New measurement technique for restoration of the trochlear offset after image-based robotic-assisted total knee arthroplasty: a reliability study

Introduction: The new concepts in total knee arthroplasty (TKA) tend to improve the alignment and ligament balancing after TKA. Nevertheless, the assessment of the anterior compartment is difficult. The purpose of this study was to describe a new measurement technique of trochlear offset restoration on CT-scan after primary robotic-assisted TKA and assess its reliability and repeatability. Method: This monocentric study assessed the trochlear offset restoration on a CT scan after 20 robotic-assisted TKA. To evaluate the trochlear offset restoration, we measured the depth difference between the native and the prosthetic trochlea. Four sequential positions were assessed on the trochlea: at full extension, at 30°, 70°, and 90° flexion. For each of these positions, we compared the highest point of the lateral native condyle and the lateral prosthetic condyle, the highest point of the medial native condyle and the medial prosthetic condyle, the deepest point of the native trochlear groove and the prosthetic trochlea. Two independent reviewers performed the measurements to assess their reliability. To determine intraobserver variability, the first observer performed the measurements twice. Results: The mean age was 67.3 years old ± 8.3. Mean values of the trochlear offset restoration for the medial condyle, trochlear groove and lateral condyle were respectively: 1.0 mm ± 1.6, 1.1 mm ± 1.5, −2.7 mm ± 2.3 in full extension; −3.5 mm ± 1.7, −1.5 mm ± 1.7, −3.9 mm ± 3.9 at 30° flexion; −5.1 mm ± 1.8, 2.1 mm ± 2.7, −3.8 mm ± 1.8 at 70° flexion; 2.0 mm ± 1.4 and 3.1 mm ± 1.5 for the medial and lateral condyles at 90° flexion. The radiographic measurements showed very good to excellent intra-observer and inter-observer agreements with mean kappa values of 0.92 and 0.74. Conclusion: We present a novel measurement technique on CT scan for evaluating the restoration of the trochlear offset after TKA, demonstrating excellent inter and intra-observer reliability

Reactivation of Clostridium tertium bone infection 30 years after the Iran-Iraq war

Clostridium tertium could be responsible forlate metal fragment bone and joint infection.LateC. tertium metal fragment bone and joint infections requires a multidisciplinary management. Late C. tertium metal fragment bone and joint infections requires metal extraction and prolonged antimicrobial therapy for healin

Management of fixed flexion contracture in primary total knee arthroplasty: recent systematic review

Introduction: This study aimed to systematically review the literature and identify the surgical management strategy for fixed flexion contracture in primary total knee arthroplasty (TKA) surgery, pre-, intra-, and post-operatively. Secondary endpoints were etiologies and factors favoring flexion contracture. Materials and methods: Searches were carried out in November 2023 in several databases (Pubmed, Scopus, Cochrane, and Google Scholar) using the following keywords: “flexion contracture AND TKA”, “fixed flexion deformity AND TKA”, “posterior capsular release AND TKA”, “posterior capsulotomy in TKA”, “distal femoral resection AND TKA”. Study quality was assessed using the STROBE checklist and the Downs and Black score. Data concerning factors or strategies leading to the development or prevention of flexion contracture after TKA were extracted from the text, figures, and tables of the included references. The effect of each predictive factor on flexion contracture after TKA was recorded. Results: Thirty-one studies were identified to meet the inclusion and exclusion criteria. These studies described a variety of preoperative and intraoperative factors that contribute to the development or correction of postoperative flexion contracture. The only clearly identified predictor of postoperative flexion contracture was preoperative flexion contracture. Intraoperative steps described to correct flexion contracture were: soft-tissue balancing (in posterior and medial compartments), distal femoral resection, flexion of the femoral component, and posterior condylar resection. However, no study has investigated these factors in a global model. Discussion: This review identified various pre-, intra-, and post-operative factors predictive of post-operative flexion contracture. In practice, these factors are likely to interact, and it is therefore crucial to further investigate them in a comprehensive model to develop an algorithm for the management of flexion contracture. Level of evidence: I

LA LUXATION DE ROTULE (ETUDE RETROSPECTIVE DE 190 CAS OPERES ET ANALYSE DE LA DYSPLASIE FEMORO-PATELLAIRE)

LYON1-BU Santé (693882101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Reconstruction du ligament fémoro-patellaire médial dans les luxations épisodiques de la rotule (étude anatomique in vitro, résultats cliniques, analyse du positionnement des tunnels osseux : Travail du Service de Chirurgie Orthopédique et Traumatologique : Centre Albert Trillat : Groupement Hospitalier Nord : Professeur Philippe Neyret)

LYON1-BU Santé (693882101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

La dysplasie coxo-fémorale (analyse des résultats du dépistage officiel (de 1993 à 2011) chez le Setter Gordon et le Setter Irlandais)

LYON1-BU Santé (693882101) / SudocTOULOUSE-EN Vétérinaire (315552301) / SudocSudocFranceF

Epidémiologie des lésions du membre inférieur du joueur de rugby professionnel

LYON1-BU Santé (693882101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Etude prospective randomisée de 130 prothèses totales de genou HLS Noetos avec composant fémoral cimenté versus sans ciment (résultats à 1 an)

LYON1-BU Santé (693882101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Acute Muscle Injuries

XVIII, 138 p. 48 illus., 31 illus. in color.onlin