The torsion of the proximal femur in cementless total hip arthroplasty: a 3-dimensional evaluation.

Introduction: The anatomy of the proximal femur at the time of total hip arthroplasty has been widely studied but the horizontal plane was never considered, or only limited to the torsion of the femoral neck.

Methods: Using CT-scan images from a group of 178 patients scheduled for cementless total hip arthroplasty (THA), we analysed the evolution of the torsion of the proximal femoral metaphysis, in reference to the posterior bicondylar plane of the femur. The evolution of the torsion, between 20 mm below the centre of the lesser trochanter and 20 mm above, was evaluated.

Prognostic factors in adult soft tissue sarcoma treated with surgery combined with radiotherapy: a retrospective single-center study on 164 patients.

The aim of the present study is to assess the disease profile, outcome and prognostic factors in patients treated with surgery combined with radiotherapy (RT), with or without chemotherapy (CXT), for soft-tissue sarcoma (STS) in a multidisciplinary setting. One hundred and sixty-four patients with STS treated between 1980 and 2010 at the Centre Hospitalier Universitaire Vaudois were enrolled in this retrospective study. Seventy-six percent of patients underwent postoperative RT with (24%), or without (52%) CXT, 15% preoperative RT with (5%), or without (10%) CXT, surgery alone (7%), or RT alone (2%) with or without CXT.

Effect of biomagnetic therapy versus physiotherapy for treatment of knee osteoarthritis: a randomized controlled trial.

Objective: To assess the effectiveness of pulsed signal therapy in the treatment of knee osteoarthritis (Kellgren II or III).

Methods: A randomized, double-blind controlled clinical trial. The first 95 patients sent to the clinic with knee osteo-arthritis were selected and randomized into treatment with pulsed signal therapy or conventional physiotherapy.

Isolated limb perfusion with tumor necrosis factor and melphalan for non-resectable soft tissue sarcomas: long-term results on efficacy and limb salvage in a selected group of patients.

Background And Objectives: Isolated limb perfusion with TNF-alpha and melphalan (TM-ILP) is a limb salvage therapy for non-resectable soft tissue sarcomas (STS) of the extremities. It is indicated for patients for whom amputation or debilitating surgery is the only alternative. It can be used either as an exclusive therapy (in palliation) or as a neo-adjuvant treatment, followed by marginal resection of tumor remnants with minimal functional impairment.

Treatment of iron deficiency anemia in orthopedic surgery with intravenous iron: efficacy and limits: a prospective study.

Background: Preoperative anemia is frequent in patients undergoing orthopedic surgery. The purpose of this study was to assess the preoperative increase of hemoglobin in iron deficiency anemia patients treated with intravenous iron.

Methods: After obtaining written informed consent, 20 patients with iron deficiency anemia received 900 mg intravenous iron sucrose over 10 days starting 4 weeks before surgery.

Leg textiloma. A case report.

Objective: To report and highlight the potential diagnostic pitfalls and consequences of leg textiloma.

Case Report And Intervention: A soft tissue pseudotumor of the left leg diagnosed in a 58-year-old man is described. The lesion was caused by a retained surgical gauze after surgery for varicose veins.

Closed and open grade I and II tibial shaft fractures treated by reamed intramedullary nailing.

Objective: To evaluate the results of closed and open grade I and II tibial shaft fractures treated by reamed nail and unreamed nailing.

Subjects And Methods: Between 1997 and 2000, 119 patients with tibial shaft fractures were treated with reamed tibial nails. Postoperatively 96 patients (70 closed and 26 grade I and II open fractures) were followed clinically and radiologically for up to 18 months.

Reliable acetabular cup orientation with a new gravity-assisted guidance system.

Acetabular cup orientation is a key factor determining hip stability, and standard mechanical guides have shown little help in improving alignment. An in vitro study was carried out to compare the accuracy and precision of a new gravity-assisted guidance system with a standard mechanical guide. Three hundred ten cups were impacted by 5 surgeons, and the final cup orientation was measured.

Three-dimensional computed cementless custom femoral stems in young patients: midterm followup.

Unlabelled: We prospectively evaluated the results of our custom cementless femoral stems to ascertain whether this technology produced reasonable clinical function, complication rates, and loosening rates at midterm. Fifty-seven consecutive patients had surgery in 62 hips for primary osteoarthritis at a mean age of 57 years using a three-dimensional computed custom cementless stem. Patients were reviewed at a mean followup of 94.

