M Kerboull

Université René Descartes - Paris 5, Lutetia Parisorum, Île-de-France, France

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Publications (65)89.68 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: PURPOSE: Zirconia was introduced in the 1980s for total hip arthroplasty (THA) with the expectation of lower polyethylene wear. The purpose of this prospective study was to evaluate the results of a continuous series of total hip arthroplasties combining a zirconia head with polyethylene socket at a minimum eight-year follow-up. METHODS: We performed an open prospective clinical trial in 1997. Our study involved 51 consecutive patients (55 hips) with a mean age of 52.5 ± 12 years (range, 25-76 years). All patients had a Charnley-Kerboull all-cemented hip replacement. A 22-mm stabilised yttrium tetragonal polycrystalline zirconia head (Y-TZP) was used in association with moderately cross-linked and annealed polyethylene. Clinical and radiological outcomes were assessed yearly. A survival analysis was performed using revision for any reason as the end-point. RESULTS: At a minimum eight-year follow-up, 12 patients (13 hips) were lost to follow-up (mean 26.8 months), two patients (two hips) had died, and six patients (six hips) were revised. The remaining 31 patients (34 hips) were alive and had not been revised on either the femoral or acetabular side at a mean follow-up of 117.1 months (range, 96-150 months). Mean functional score at last follow-up was 17.7. Mean linear head penetration was 0.23 mm/year. More than 90 % of the remaining hips had signs of periprosthetic osteolysis. Five stems were loosened. The survival at eight years was 87.3 % (95 % IC: 76.7-97.8). CONCLUSION: This study confirms earlier short-terms results, and demonstrates that zirconia should no longer be used in THA.
    International Orthopaedics 01/2013; 37(3). DOI:10.1007/s00264-013-1792-x · 2.02 Impact Factor
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    ABSTRACT: We have evaluated the in vivo migration patterns of 164 primary consecutive Charnley-Kerboull total hip replacements which were undertaken in 155 patients. The femoral preparation included removal of diaphyseal cancellous bone to obtain primary rotational stability of the stem before line-to-line cementing. We used the Ein Bild Roentgen Analyse femoral component method to assess the subsidence of the femoral component. At a mean of 17.3 years (15.1 to 18.3) 73 patients were still alive and had not been revised, eight had been revised, 66 had died and eight had been lost to follow-up. The mean subsidence of the entire series was 0.63 mm (0.0 to 1.94). When using a 1.5 mm threshold, only four stems were considered to have subsided. Our study showed that, in most cases, a highly polished double-tapered stem cemented line-to-line does not subside at least up to 18 years after implantation.
    The Bone & Joint Journal 03/2010; 92(3):342-8. DOI:10.1302/0301-620X.92B3.23151 · 2.80 Impact Factor
  • L Kerboull, M Hamadouche, M Kerboull
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    ABSTRACT: We describe 129 consecutive revision total hip replacements using a Charnley-Kerboull femoral component of standard length with impaction allografting. The mean follow-up was 8.2 years (2 to 16). Additionally, extramedullary reinforcement was performed using struts of cortical allograft in 49 hips and cerclage wires in 30. There was one intra-operative fracture of the femur but none later. Two femoral components subsided by 5 mm and 8 mm respectively, and were considered to be radiological failures. No further revision of a femoral component was required. The rate of survival of the femoral component at nine years, using radiological failure as the endpoint, was 98%. Our study showed that impaction grafting in association with a Charnley-Kerboull femoral component has a low rate of subsidence. Reconstruction of deficiencies of distal bone with struts of cortical allograft appeared to be an efficient way of preventing postoperative femoral fracture for up to 16 years.
    The Bone & Joint Journal 04/2009; 91(3):304-9. DOI:10.1302/0301-620X.91B3.21489 · 2.80 Impact Factor
  • M. Kerboull
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    ABSTRACT: La artroplastia total de cadera es una intervención de reemplazo articular mediante prótesis cuya eficacia depende de la calidad de la reconstrucción estructural y mecánica de la cadera artificial, así como de la integridad y del equilibro de la musculatura periarticular. Para alcanzar este doble objetivo, son indispensables dos elementos: un acceso a la cadera que respete lo mejor posible la musculatura y que sea capaz de restablecer su equilibrio y una prótesis adecuada.
