Clinical examination of the knee [L'examen clinique du genou]

L’examen clinique permet de déterminer le type d’examen technique utile à l’élaboration du diagnostic. Il doit être systématique et sera influencé par l’anamnèse. Bien conduit, il permettra de faire 90% du diagnostic final

Trends in France for the use of the ELISA method in routine seed potato testing and problems of cross reactions between potato viruses A and Y1.

International audienc

Detection of PVY (Potato virusy) and PLRV (Potato leaf rool virus) in potatoo tubers : use of Elisa and immune electron microscopy.

International audienc

Trends in France for the use of the ELISA method in routine seed potato testing and problems of cross reactions between potato viruses A and Y1.

International audienc

Femoral sizing in total knee arthroplasty is rotation dependant

PURPOSE: The mismatch between the medio-lateral (ML) and the antero-posterior (AP) size of femoral components in total knee arthroplasty (TKA) has been linked to gender, ethnicity, morphotype and height differences in patients. The hypothesis of this study was that the AP size measurement of a femoral component increases with more external rotation in posterior referencing TKA. METHODS: During a 2-year period, 201 patients were included in this prospective study. The AP distance of the distal femur was measured with an AP sizer of the Vanguard (Biomet, Warsaw, US) knee system. This AP sizer allows to dial in external rotation by 1° increments and to determine the femoral size with an anterior boom. AP size was noted at 0°, 3° and 5° of external rotation and then compared for ML matching. RESULTS: Antero-posterior and corresponding ML sizes match perfectly for the Vanguard at 0° of external rotation and a central boom position on the anterior femoral surface. Then, the anterior boom was positioned on the antero-lateral cortex and the AP size increased a mean (SD) 1 (0.5) mm. With 3° of external rotation, the AP size increased a mean (SD) 2.3 (0.4) mm and for 5° a mean (SD) 3.8 (0.3) mm (P < 0.05). This increase in AP size resulted in ML overhang of 2.2 (1.2) mm for 3° and 4.8 (2.6) mm for 5° (P < 0.05). CONCLUSIONS: Antero-posterior size measurement of the distal femur is determined by the anatomy of the anterior surface with a higher antero-lateral cortex and the amount of external rotation that is dialled in during surgery. Since these parameters vary case per case, the availability of narrow components offers more surgical options to the surgeon and its importance extends beyond the gender aspect allowing different amounts of external rotation to be used without ML overhang

Impact of lighting renovation on energy consumption and visual comfort: a case study in social dwellings

The use of energy efficient lighting in dwellings in combination with the preservation, or the improvement of visual comfort is a huge challenge. This paper presents a lighting renovation project in eight social apartments, in Belgium. The lighting system was renovated at four levels of quality, in order to evaluate the light saving potential, the lighting comfort and the influence of the human behaviour on the lighting consumption. The methodology dealt with the criteria and targets of the lighting renovation, the way to record monitoring data and the concept of the extrapolation of consumption. This extrapolation presented a way to obtain more case studies without knowing the occupancy schedule of the occupants. Illuminance, power, luminance, UGR values reached for the different lighting solutions were determined. The measurements showed that if the occupant selected his lighting installation, the comfort is seldom reached. Replacing initial lamps (incandescent) by high efficient compact fl uorescent lamps induced high energy savings and comfort level was reached more often. The visual comfort (higher illuminance level) could even be improved by the use of efficient luminaires. Finally, the paper concludes that, the human behaviour has a large influence on the lighting installation and consumption. Moreover, occupants tended to install the worst lighting equipment (high power level, low visual comfort). However efficient luminaries are not widespread on the domestic lighting market. On the other hand, the extrapolation allowed concluding that for some behaviour profiles there were no economic gains from the use of economic lamps and efficientluminaires. With this study, we point to the importance of evaluating correctly the needs of the occupants in terms of visual comfort and to install adequate energy saving lamps and luminaires

The minimally invasive far medial subvastus approach for total knee arthroplasty in valgus knees

Purpose: The lateral approach in the valgus knee asks for a lot of soft tissue releases during the arthrotomy. The hypothesis of this study was that the far medial subvastus approach could be used in valgus knees and would guarantee both functional and radiological good to excellent results. Methods: This is a retrospective study on 78 patients (84 knees) undergoing primary total knee arthroplasty (TKA) for type I or II fixed valgus knees. The mean (SD) preoperative mechanical alignment was 187° (4°) HKA angle. Functional recovery, pain, tourniquet times, necessary soft tissue releases as well as radiological alignment were measured. Results: The Knee Score improved significantly from 45 (10) to 90 (10) (P &lt; 0.05) and the function score improved as well from 35 (20) to 85 (10) (P &lt; 0.05). Flexion improved from 110° (10°) to 137° (8°). Hospital stay was 4 (1.2) days. Alignment was corrected to 181° (1.5°) HKA angle with a postoperative joint line shift of +2.8 (3.2) mm. No clinical instability, as evaluated by the senior author, or osteolytic lines was observed at minimal one-year radiological follow-up. Conclusion: The far medial subvastus approach is an excellent approach to perform Krackow type I and II TKA with primary PS implants. Level of evidence: IV. © 2013 Springer-Verlag Berlin Heidelberg