Publications by authors named "Lhotellier L"

Introduction: Spinopelvic kinematics, reflected by the change in spinopelvic tilt (ΔSPT) from a standing position to a flexed seated position, has been associated with the risk of prosthetic impingement and hip dislocation. Some studies have suggested changes in spinopelvic mobility after total hip arthroplasty (THA), but none have explored changes in mobility in the first three months following THA using a direct anterior approach.

Hypothesis: Our hypothesis was that changes in spinopelvic mobility occur in the first 3 months postoperatively, leading to increased hip mobility and increased spinopelvic kinematic abnormalities.

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Article Synopsis
  • The study investigates the relationship between hip mobility and spinopelvic tilt, finding that higher hip movement (∆PFA ≥ 95°) significantly increases the risk of adverse spinopelvic mobility when transitioning from standing to seated positions.
  • 337 patients undergoing total hip arthroplasty (THA) were analyzed using x-rays to measure spinopelvic tilt (∆SPT) and pelvic femoral angle (∆PFA), demonstrating distinct differences in these measurements based on patient mobility levels.
  • Results indicate that patients with high hip mobility are at a much greater risk of experiencing significant spinopelvic mobility issues, suggesting the importance of assessing hip function before surgery to manage potential complications.
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Purpose: This prospective clinical cohort was undertaken to determine the long-term risks of reinfection and all-cause aseptic failure after 1-stage exchange total knee arthroplasties (TKA) in a large series of consecutive patients with periprosthetic joint infection (PJI) following TKA.

Hypothesis: One-stage exchange for chronic PJI is an effective strategy, even in a non-selected population.

Patients And Methods: Non-selected patients (152 with 154 PJI) undergoing 1-stage-exchange TKA for PJI (January 2003-August 2015) were prospectively included and monitored for ≥2 years.

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Introduction: The first results of cementless prosthesis were rather disappointing. However recent progress in methods of cementless fixation of prosthesis should lead to better results in terms of survival of these prostheses. The main objective is to compare the survival rate at last follow-up of UKA with cemented tibial or cementless.

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Background: An important aspect of preoperative planning for total hip arthroplasty is templating. Although two-dimensional (2D) templating remains the gold standard, computerized tomography (CT)-based three-dimensional (3D) templating is a novel preoperative planning technique. This study aims to compare the accuracy of a 2D and 3D plan using an anterior approach for the placement of the same uncemented prosthesis.

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Purpose: Although rare, fractures of ceramic components are difficult to revise, mainly due to the presence of residual ceramic debris that can cause catastrophic wear of the replacement components. Modern ceramic-on-ceramic bearings are suggested to improve outcomes of revision total hip arthroplasty (THA) for ceramic fractures. However, there are few published reports of mid-term outcomes of revision THA using ceramic-on-ceramic bearings.

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Background: Femorotomy is a commonly used technique during cementless stem removal but should be preferred in selective revision cases to prevent intraoperative femoral fracture associated with deteriorated clinical outcome. Our aim was to assess the risk factors for fracture or femorotomy and develop a predictive risk stratification score.

Methods: A monocentric retrospective cohort including 202 patients was analyzed.

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Article Synopsis
  • Despite the general success of total hip arthroplasty (THA), some patients, particularly younger and more active ones, are concerned about the added weight of implants, which the study aimed to address.
  • The research involved 104 patients and found that both cementless and cemented THA implants were significantly heavier than the tissue and bone removed during surgery, with a median weight gain of 145g and 241g respectively.
  • Factors such as lower BMI, gender, and implant type influenced weight gain, with women and patients receiving cemented stems experiencing more significant increases; however, the long-term impact of this weight gain remains unclear.
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Prosthetic hip infection (PHI) is a disastrous scenario after an arthroplasty. International guidelines contraindicate one-stage exchange arthroplasty for fistulizing chronic prosthetic hip infection (FCPHI), nevertheless few surgical teams, mostly from Europe, support one stage procedure for this indication. Analysis of infection recurrence and implant failure of a series of FCPHIs treated with one stage arthroplasty.

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Background: Prosthetic joint infection (PJI) is a rare (incidence, 0.15% to 0.9%) but serious complication of knee arthroplasty.

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Objective: Prosthetic joint infection (PJI) is a serious complication of joint replacement surgery. The major pharmacological and surgical treatments required by PJI increase the risk of peri-operative complications in elderly patients. The increase in life expectancy combined with procedural advances make these treatments possible even in the oldest patients.

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Objective: Tuberculous prosthetic joint infection (PJI) is uncommon and often diagnosed late. The objective here is to describe the management of tuberculous PJI at an osteoarticular infection referral center.