    01/2009; 1(1):1–11. DOI:10.1016/S2211-033X(09)71650-0
  • M. Kerboull
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    ABSTRACT: La existencia de una anquilosis de cadera modifica seriamente las condiciones anatómicas habituales a la hora de realizar una artroplastia total. Estas modificaciones son de varios tipos. Se deben a la naturaleza de la enfermedad causal, a la existencia de la anquilosis, a su situación, a su postura viciosa o no, a la forma en la que se originó, así como a su repercusión sobre los músculos periarticulares, la estática general y las articulaciones vecinas, en especial en la columna lumbar y en la rodilla subyacente.
    01/2009; 1(1):1–9. DOI:10.1016/S2211-033X(09)71652-4
  • L. Kerboull, M. Hamadouche, M. Kerboull
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    ABSTRACT: We report here the study of a personal series of 129 consecutive femoral impaction grafting during hip revision replacement performed between January 1991 and December 2005. The indication for the revision of the femoral component was aseptic loosening in 127 hips and septic loosening in two. The precise locations of the segmental defects and osteolytic areas were determined and classified, with use of the Endo-Klinik System, as follows: grade 2 in 75 hips, grade 3 in 43, and grade 4 in 11. Removal of the components, debris and cement was done with special care to achieve a complete resection of fibrous tissue in the medullary canal to ensure a direct contact between the graft and the host bone. Before impaction grafting, femoral segmental bone defects or windows were reconstructed and reinforced with strut allograft and cerclage wires. We used in all hips a special revision set of instruments specially designed for impaction grafting. All the acetabular cups were also revised. Clinical and radiologic evaluation was performed at six weeks, three months, six months and one year. Then, patients were reviewed every year for the first five postoperative years and every two years thereafter. A survivorship analysis was performed to determine the overall success of the procedure. Failure was defined as an implant that had been revised or that was radiologically loosened at the time of follow-up. The survival curve was derived from the cumulative survival rate over time, as calculated from the actuarial life table. At the last follow-up evaluation, seven patients (seven hips) had died and two (two hips) were lost to follow-up. The follow-up of these nine patients ranged from two to ten years. One hundred and twenty patients (120 hips) were reviewed with a mean follow-up of 8.2 years (range, two to 16 years). The average follow-up of the whole series was 8.4 years (range, two to 16 years). At the time of the final review 1 of the 129 hips had migration of the stem’s cement mantle relative to the bone (5 mm) with lucent lines at the graft-host interface in three Gruen zones. Another one had migration within the cement (8 mm) with lucent line at the distal graft-host interface and a distal fracture of the cement mantle. These two stems were considered as definitely loosed according to the criteria of Johnston et al. but none of them was revised. The remaining 127 hips showed no radiological changes at the latest examination concerning stem migration and radiolucent lines. One acetabular definite loosening occurred at ten years and was revised at 11 years postoperatively. In this respect, of the 129 hips, only one hip was revised at 11 years’ follow-up (0.7%). The survivorship analysis, with radiologic loosening as the endpoint, yielded a 98% cumulative survival rate for the femoral component and for the acetabular component, 99% at eleven years follow-up. The survival rate with revision for any reason as the endpoint was 99.4% at eleven years follow-up. The results observed in this series, regarding the need for a repeat revision for any reason, are in agreement with the excellent outcome reported by other authors using similar technique. Nevertheless two main differences must be emphasized when comparing the results of this study with the others. The first one is the low rate of subsidence and the second is the absence of postoperative femoral fracture. The quality of bone grafting and the use of a Kerboull stem, double tapered and polish, were associated with the very low rate of distal migration. The unconditional reconstruction of distal bone deficiency or weakness with bone graft strut appeared efficient to prevent the occurrence of femoral fracture, despite the unique use or standard stems.
