Nicolas Jacquot
University of Nice Sophia Antipolis
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Revue De Chirurgie Orthopedique Et Reparatrice De L Appareil Moteur | 2007
Jean-Christian Balestro; Christophe Trojani; Nicolas Jacquot; S. Gonfrier; Pascal Boileau
Introduction La resection intra-articulaire du long biceps est une option therapeutique efficace dans les ruptures irreparables de la coiffe des rotateurs. Les deformations du biceps, l’apparition de crampes, et la perte de force sont les sequelles possibles de cette intervention. Les objectifs de cette etude etaient d’evaluer les sequelles esthetiques et fonctionnelles de la tenotomie et de les comparer a celle de la tenodese du long biceps par vis d’interference. Materiel et methodes Nous avons realise une etude retrospective sur 158 patients presentant une rupture irreparable de la coiffe des rotateurs. Soixante et onze patients ont beneficie d’une tenotomie du long biceps et 87 d’une tenodese du long biceps par vis d’interference. Le recul moyen etait de 44 mois pour les tenodeses et 86 mois pour les tenotomies. Un examinateur independant a recherche une deformation bicipitale (signe de popeye) et la presence de crampes du biceps pour tous les patients, alors que l’etude de la force a ete realisee sur 53 tenotomies contre 52 tenodeses. La force en flexion du coude etait mesuree de facon bilaterale avec un dynamometre standard, et la force en supination avec un dynamometre de poignet. La perte de force a ete calculee par rapport au cote controlateral et par rapport a la force theorique du cote dominant. Resultats La retraction de la longue portion du biceps (signe de popeye) etait evidente objectivement chez 28 % des tenotomies contre 10 % dans la serie de tenodese (p Conclusion La tenodese du long biceps diminue nettement l’incidence du signe de popeye et des crampes par rapport a une tenotomie. Elle permet aussi une meilleure conservation de la force en flexion du coude et en supination.
Revue De Chirurgie Orthopedique Et Reparatrice De L Appareil Moteur | 2007
Nicolas Jacquot; Pascal Boileau
Introduction La pathologie du tendon de long biceps (TLB) est une cause de douleurs dans les ruptures de la coiffe des rotateurs (RCR). Objectifs 1) Etablir une base de donnees epidemiologiques des lesions du TLB dans les RCR. 2) Etudier le comportement dynamique du TLB dans les RCR. 3) Correler les donnees de l’imagerie injectee aux constations arthroscopiques. Materiel et Methodes Etude prospective, continue, multicentrique (avril 2005 a juin 2006). Criteres d’inclusion : 1) RCR partielle ou transfixiante a l’arthroscopie, 2) Description arthroscopique du TLB, 3) Imagerie avec injection (arthro-scanner ou arthro-IRM) 4) Recueil des donnees sur le site internet de la SFA. Les autres motifs d’arthroscopie, les antecedents chirurgicaux et les IRM etaient exclus. L’examen dynamique consistait a rechercher une incapacite du TLB a coulisser dans sa gouttiere lors de l’abduction passive du bras entrainant une plicature intra-articulaire (test du sablier) et une instabilite du TLB dans sa gouttiere lors des rotations externe (instabilite mediale) ou interne (instabilite laterale) bras a 90° d’abduction (test en RE2 et RI2). L’extension de la RCR dans le plan frontal et sagittal etaient determine en accord avec la classification SFA. Resultats 378 patients (378 epaules) inclus (211 femmes, 167 hommes), âge moyen 57,9 ans (28-83). On disposait de 312 arthro-scanners et 66 arthro-IRM retrouvant 61 RCR partielles profondes et 317 RCR transfixiantes. Parmi les RCR transfixiantes 15 concernees le sub-scapularis (SSc) seul, une l’infra-spinatus (ISp) seul et 301 au moins le supra-spinatus (SSp) (avec 52 extensions posterieures a ISp, 90 anterieures au SSc et 31 mixtes). Donnees epidemiologiques (etude statique) : TLB intact 21 %, tenosynovites 51 %, hypertrophies 21 %, delaminations 12 %, pre-ruptures 7 %, sub-luxations 18 %, luxations 9 %, ruptures 2 %. Pas d’influence de l’âge, du sexe ou du cote opere. A l’inverse, la frequence des lesions augmentait significativement avec l’extension de la RCR dans le plan frontal et sagittal. Etude dynamique : test du sablier positif 29 %, instabilites en RE2 26 %, instabilite en RI2 8 %. Le test du sablier etait correle a une hypertrophie intra-articulaire du TLB (76 % versus 2 %). Une rupture du SSc entrainait une instabilite mediale dans 82 % des cas. Parmi les 81 TLB intacts en statique, 17 % presentaient une anomalie dynamique. Au total, examens statique et dynamique ne laissaient que 18 % de TLB intact. Correlation imagerie/arthroscopie dynamique : 25 % des lesions du TLB ne sont pas diagnostiquees par l’imagerie injectee. A l’inverse bonne correlation pour determiner la position du TLB dans sa gouttiere.
