.7 years.

[Radiographic assessment of polyethylene wear in machined versus molded polyethylene in total hip prosthesis].

Purpose Of The Study: Wear of polyethylene acetabular components is an important issue in total hip arthroplasty. This study was designed to evaluate differences in polyethylene wear rates between machined and direct compression molded acetabular cups.

Methods: Two hundred thirty-nine prostheses underwent radiographic evaluation using the technique of Chevrot-Kerboull.

Prevention of heterotopic ossification in hip arthroplasty. The influence of the duration of treatment.

A retrospective study has been carried out to assess the effectiveness of indomethacin in preventing heterotopic ossification after total hip arthroplasty, and the effect of using it for different periods of time. One hundred and sixty-eight hips operated on in 1983 were not given indomethacin and acted as a control. One hundred and fifty hips operated on in 1988 were given indomethacin and divided into 3 groups: 42 received indomethacin for 5 days, 49 for 11 days and 59 for 45 days.

[Functioning of a bone tissue bank in 1998].

Last few years, the french legislation and reglementation concerning donated human tissues, safety precautions, and human tissues' uses have been deeply modified. Therefore, tissue banks' organisation, processing of allograft tissue, and the way surgeons use frozen bone graft have changed. Accordingly, authors describe different obligations these activities implicate and practical consequences for tissue banks and surgeons.

Validation of the Ottawa ankle rules in France: a study in the surgical emergency department of a teaching hospital.

Study Objective: To validate the Ottawa ankle rules to predict fractures in a French clinical setting when they are used by physicians not involved in their development.

Methods: We used a prospective patient survey by emergency physicians in a surgical emergency department of a university teaching hospital of the Assistance Publique-Hôpitaux de Paris. The study group consisted of 416 consecutive patients aged 18 years and older who presented with acute ankle or midfoot injuries in the surgical ED during a 4-month period.

Heterotopic ossification after total hip arthroplasty: risk factors and prevention.

A retrospective review of 168 consecutive total hip arthroplasty procedures done in 1983 at the Cochin Teaching Hospital, Paris, France, was conducted to determine the rate of occurrence of heterotopic paraarticular ossification and to look for risk factors for this complication. None of the patients received preventive therapy for heterotopic ossification. Mean age was 66.