Recession wedge trochleoplasty as an additional procedure in the surgical treatment of patellar instability with major trochlear dysplasia: early results.

Introduction: The importance of a dysplastic trochlea as a component of patellar instability has long been recognized. An original trochleoplasty technique consisting in retro-trochlear recession wedge osteotomy was described by Goutallier et al. The aim is not to fashion a groove but to reduce the bump without modifying patellofemoral congruence.

Discoid medial meniscus: report of four cases and literature review.

Introduction: Discoid medial meniscus is a rare abnormality, with incidence estimated at 0.12%. The present study describes this congenital abnormality anatomically and reports clinical results in four symptomatic cases managed by surgery.

Rotational positioning of the tibial tray in total knee arthroplasty: a CT evaluation.

Introduction: Various surgical techniques have been described to set the rotational alignment of the tibial baseplate during total knee arthroplasty. The self-positioning method ("self-adjustment") aligns the tibial implant according to the rotational alignment of the femoral component which is used as a reference after performing repeated knee flexion/extension cycles. Postoperative computed tomography scanning produces accurate measurements of the tibial baseplate rotational alignment with respect to the femoral component.

Concomitant axillary mycobacteriosis and neuro-sarcoidosis: diagnostic pitfalls.

There are many similarities between mycobacteriosis, in particular, tuberculosis, and sarcoidosis such as predominant intrathoracic localisation (even if all organs and tissues may be concerned), great variability of phenotypic expression, and granulomatous inflammatory reaction, caseous necrosis not being an absolute criterion of tuberculosis. Moreover, microbial (or mycobacterial?) agents may play a role in the pathogenesis of sarcoidosis which remains a diagnosis of exclusion particularly in atypical cases. The authors report a case of a non-immunocompromised female patient who presented, simultaneously, isolated axillary tubercular adenitis and neuro-sarcoidosis without any other localisation.

Comparative study of intraoperative knee flexion with three different TKR designs.

Introduction: Substantial flexion after total knee arthroplasty (TKA) is required for certain categories of patients who wish to squat or kneel in their daily life. Many factors influence this postoperative flexion, including the prosthesis design. It is therefore valuable to in vivo analyze these factors on three knee prosthesis designs through a study of their intraoperative flexion.

Anterior cruciate ligament mucoid degeneration: selecting the best treatment option.

Introduction: Mucoid degeneration of the anterior cruciate ligament (ACL) is a little-known entity. The clinical presentation is one of posterior pain with limited flexion. Its interstitial nature within the ACL structure contrasts with synovial cyst of the ACL.

Matrix metalloproteinase-3 and intracranial arterial dolichoectasia.

Objective: Intracranial arterial dolichoectasia (IADE), also called dilatative arteriopathy of the brain, is defined as an increase in length and diameter of intracranial arteries. Abdominal aortic aneurysm and ectasia of coronary arteries have been reported in association with IADE. In both conditions, a dysfunction of matrix metalloproteinases (MMP)-2, -3, and -9 have been found.

Vascular lesions associated with bicruciate and knee dislocation ligamentous injury.

Introduction: The incidence of associated vascular lesions in biligamentous cruciate injuries of the knee ranges from 16 to 64%, with a mean rate of 30%. Treatment of ischemic vascular lesions associated with ligaments injury is well established, comprising emergency arterial vascular repair, most of the times combined to external fixation. In the absence of clinical symptoms of vascular lesion, some authors recommend systematically performing arteriography, while others advocate selectively prescribing this examination in doubtful clinical situations.

Cementless cups do not increase osteolysis risk in metal-on-metal total hip arthroplasty. Apropos of 106 cases.

Background: Metal-on-metal bearings in total hip arthroplasty (THA) were introduced to reduce the production of wear debris and debris-induced periprosthetic osteolysis. Analysis of various series according to the type of selected acetabular fixation highlights different evolutions: favourable results with uncemented cups contrasting with loosening and radiolucent lines (RLL) evolution for cemented cups.

Hypothesis: Combining metal-on-metal bearings to uncemented cups does not increase the osteolysis risk at a minimum 5 years' follow-up.

Does lateral versus medial exposure influence total knee tibial component final external rotation? A CT based study.

