8 research outputs found
Histologic study of periprosthetic osteolytic lesions after AES total ankle replacement. A 22 case series
No full textIntroduction: Medium-term results for total ankle replacement (TAR) are in general satisfactory, but there is a high redo rate for periprosthetic osteolysis associated with the AES implant. Hypothesis: Comparing radioclinical findings and histologic analysis of implant revision procedure specimens can account for the elevated rate of osteolysis associated with the AES TAR implant. Material and method: In a prospective series of 84 AES TAR implants (2003—2008), 25 underwent revision for osteolysis (including three undergoing revision twice) at a mean 59.8 months. Eight patients had hydroxyapatite (HA) coated models and the others had titanium-hydroxyapatite (Ti-HA) coatings. Radiographs were systematically analyzed on Besse’s protocol and evolution was monitored on AOFAS scores. The 94 specimens taken for histologic analysis during revision were re-examined, focusing specifically on foreign bodies
Peut-on prévoir le niveau de contrainte d'une PTG lors d'une révision ? Comment gérer en peropératoire un changement de contrainte non prévu ?
No full textInternational audienc
Condylar constrained knee prosthesis and rotating hinge prosthesis for revision total knee arthroplasty for mechanical failure have not the same indications and same results
No full textPurpose: This study aimed to evaluate whether there are any differences in outcomes and complication rates between condylar constrained knee (CCK) and rotating hinge knee (RHK) prostheses used for the first revision of total knee arthroplasty (rTKA) after mechanical failure. Methods: Sixty-three consecutive non-septic revisions of posterior stabilized implants using 33 CCK and 30 RHK prostheses were included. Clinical evaluation and revision rate were compared between the two groups at two years minimum follow-up. Results: The CCK group had significantly better clinical outcomes and satisfaction rates compared to patients with RHK (KSS-knee 70.5 versus 60.7 (p < 0.003) and KSS-function 74.9 versus 47.7 (p < 0.004) at 3.7 (2.0–9.4) years mean follow-up. Moreover, the clinical improvement was significantly higher for the CCK group concerning the KSS-Knee (+23.9 vs. +15.2 points, p = 0.03). The postoperative flexion was significantly better in the CCK group compared to the RHK group (115° vs. 103°, p = 0.01). The prosthesis-related complications and the re-revision rate were higher in the RHK group, especially due to patellofemoral complications and mechanical failures. Conclusions: CCK prostheses provided better clinical and functional outcomes and fewer complications than RHK prostheses when used for the first non-septic rTKA. CCK is a safe and effective implant for selected patients, while RHK should be used with caution as a salvage device for complex knee conditions, with particular attention to the balance of the extensor mechanism
The Lauren classification highlights the role of epithelial-to-mesenchymal transition in gastric carcinogenesis: an immunohistochemistry study of the STAT3 and adhesion molecules expression
No full textInternational audienceDespite some recent advances, gastric cancer remains an important cause of death at world level. This indicates an absence of therapeutic options, stemming from the limited understanding of the molecular mechanisms involved in carcinogenesis. Nearly fifty years ago Lauren classified gastric cancers, according to the morphological aspect, as intestinal or diffuse. The phenotype of the cells indicates the presence of different molecular mechanisms, which can be approached in the light of recent data and identified with the help of current techniques. The best described are the germline/somatic mutations or the hypermethylations of the E-cadherin 1 CDH1 gene promotor
[A 1993-1995 epidemiological survey of home parenteral nutrition in approved centers for adults in France]
No full textInternational audienceOBJECTIVES: A 1993-1995 three year epidemiological survey of home parenteral nutrition was performed through in France in approved centers for adults. METHODS: Data were retrospectively collected each year on a standardized questionnaire focussing on indications and short term outcome. RESULTS: All centers (n = 14) participated in the study and 524 new adult patients were recruited. The overall incidence was unchanged at 3.75 patients/10(6) adults. Indications for AIDS rose (8 to 18%) whereas other indications were stable. Prevalence increased by 19%: 4.40 adults/10(6) patients at 01.01.1996. At six months, the probability to stay on treatment was 19.5% for AIDS and cancer indications but 52% for others, whereas death rates were 59% and 9% respectively. CONCLUSIONS: For both cancer and AIDS indications, short-term treatment was due to a poor prognosis. For other diagnosis, complicated with a short bowel in 51% of cases, prognosis was excellent but associated with treatment dependency. The latter point focuses on the need for additional treatments in irreversible intestinal failure