Journal of Shoulder and Elbow Surgery | 2007
Pascal Boileau; Julian Richou; Jean Francois Gonzalez; Ryan T. Bicknell; Lionel Neyton; Nicolas Jacquot; Christopher Chuinard
The purpose of this study is to report the results of arthroscopic Bankart repair following failed open treatment of anterior instability. We performed a retrospective review of twenty-two patients with recurrent anterior shoulder instability (i.e. subluxations or dislocations, with or without pain) after open surgical stabilization. There were seventeen men and five women with an average age of thirty-one years (range, 15–65). The most recent interventions consisted of sixteen osseous transfers (twelve Latarjet and four Eden-Hybinette), three open Bankart repairs and three capsular shifts. The causes of failure were additional trauma in twelve patients and complications related to the bone-block in thirteen (poor position, fracture, pseudarthrosis or lysis). All patients were noted to have distension of the anterior-inferior capsular structures. Labral re-attachment and capsulo-ligamentous re-tensioning with suture anchors was performed in all cases with an additional rotator interval closure in four patients and an inferior capsular plication in twelve patients; the bone block screws were removed in eight patients. At an average follow-up of forty-three months (range, twenty-four to seventy-two months), nineteen patients were evaluated by two independent observers. One patient had recurrent subluxation, and two patients had persistent apprehension. Anterior elevation was unchanged, and loss of external rotation (RE1) was 6°. Nine patients returned to sport at the same level; all patients returned to their previous occupations, including the six cases of work-related injury. Eighty-nine percent were satisfied or very satisfied; the subjective shoulder value (SSV) was 83% ± 23%; the Walch-Duplay, Rowe and UCLA scores were 85 ± 21, 81 ± 23 and 30 ± 7 points respectively. The number of previous interventions did not influence the results. Eight patients (42%) were still painful (six with light pain and two with moderate pain). Arthroscopic revision of open anterior shoulder stabilization gives satisfactory results. The shoulders are both stable and functional. While the stability obtained with this approach is encouraging, our enthusiasm is tempered by some cases of persistent pain.
Arthroscopy | 2007
Ryan T. Bicknell; Julian Richou; Jean-François Gonzalez; Lionel Neyton; Nicolas Jacquot; Christopher Chuinard; Pascal Boileau
The purpose of this study is to report the results of arthroscopic Bankart repair following failed open treatment of anterior instability. We performed a retrospective review of twenty-two patients with recurrent anterior shoulder instability (i.e. subluxations or dislocations, with or without pain) after open surgical stabilization. There were seventeen men and five women with an average age of thirty-one years (range, 15–65). The most recent interventions consisted of sixteen osseous transfers (twelve Latarjet and four Eden-Hybinette), three open Bankart repairs and three capsular shifts. The causes of failure were additional trauma in twelve patients and complications related to the bone-block in thirteen (poor position, fracture, pseudarthrosis or lysis). All patients were noted to have distension of the anterior-inferior capsular structures. Labral re-attachment and capsulo-ligamentous re-tensioning with suture anchors was performed in all cases with an additional rotator interval closure in four patients and an inferior capsular plication in twelve patients; the bone block screws were removed in eight patients. At an average follow-up of forty-three months (range, twenty-four to seventy-two months), nineteen patients were evaluated by two independent observers. One patient had recurrent subluxation, and two patients had persistent apprehension. Anterior elevation was unchanged, and loss of external rotation (RE1) was 6°. Nine patients returned to sport at the same level; all patients returned to their previous occupations, including the six cases of work-related injury. Eighty-nine percent were satisfied or very satisfied; the subjective shoulder value (SSV) was 83% ± 23%; the Walch-Duplay, Rowe and UCLA scores were 85 ± 21, 81 ± 23 and 30 ± 7 points respectively. The number of previous interventions did not influence the results. Eight patients (42%) were still painful (six with light pain and two with moderate pain). Arthroscopic revision of open anterior shoulder stabilization gives satisfactory results. The shoulders are both stable and functional. While the stability obtained with this approach is encouraging, our enthusiasm is tempered by some cases of persistent pain.
Revue De Chirurgie Orthopedique Et Reparatrice De L Appareil Moteur | 2004
Nicolas Jacquot; Jean-François Kempf; Luc Favard; Jean-Charles Le Huec; Daniel Molé; Gilles Walch; Pascal Boileau
Arthroscopy | 2007
Ryan T. Bicknell; Sebastian Parratte; Christopher Chuinard; Nicolas Jacquot; Christophe Trojani; Pascal Boileau
/data/revues/00351040/0090Sup6/2S145/ | 2008
Nicolas Jacquot; Jean-François Kempf; Luc Favard; Jean-Charles Le Huec; Daniel Molé; Gilles Walch; Pascal Boileau
Orthopaedic Proceedings | 2009
Ryan T. Bicknell; Pascal Boileau; Christopher Chuinard; Nicolas Jacquot; Sébastien Parratte; Christophe Trojani
Orthopaedic Proceedings | 2009
Ryan T. Bicknell; Pascal Boileau; Christopher Chuinard; Nicolas Jacquot; Lionel Neyton; Julian Richou
Orthopaedic Proceedings | 2008
Lionel Neyton; Sébastien Parratte; Cédric Pelegri; Nicolas Jacquot; Pascal Boileau