Revue de chirurgie orthopédique et réparatrice de l'appareil moteur
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Rev Chir Orthop Reparatrice Appar Mot · Feb 2004
Multicenter Study[Revision total knee arthroplasty after unicompartmental femorotibial prosthesis: 54 cases].
We analyzed technical difficulties encountered when performing revision total knee arthroplasty in patients with unicompartmental femorotibial prostheses. ⋯ Loss of bone stock raises specific problems during revision of unicompartmental knee prostheses. Loss of tibial bone is more frequent but it is more difficult to correct for loss of femoral bone. A gliding knee prosthesis is generally preferred for first intention revision. We recommend a long stem when the bone defect is important or involves loss of cortical bone. We have had good mid-term results with revision total knee prostheses after unicompartmental prostheses. Longer follow-up is needed. Poor results were obtained when revision was performed for persistent pain without a clearly defined cause. The presence or not of significant bone loss did not appear to affect outcome. The observation of medial laxity in case of failed lateral unicompartmental prostheses suggests a more constrained total knee prosthesis might be indicated. Compared with earlier series, our results with total knee prostheses after unicompartmental prostheses appear to be better than after tibial valgus osteotomy and also better than after total knee arthroplasty. Conversely, they would be less satisfactory than for primary total knee arthroplasty. The surgical procedure for revision total knee arthroplasty after unicompartmental prosthesis requires precision and skill but is not technically difficult.
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Rev Chir Orthop Reparatrice Appar Mot · Feb 2004
[Intraoperative and early postoperative complications of lumbar and lumbosacral fusion: prospective analysis of 872 patients].
Incidence of complications following lumbar or lumbosacral fusion is still an imprecise notion. The aim of this prospective observational study was to determine the frequency of intraoperative and early postoperative complications after this procedure and to analyze favoring factors. ⋯ This study enabled a precise assessment of the incidence of complications subsequent to lumbar or lumbosacral fusion: 23%. The incidence of serious complications requiring a reoperation was 14.7%. This finding, together with the factors found to influence occurrence of these complications should be kept in mind when determining indications for lumbar or lumbosacral fusion.
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Rev Chir Orthop Reparatrice Appar Mot · Feb 2004
Case Reports[Para-articular osteochondroma: a case report].
Para-articular osteochondroma, a benign osteoarticular tumor which develops near joints, is, unlike classical osteochondroma, extremely rare. We present the case of a 59-year-old woman who developed a calcified mass in the infrapatellar region. The differential diagnosis between chondrosarcoma, synovial chondromatosis, and para-aticular osteochondroma was only possible after resection and pathology examination of the surgical specimen.