Fetal bone cells for tissue engineering.

We envision the use of human fetal bone cells for engineered regeneration of adult skeletal tissue. A description of their cellular function is then necessary. To our knowledge, there is no description of human primary fetal bone cells treated with differentiation factors.

[The role of diagnostic imaging in sarcoma].

A radiologist should be included in the multidisciplinary approach which will allow optimal diagnostic evaluation and treatment of sarcoma. The appropriate use of ultrasound, computed tomography and magnetic resonance imaging plays a significant role in the evaluation of these tumors and their recurrences. The potential role of dynamic magnetic resonance imaging has also been evaluated.

[Biopsy and surgical treatment of soft tissue tumors].

When a soft tissue tumor is initially misdiagnosed as a simple trauma or a mass, treatment may be adversely affected by the delay in diagnosis or an inappropriate invasive procedure that results in extension of a probable malignant tumor. Patients with soft tissue tumors present a diagnostic challenge to the clinician. A systematic approach to the evaluation and biopsy is necessary in order to minimize diagnostic errors and biopsy complications.

[Prevention of heterotopic ossification following prosthetic total hip replacement].

Heterotopic ossification, mostly of the hip, is a frequent complication after reconstructive surgery. Most common prophylactic therapies are non-steroidal anti-inflammatory medication (AINS) applied post-operatively and external radiotherapy (RT) administered in the pre- or post-operative setting. Both treatments proved to be efficient in several randomised clinical trials.

Detraining effects on the mechanical properties and morphology of rat tibiae.

To study bone adaptation to detraining in growing rats, nine weeks-old immature female Wistar rats (n=110) were subjected to treadmill running programs (30 or 60 minutes-a-day) for up to 15 weeks, followed by unrestricted cage activities for the subsequent 15 weeks. The results revealed that (1) the cross-sectional area and mechanical properties of the midshaft bone significantly increased in response to running exercise, (2) its structural properties remained unchanged after the cessation of exercise, whereas the material properties returned to control level at a relatively early stage, (3) in the metaphysis, cortical bone area remained unchanged but trabecular bone area decreased in response to running exercise, (4) both areas slightly increased after the cessation of exercise, and (5) the changes in the mechanical properties and morphology of bone depended upon the repetition number and/or the duration of exercise, and were larger with longer duration of exercise.

[Tomodensitometry measurements of proximal tibia and acceleration in marathon athletes].

We evaluated bone adaptation of the tibia to mechanical stresses in male marathon runners and in sedentary controls in function of the ground impact measured by accelerometry and of the bone mineral density assessed by peripheral quantitative computed tomography (QCT). Sixty-three subjects (51 runners and 12 controls) were enrolled. All had measurements of bone mineral density of the proximal tibia and of acceleration at the same site during a jogging at 9 km/hour.

Cable fixation and early total hip arthroplasty in the treatment of acetabular fractures in elderly patients.

Eighteen patients with acetabular fractures, with a mean age of 76 years, were treated with cable fixation and acute total hip arthroplasty. Nine were T-shaped fractures, 4 associated transverse and posterior wall, 2 transverse, 2 posterior column and posterior wall, and 1 anterior and posterior hemitransverse fractures. One patient experienced 3 episodes of hip dislocation within 10 months after surgery.

Acute fractures of medial and lateral great toe sesamoids in an athlete.

We report a case of acute fracture of both sesamoids of the great toe in an athlete. The fractures healed uneventfully after non-surgical treatment.

Endurance training enhances vasodilation induced by nitric oxide in human skin.

Endurance training modifies the thermoregulatory control of skin blood flow, as manifested by a greater augmentation of skin perfusion for the same increase in core temperature in athletes, in comparison with sedentary subjects. In this study, we tested the hypothesis that a component of this adaptation might reside in a higher ability of cutaneous blood vessels to respond to vasodilatory stimuli. We recruited healthy nonsmoking males, either endurance trained or sedentary, in two different age ranges (18-35 y and >50 y).

Acute total hip arthroplasty for acetabular fractures in the elderly: 11 patients followed for 2 years.

We describe the use of cable fixation and acute total hip replacement for acetabular fracture in the elderly. 12 patients with acetabular fractures, having a mean age of 79 (65-93) years, were treated with cable fixation and acute total hip arthroplasty. 8 were T-shaped fractures and 4 associated fractures of the posterior column and posterior wall.