Introduction: A previous study demonstrated that performing a total knee arthroplasty through a lateral approach including anterior tibial tuberosity (ATT) osteotomy (refixed in its original position) presented numerous advantages: correcting the preoperative patella lateral tilt and improving postoperative patella tracking. We hypothesized that these improvements in patella centering were, at least in part, due to an increased external rotation of the tibial component. Postoperative scannographic studies were, therefore, undertaken to measure tibial component rotation and analyze the results according the medial and lateral exposure used.

Distal femur rotational alignment and patellar subluxation: a CT scan in vivo assessment.

Background: Patellofemoral instability following total knee arthroplasty is a very common complication which may result from a defective rotational positioning of the femoral component. However, rotational landmarks for optimal orientation are not unequivocal. Moreover, no proven correlation has yet been established between preexisting rotational malposition and patellofemoral instability occurrence.

Long term GP opinions and involvement after a consultation-liaison intervention for mental health problems.

Background: Shared Mental Health care between Psychiatry and Primary care has been developed to improve the care of common mental health problems but has not hitherto been adequately evaluated. The present study evaluated a consultation-liaison intervention with two objectives: to explore long-term GP opinions (relating to impact on their management and on patient medical outcome) and to determine the secondary referral rate, after a sufficient time lapse following the intervention to reflect a "real-world" primary care setting.

Methods: All the 139 collaborating GPs (response rate: 84.

Basilar artery diameter and 5-year mortality in patients with stroke.

Background And Purpose: Few and conflicting data exist on the case fatality rate in stroke patients with basilar artery dolichoectasia. We analyzed basilar artery characteristics (diameter, height of bifurcation, transverse position) and 5-year mortality (all-cause, nonstroke vascular, and stroke) in patients with brain infarction.

Methods: The basilar artery diameter was measured with a 16-diopter lens in 466 consecutively recruited patients with brain infarction confirmed by magnetic resonance imaging.

Intracranial arterial dolichoectasia is associated with enlarged descending thoracic aorta.

Background: Intracranial arterial dolichoectasia (IADE) is defined as an increase in length and diameter of the intracranial arteries and is present in 12% of stroke patients. The pathophysiology is unknown; some data suggest that IADE is not merely a complication of atherosclerosis, but a distinct arteriopathy characterized by loss of elastic tissue in the media.

Objective: To investigate the relationship between IADE and transesophageal echocardiography (TEE) variables such as ascending and descending thoracic aorta diameters.

Intracranial arterial dolichoectasia and its relation with atherosclerosis and stroke subtype.

Objective: To investigate the relationship between intracranial arterial dolichoectasia (IADE) and vascular risk factors, atherosclerosis of the carotid arteries as measured by ultrasound scan, and stroke subtypes.

Methods: The sample consists of 510 consecutively recruited patients with brain infarction confirmed by MRI. The diagnosis of IADE was made by consensus between two neurologists based on MRI results.

Could cognitive vulnerability identify high-risk subjects for schizophrenia?

This review puts into questions the possible role of cognitive vulnerability markers in prediction and prevention of schizophrenia. Until recently, none of the identified cognitive anomalies has been proved to be definitive. However, as new promising candidates are emerging (DS-CPT, CPT-IP, P suppression, Saccadic Eye Movements), the predictive value of these trait-type anomalies may be criticized regarding four issues, which are discussed: technical, metrological, theoretical, and clinical.

Biomarkers of oxidative stress: an analytical approach.

Oxidative stress is implicated in many pathological processes and results from a disruption of the prooxidant/antioxidant balance. This review will focus on noninvasive biomarkers of radical-induced damage in biological fluids and particularly in blood. Special attention will be addressed to new analytical methods for the measurement of radical-mediated alterations in the integrity of lipids, proteins and DNA.

Short- and medium-term duplex sonography follow-up of deep venous thrombosis of the lower limbs.

Purpose: We conducted this study to assess the progression or regression of venous thrombi during and after treatment and to search for criteria of embolism risk.

Methods: We prospectively studied 75 patients with lower limb deep venous thrombosis. We used B-mode sonography for the diagnosis and follow-up of these thrombi.