Xavier Crevoisier

Publications (11)4.64 Total impact

• Article: Step activity monitoring to assess ambulation before and after total ankle arthroplasty.

  Mathieu Assal, Amin Che Ahmad, Alain Lacraz, Delphine S Courvoisier, Richard Stern, Xavier Crevoisier
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  ABSTRACT: The study objective was to compare walking activity before and after total ankle arthroplasty (TAA). Nineteen patients who underwent TAA were prospectively reviewed with a dedicated ambulatory activity-monitoring device. Patients were tested 1 month prior to surgery, and at least 18 months post-operative. Ambulatory parameters included number of steps at different cadences and time spent walking at different paces. The American Orthopaedic Foot and Ankle (AOFAS) hindfoot scale was assessed at similar intervals. Following TAA, there was significant improvement in the number of steps walked at normal cadence, while importantly the number of steps walked at low and medium cadence decreased. There was no significant difference between the time actually spent walking at any cadence after arthroplasty. The mean AOFAS hindfoot scale significantly improved. Following TAA, patients show an improved walking pace and AOFAS hindfoot scale, but no difference in the amount of time spent walking.
  Foot and Ankle Surgery 09/2011; 17(3):136-9.
• Article: The isolated talonavicular arthrodesis.

  Xavier Crevoisier
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  ABSTRACT: Based on a high percentage of good results, retrospective studies strongly suggest that isolated talonavicular arthrodesis provides efficient pain relief and functional improvement in case of talonavicular arthritis in rheumatoid arthritis, primary or posttraumatic arthritis, flexible acquired flatfoot deformity, residual dorsolateral subluxation of the talonavicular joint after surgical treatment of clubfoot, and some neurologic disorders. However, prospective trials with rigorous methodology are required to establish evidence of efficacy for this procedure. Well-designed biomechanical studies have demonstrated the key role of the talonavicular joint in the complex hindfoot motion and may serve as baseline for further prospective studies.
  Foot and ankle clinics 03/2011; 16(1):49-59.
• Article: [What's new in forefoot surgery].

  Adrien Ray, Xavier Crevoisier, Mathieu Assal
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  ABSTRACT: New implants and instruments have recently emerged in foot surgery. However, an additional and important development is the technique of minimally invasive surgery. As a result of new surgical approaches some common foot deformities can be corrected in a percutaneous manner. The benefits include improved wound healing, less pain, faster recovery, and less need for outpatient care. The main indications for such a technique are hallux valgus, correction of the lesser metatarsals, hallux rigidus, and some diabetic foot deformities.
  Revue médicale suisse 12/2010; 6(276):2459-62.
• Article: [Acute ankle sprain: which immobilization?].

  Mathieu Assal, Xavier Crevoisier
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  ABSTRACT: Acute ankle sprain is the most frequent orthopaedic injury. Up to 4% of patients admitted to the emergency room will present with an acute ankle sprain. The lateral ligaments are involved at various degrees (anterior talo-fibular and calcaneo-fibular ligaments). Grade I acute ankle sprains are well treated with a compression bandage or an Aircast brace. Grade II and III acute ankle sprains are best treated with a below-knee cast. The Aircast brace is the next best treatment for such lesions (grades II and III) and will provide satisfactory support, but has been shown to be not as effective as the below-knee cast in terms of short to mid-term patients outcome (pain and function).
  Revue médicale suisse 09/2009; 5(212):1551-4.
• Article: A new conservative-dynamic treatment for the acute ruptured Achilles tendon.

  Felix Neumayer, Elyazid Mouhsine, Yvan Arlettaz, Gérald Gremion, Michael Wettstein, Xavier Crevoisier
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  ABSTRACT: There is a trend towards surgical treatment of acute ruptured Achilles tendon. While classical open surgical procedures have been shown to restore good functional capacity, they are potentially associated with significant complications like wound infection and paresthesia. Modern mini-invasive surgical techniques significantly reduce these complications and are also associated with good functional results so that they can be considered as the surgical treatment of choice. Nevertheless, there is still a need for conservative alternative and recent studies report good results with conservative treatment in rigid casts or braces. We report the use of a dynamic ankle brace in the conservative treatment of Achilles tendon rupture in a prospective non-randomised study of 57 consecutive patients. Patients were evaluated at an average follow-up time of 5 years using the modified Leppilahti Ankle Score, and the first 30 patients additionally underwent a clinical examination and muscular testing with a Cybex isokinetic dynamometer at 6 and 12 months. We found good and excellent results in most cases. We observed five complete re-ruptures, almost exclusively in case of poor patient's compliance, two partial re-ruptures and one deep venous thrombosis complicated by pulmonary embolism. Although prospective comparison with other modern treatment options is still required, the functional outcome after early ankle mobilisation in a dynamic cast is good enough to ethically propose this method as an alternative to surgical treatment.
  Archives of Orthopaedic and Trauma Surgery 05/2009; 130(3):363-8. · 1.37 Impact Factor
• Article: [Surgery of the rheumatoid foot and ankle].