    Interactive Surgery 06/2008; 3(2):72-80. DOI:10.1007/s11610-008-0075-5
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    ABSTRACT: The optimal surface finish for a cemented THA stem is still debated. We hypothesized surface finish would influence survival of Kerboull cemented hip arthroplasties and a matte finish would have lower survival. We reviewed survival of 433 total hip arthroplasties in 395 patients: 284 consecutive patients (310 hips) were enrolled in a prospective, randomized study of polished (165 hips) or matte finish stems (145 hips) and compared to a historical series of satin stems (123 hips) in 111 patients. The satin and matte finish implants had similar geometry but the polished was quadrangular rather than oval. Finish roughnesses were: polished (radius, 0.04 microm), satin (radius, 0.9 microm), and matte (radius, 1.7 microm). The mean age of the patients at the time of the index arthroplasty was 63.6 years. The survival rate at 13 years, using radiographic loosening as the end point, was 97.3%+/-2.6% for polished stems, 97.1%+/-2.1% for satin stems, and 78.9%+/-5.8% for matte stems. The data suggest survival of Kerboull stems was higher with a polished or satin surface finish than with a matte finish. LEVEL OF EVIDENCE: Level II, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
    Clinical Orthopaedics and Related Research 03/2008; 466(2):332-9. DOI:10.1007/s11999-007-0074-6 · 2.88 Impact Factor
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    ABSTRACT: Extensive bone loss raises formidable challenges in total hip revision. The aim of this study was to evaluate the results of reconstruction using a cemented long-stem and massive structural allograft implanted in a filleted proximal femur, with and without the use of a trochanteric claw plate. Between 1988 and 2001, 44 revisions were performed in 42 patients. After a transtrochanteric approach, the femur was cut longitudinally. A long, cemented Charnley-type prosthesis was used, and flaps of the residual femur were folded around the allograft. The greater trochanter was reinserted with wires in all revisions, and with both wires and a claw plate in 20 revisions. Mean follow-up was 7.15 years (range: 3-16); seven patients, died and four were lost to follow-up. The follow-up exceeded five years in 34 patients. The major complication was nonunion of the greater trochanter, which occurred in 25 cases. Six dislocations, one recurrence of infection, two mechanical loosening, and two fractures below the stem were also recorded. The use of a trochanteric claw plate significantly improved final hip stability, even in patients with nonunion. Femoral reconstruction with a massive structural allograft is reliable and long-lived, and serious complications and long-term resorption are uncommon. The use of a trochanteric claw plate significantly improves final hip stability. Level of evidence: Therapeutic study, level III (retrospective comparative study).
    International Orthopaedics 01/2008; 31(6):851-7. DOI:10.1007/s00264-006-0275-8 · 2.02 Impact Factor
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    M Kerboull
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    ABSTRACT: L'arthroplastie totale de hanche est une intervention de remplacement articulaire prothétique dont l'efficacité dépend de la qualité de la reconstruction architecturale et mécanique de la hanche artificielle, de l'intégrité et de l'équilibre de la musculature périarticulaire. Pour atteindre ce double but, deux éléments sont indispensables : un accès à la hanche qui respecte au mieux la musculature et soit capable d'en rétablir l'équilibre, et une prothèse adéquate.
    01/2008; 3(1). DOI:10.1016/S0246-0467(08)46807-1
  • Revue de Chirurgie Orthopédique et Réparatrice de l Appareil Moteur 11/2007; 93(7):121-121. DOI:10.1016/S0035-1040(07)79561-2 · 0.55 Impact Factor
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    L. Kerboull, M. Hamadouche, M. Kerboull
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    ABSTRACT: Once routinely used, trochanteric osteotomy in total hip arthroplasty now is usually limited to difficult primary and revision cases. Many variations of the osteotomy and many various techniques for the trochanter reattachment have been described. Our specific surgical technique is presented as well as its advantages and drawbacks. Primary total hip arthroplasty procedures requiring the enhanced exposure provided by trochanteric osteotomy is needed in patients with hip ankylosis or fusion, protrusio acetabuli, proximal femoral deformities, developmental dysplasia, or abductor muscle laxity. Trochanteric osteotomy, in revision arthroplasties, facilitates the removal of well-fixed femoral components and enhance acetabular exposure. In all cases trochanteric osteotomy remains useful to preserve the periarticular muscles and restore the geometry of the artificial hip which are the best ways to prevent dislocation.
    Interactive Surgery 01/2007; 2(3):149-154. DOI:10.1007/s11610-007-0068-9
  • Luc Kerboull, Moussa Hamadouche, Marcel Kerboull
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    ABSTRACT: A consecutive series of 118 total hip arthroplasties was performed for Crowe type IV developmental hip dysplasia in 89 patients. The mean age of the patients was 52 years. All procedures were carried out through a transtrochanteric approach by the same surgeon. In all cases, the acetabular component was placed at the level of the true acetabulum. The mean lengthening of the operated limb was 3.8 cm. The average follow-up of the whole series was 16.9 years. At the last follow-up evaluation, 41 patients (48 hips) had died and 7 patients (9 hips) were lost to followup. Forty patients (61 hips) were still alive at a mean follow-up of 22 years. At the time of last follow-up, the mean Merle d’Aubigné hip score was 17 compared with 10.6 preoperatively. The survival rate, with revision for any reason as the endpoint, was 75% at 25-year follow-up.
