Laurent Maubisson

Anterior Cruciate Ligament Reconstruction in Children With A Quadrupled Semitendinosus Graft: Preliminary Results With Minimum 2 Years of Follow-up

Background: The management of anterior cruciate ligament (ACL) tears in growing patients must balance activity modification with the risk of secondary (meniscal and cartilaginous) lesions, and surgical intervention, which could adversely affect skeletal growth. Many ACL reconstruction techniques have been developed or modified to decrease the risk of growth disturbance. We have not found any description of ACL reconstruction using a single hamstring, short graft implanted into intraepiphyseal, retroreamed sockets. Our hypothesis was that the technique that we used restored the knee stability and did not cause any growth disturbances. Methods: We retrospectively studied 28 patients (20 boys, 8 girls) who presented with a unilateral ACL tear and open growth plates. We performed short graft ligament reconstruction with the semitendinosus folded into 4 strands around 2 polyethylene terephthalate tapes. The graft was implanted into sockets that were retroreamed in the femoral and tibial epiphysis and the tapes were fixed remotely by interference screws. After a minimum period of 2 years, we evaluated the comparative knee laxity, the radiographic limb morphology, the appearance of secondary lesions, and the functional outcomes using the Lysholm and Tegner scores. Comparative analyses were performed using the Student t test with subgroups depending on the type of fixation used. Results: The mean age of the patients was 13 years (range, 9 to 15 y). The mean follow-up was 2.8 years (range, 2 to 5 y). The mean difference in laxity at 134 N was 0.3 mm, as determined using a GNRB arthrometer. No patients reported meniscal symptoms or degenerative changes. We found no angular deformity or leg length inequality. Two patients suffered a recurrent ACL tear. Conclusions: The preliminary results from this series are consistent with prior studies demonstrating that intraepiphyseal ACL reconstruction is a safe reliable alternative for the pediatric population. Study Design: Case series; level of evidence 4.

Traumax screw plate vs. Gamma nail. Blood loss in pertrochanteric fractures treated by minimally invasive osteosynthesis

Purpose This study is aimed to determine whether the Traumax dynamic hip screw reduces perioperative blood loss and transfusion rate compared to the Gamma nail in the treatment of pertrochanteric fractures. Materials and Methods A series of 331 patients were followed prospectively in a cohort study between February 2008 and October 2011 after a pertrochanteric fracture. Two types of fixation were used, 163 patients were treated with a Gamma nail and 168 patients with a minimally invasive screw plate Traumax. Perioperative blood loss, evaluated by the Mercuriali formula based on pre- and postoperative haemoglobin and transfusion rates were compared in order to assess risk factors. Results Increased perioperative blood loss was significantly linked with patient-related parameters (age, anticoagulant and platelet aggregation inhibitor treatment). Type of osteosynthesis and type of fracture were also risk factors for blood loss and transfusion. The Traumax group had significantly lower blood loss (347 ml vs. 577 ml) and transfusion rate (33.9% vs. 63.8%) than the Gamma group. Involvement of the greater trochanter increased the risk of blood loss only in the Gamma group. Functional results and bone healing were comparable at six months follow-up. Conclusion Screw plate Traumax significantly reduces perioperative bleeding after pertrochanteric fractures. It avoids fracture gaps that tend to maintain bleeding. Given the morbidity and complications related to acute anaemia and blood transfusion, the surgical management of these elderly patients is aided by this choice of fixation.

Radiological validation of a fluoroscopic guided technique for femoral implant positioning during hip resurfacing

PurposeThe positioning of the femoral cup in hip resurfacing is essential for the survival of the implant. We described a technique in 2005 to position the femoral cup guided by fluoroscopy independent of the approach performed. The main objectives were to study the positioning of the femoral components of the implant and the accuracy of the technique.MethodsBetween 2003 and 2011 we conducted a prospective study of 160 consecutive hip resurfacings all operated with this fluoroscopic-guided technique. Three independent observers performed a radiographic analysis at the pre-operative planning stage and on postoperative radiographs using OsiriX software. The statistical analysis was based on comparison of two groups by Student’s t test.ResultsThe entire implant was positioned in valgus, with an average of 7.816° valgus (p <0.001). All implants were positioned in neutral or anteverted with a mean of 1.98° (p <0.001). The risk of malpositioning on the antero-posterior plane was less than 1.41° with p <0.019. The risk of profile positioning error was lower than 0.80° with p <0.047.ConclusionThis study validates a technique of femoral implant positioning for resurfacing. It is simple, precise and independent of the approach performed.

Nostalgia and technology innovation driving retro music consumption

Purpose – Understanding a prima facie attraction of retro pop-rock by a broad spectrum of people and the role of technology innovation in driving the importance of this genre. A key idea of this paper is that ongoing popularity of retro pop-rock music is associated with a confluence of demand-side and supply-side factors. The demand side is thought to be characterized by a combination of psychological factors contributing to individuals’ desires to enjoy, reflect on, or even “live in” the past. On the supply-side, technology has roles in the production, distribution and consumption of music. Design/methodology/approach – The approach of this paper is to provide an extensive search and synthesis of relevant literature and to present and analyze findings from online surveys. Findings – The literature supports the idea that attraction to retro music is heavily influenced by psychological factors as well as technology innovation. The survey provides supporting evidence. Of particular interest are findings rel...

Bien-être et implication : quel apport à la compréhension du don de sang

Blood donation is often associated with well-being in advertising campaigns and in the beliefs linked to this practice. The aim of this study is to investigate the relationship between well-being, involvement in the cause and donating blood (behaviour and intentions of blood donors and potential donors). Based on the literature and an empirical study (N=407), the results show that involvement has an effect on blood donation intentions, on word-of-mouth intentions and blood donation behaviours. The results however call into question the direct link set out by the EFS (French Blood Agency) between well-being and donation behaviour (donation frequency) and suggest modifying current advertising campaigns to increase blood donation behaviour. Keywords: well-being, blood donation, involvement in, intention of donating, word-of-mouth.

Reproducibility of radiographic assessment of femoral implant position after hip resurfacing arthroplasty: a pilot study

To determine whether femoral implant position can be reproducibly measured on plain digital radiographs, we prospectively studied 40 patients after hip resurfacing arthroplasty. Three observers performed double blinded randomized analysis of calibrated digital radiographs meeting strict quality criteria. The implant stem–shaft angle and femoral anteversion angle were measured by the trapezoid method of axis determination using OsiriX software. The upper and lower offset and the anterior and posterior offset were measured. The statistical analysis was performed using Pearson correlation tests (intra-observer reproducibility) and Fisher F tests (inter-observer reproducibility). Intra-observer reproducibility was very good for all parameters and all observers. Inter-observer reproducibility was excellent except for superior offset measurement. Thus, this study validates a radiographic method for assessing the femoral implant position in hip resurfacing. We believe this could be useful for future studies on hip resurfacing devices.