  Xavier Crevoisier, Matthieu Assal
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  ABSTRACT: Surgery of the rheumatoid foot and ankle Initial presentation of rheumatoid arthritis (RA) will be foot and ankle symptoms in 20% of cases. Eventually, 50-90% of patients will develop foot and ankle alterations. Typical deformities of the forefoot include hallux valgus and dorso-lateral dislocation of the lesser metatarso-phalangeal joints. RA involvement of the hindfoot frequently leads to plano-valgus deformity. Approximately 20% of surgery performed for RA is done at the foot and ankle. Early surgery is efficient against pain and deformity. Patient's satisfaction rate after surgery is high despite a slight higher complication rate compared to conventional foot and ankle surgery.
  Revue médicale suisse 01/2009; 4(184):2732-6.
• Article: [Fractures of the calcaneus: the injury and its sequelae].

  Mathieu Assal, Xavier Crevoisier
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  ABSTRACT: The calcaneus gives shape to the heel. Its special position places it in direct contact with the floor, upon which rests the weight of the body. It assures the transition between the vertical skeleton and horizontal surface of the foot, thus permitting ambulation. The calcaneus is subjected to high physical stress, yet at the same time its complex articulating surfaces permit fine adaptation to the ground. Fractures of the calcaneus result from a high energy injury, usually a fall from a height. The treatment of such fractures poses difficult problems. The functional sequelae of the injury may be severe, prolonged, and frequently results in a permanent disability. This is due not only to the type of fracture, but the orthopaedic management as well. Careful evaluation of the patient, fracture pattern, soft tissue condition, and treatment modalities is obligatory to achieve the optimal result.
  Revue médicale suisse 11/2008; 4(173):2108-13.
• Article: [Acquired adult flatfoot deformity: a pragmatic approach].

  Xavier Crevoisier, Mathieu Assal
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  ABSTRACT: Acquired adult flatfoot deformity is a commonly encountered entity in orthopaedic practice. It results mainly from posterior tibial tendon (PTT) dysfunction, is more common in women and frequently associated with obesity. The four severity stages are based on dysfunction of the PTT, on the reducibility of the deformity, and on the condition of the hindfoot joints. Conservative treatment is functionally efficient in the early stages and may also contribute to analgesia in advanced stages. The goal of surgery is to restore a functional mobility in the early stages and to achieve rigid stabilization of the hindfoot in the late stages. The treatment's choice and the control of the predisposing factors for acquired flatfoot depends upon a close collaboration between the family physician and the orthopaedic surgeon.
  Revue médicale suisse 01/2008; 3(138):2892-4, 2896-8.
• Article: Peroneal tendon dislocation. A tendon protective and bone preserving technique of stabilization.

  Alain Akiki, Yvan Arlettaz, Xavier Crevoisier
  Saudi medical journal 11/2007; 28(10):1607-9. · 0.52 Impact Factor
• Article: Acute total hip arthroplasty for acetabular fractures in the elderly: 11 patients followed for 2 years.

  Elyazid Mouhsine, Raffaele Garofalo, Olivier Borens, Jean-François Fischer, Xavier Crevoisier, Stéphane Pelet, Claude Henri Blanc, Pierre François Leyvraz
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  ABSTRACT: We describe the use of cable fixation and acute total hip replacement for acetabular fracture in the elderly. 12 patients with acetabular fractures, having a mean age of 79 (65-93) years, were treated with cable fixation and acute total hip arthroplasty. 8 were T-shaped fractures and 4 associated fractures of the posterior column and posterior wall. 1 patient died 5 months after surgery and the remaining 11 were followed for 2 years. All patients had a good clinical outcome. Radiographic assessment showed healing of the fracture and a satisfactory alignment of the cup without loosening. This surgical technique provides good primary fixation, stabilizes complex acetabular fractures in elderly patients with osteoporotic bone and permits early postoperative mobilization.
  Acta Orthopaedica Scandinavica 01/2003; 73(6):615-8.
• Article: Grade I and II acromioclavicular dislocations: results of conservative treatment.

  Elyazid Mouhsine, Raffaele Garofalo, Xavier Crevoisier, Alain Farron
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  ABSTRACT: The purpose of this study was to assess the results of acute grade I and II acromioclavicular (AC) joint sprains treated by conservative measures. Between 1993 and 1997, 37 consecutive patients were treated conservatively for AC joint sprains, grade I and II in the Tossy classification. Of these patients, 4 were excluded (three lost to follow-up and one sustained a further AC injury), leaving a series of 33 patients. Among them, in 9 (27%), chronic AC joint pathology that required subsequent surgery developed at a mean of 26 months after injury. The remaining 24 were reviewed clinically and radiologically at a mean of 6.3 years (range, 4-8 years) after injury. At the latest follow-up, 17 of the 33 patients (52%) remained asymptomatic. Of the 24 patients reviewed, 7 complained of activity-related pain. Eight patients presented with residual anteroposterior instability. Tenderness at the AC joint as well as a positive cross-body test was observed in 12 patients. The mean Constant score at follow-up was 82 points. The x-ray films showed degenerative changes in 13 patients, ossification of the coracoclavicular ligaments in 2, an association of degenerative changes with ossification of the coracoclavicular ligaments in 3, and distal clavicular osteolysis in 3. Only 4 cases had no radiographic changes after this kind of AC injury. On the basis of these results, we conclude that the severity of the consequences after grade I and II AC sprains is underestimated.
  Journal of Shoulder and Elbow Surgery 12(6):599-602. · 2.75 Impact Factor