Methods: A single-center retrospective study of patients managed between 1987 and 2016 was performed.

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Background: Concomitant infections of several prostheses are very rare, serious events that pose particular medical and surgical therapeutic challenges. This study was undertaken to describe epidemiologic, clinical, and microbiological characteristics of concomitant multiple joint arthroplasty infections, their treatments, and outcomes.

Methods: Retrospective (January 2000 and January 2014), single-center, cohort study in a referral center for bone and joint infections.

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Perceived working conditions lead to various negative outcomes for employee behaviors, including turnover intentions. Although potential mediators for these relationships were previously identified, the importance of meaning of work has not yet been investigated. This study examines the role of this psychological resource as a mediator for the relationships between perceived working conditions and turnover intentions in a sample of 336 French workers from different job contexts.

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Objectives: To describe the occurrence in prosthetic joints of crystal-induced arthritis (CIA) defined as the deposition within the synovial membrane and/or joint cavity of calcium pyrophosphate dehydrate (CPPD) (chondrocalcinosis), sodium urate (gout), or hydroxyapatite.

Methods: We retrospectively reviewed the 7 cases of prosthetic-joint CIA seen between 1993 and 2013 at a medical-surgical center specialized in the management of osteoarticular infections.

Results: The 4 females and 3 males ranged in age from 67 to 79 years.

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Purpose: Revision of infected total knee replacements (TKR) is usually delayed for a period in which the joint space is filled with an antibiotic-loaded acrylic spacer. In contrast, one-stage re-implantation supposes immediate re-implantation. Formal comparisons between the two methods are scarce.

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Background: The main reasons for revision of unicompartmental knee arthroplasty (UKA) are loosening, wear, extension of osteoarthritis to another compartment, and infection. There have been no studies of the management of infected UKA, whose incidence varies from 0.2% to 1%.

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Background: Exchange arthroplasty of one or two stages is required for the treatment of chronic periprosthetic joint infections. Two-stage exchange is costly and has high morbidity with limited patient mobility between procedures. One-stage exchange has been promoted by several European teams as the preferred alternative.

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Few cases of Campylobacter prosthetic joint infection (PJI) have been reported so far. We describe the demographic characteristics, underlying conditions, clinical features, treatment, and outcome of 8 patients with Campylobacter PJI in our hospital. All strains were confirmed at the French National Reference Center for Campylobacter and Helicobacter.

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Few data are available on treatment and outcome of methicillin-resistant (MR) staphylococcal prosthetic joint infections. Vancomycin remains the treatment of choice for these infections, but its efficacy and safety in bone-and-joint infections are insufficiently documented. We conducted a prospective cohort study on 60 patients treated between November 2002 and December 2008 for chronic MR staphylococcal (44 S.

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Introduction: Better outcomes have been reported for two-stage total hip arthroplasty (THA) revision for infection. However, one-stage revision arthroplasty remains an attractive alternative option since it requires only one operation. A decision tree has been developed by the authors in order to determine which type of surgical procedure can be performed safely.

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Purpose: Infection of a total hip replacement is potentially a devastating complication. Statistical process control methods have been generating interest as a means of improving the quality of healthcare, and we report our experience with the implementation of such a method to monitor the one year infection rate after primary total hip replacement.

Method: Infection was defined as the growth of the same organism in cultures of at least two aspirates or intra-operative specimens, or growth of one pathogen in a patient with local signs of infection such as erythema, abscess or draining sinus tract.

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Introduction: Treatment of infection after total hip replacement (THR) is complex and costly. Debridement with component retention is an attractive solution. Success rates in the literature vary widely (18-90%) according to patient selection criteria.

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Introduction: The most feared complication of arthroplasty after septic arthritis (active or quiescent) on a degenerative joint is septic failure, but this risk is difficult to assess. The aim of the present study was to analyze the results of arthroplasties after septic arthritis of native knee and hip joints, in terms of functional results and infection control and to seek eventual risk factors of failure.

Patients And Methods: Fifty-three cases of septic arthritis treated by arthroplasty (31 knees and 22 hips) were retrospectively included.

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Article Synopsis
  • The study focused on understanding the characteristics and outcomes of patients with group B streptococcal (GBS) infections in prosthetic joints, involving 30 patients over a period from 1994 to 2006.
  • Most patients had underlying health issues, and infections were generally contracted through the bloodstream, with various identified entry points.
  • Treatment involved surgery and long-term antibiotics, but while many patients were cured, there were complications, including relapses and 2 deaths associated with infections or treatments.
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