    12/2006: pages 211-219;
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    ABSTRACT: The purpose of this retrospective study was to report the minimum 10-year follow-up results of a consecutive series of 122 cemented low-friction total hip arthroplasties performed for osteonecrosis. Revision was performed for high polyethylene wear associated with periprosthetic osteolysis and socket loosening in 6 hips, and for deep sepsis in 1. The survival rate at 15 years, using revision for any reason as the end point, was 88.5%. Among the variables studied in this series, the only factor associated with a higher risk of revision was a socket wear rate greater than 0.1 mm/y. This series indicated that cemented low-friction total hip arthroplasty performed for avascular necrosis could grant satisfactory long-term results, provided that polyethylene socket wear remained below 0.1 mm/y.
    The Journal of Arthroplasty 07/2006; 21(4):533-40. DOI:10.1016/j.arth.2005.05.028 · 2.37 Impact Factor
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    ABSTRACT: Purpose of the studyNew bearings have been developed to reduce polyethylene wear. Zirconia ceramic is one proposal with attractive tribologic properties. The purpose of this prospective study was to evaluate the clinical and radiological results at least two years after implantation in a continuous series of total hip arthroplasties combining a zirconia head with polyethylene socket.Material and methodsThe series included 56 total hip arthroplasties performed in 51 patients (30 females and 21 males), mean age 52.2 ± 12 years (25-76 years). Prostheses were implanted for primary degenerative disease (43%) and dysplasia (27%). The femoral component was a stainless steel stem with a Morse cone measuring 11̊25’ for 27 hips and 5̊40’ for 28 hips. A 22-mm stabilized yttrium tetragonal polycrystalline zirconia head (Y-TZP) was used. The transtrochanteric approach was used for all arthroplaties with implantation of a cemented Charnley-Kerboull prosthesis. Clinical outcome was assessed with the Postel-Merle-d’Aubligné (PMA) score. Acetabular cup wear and periprosthetic osteolysis were measured on successive AP x-rays of the pelvis.ResultsMean follow-up was 32 months (24-48). None of the patients were lost to follow-up. Mean function score at last follow-up was 17.8 ± 0.2 (16-18) versus 12.2 ± 2.6 preoperatively (Wilcoxon, p < 0.0001). There were no cases of implant migration (femoral or acetabular). An endosteal defect by femoral osteolysis in the calcar femoral was observed in 19 of 55 cases. It appeared early between first and second post-operative year and did not progress later. Its surface remained less than 1 cm2 in all cases. We were unable to identify any factor predictive of these osteolytic lesions.DiscussionThe short-term clinical results with this type of arthroplasty was comparable with earlier results described with classical Charnely-Kerboull implants using a metal-polyethylene bearing. The Merkel osteolysis observed in this series occurred early for one-third of the hips with no measurable polyethylene wear. We suggest surgeons should be cautious about using the zirconia head. We are continuing our surveillance of these patients.
    Revue de Chirurgie Orthopédique et Réparatrice de l Appareil Moteur 09/2005; 91(5):439-445. DOI:10.1016/S0035-1040(05)84361-2 · 0.55 Impact Factor
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    ABSTRACT: New bearings have been developed to reduce polyethylene wear. Zirconia ceramic is one proposal with attractive tribologic properties. The purpose of this prospective study was to evaluate the clinical and radiological results at least two years after implantation in a continuous series of total hip arthroplasties combining a zirconia head with polyethylene socket. The series included 56total hip arthroplasties performed in 51 patients (30 females and 21 males), mean age 52.2 +/- 12 years (25-76 years). Prostheses were implanted for primary degenerative disease (43%) and dysplasia (27%). The femoral component was a stainless steel stem with a Morse cone measuring 11degrees 25' for 27 hips and 5 degrees 40' for 28 hips. A 22-mm stabilized yttrium tetragonal polycrystalline zirconia head (Y-TZP) was used. The transtrochanteric approach was used for all arthroplaties with implantation of a cemented Charnley-Kerboull prosthesis. Clinical outcome was assessed with the Postel-Merle-d'Aubligné (PMA) score. Acetabular cup wear and periprosthetic osteolysis were measured on successive AP x-rays of the pelvis. Mean follow-up was 32 months (24-48). None of the patients were lost to follow-up. Mean function score at last follow-up was 17.8 +/- 0.2 (16-18) versus 12.2 +/- 2.6 preoperatively (Wilcoxon, p < 0.0001). There were no cases of implant migration (femoral or acetabular). An endosteal defect by femoral osteolysis in the calcar femoral was observed in 19 of 55 cases. It appeared early between first and second post-operative year and did not progress later. Its surface remained less than 1 cm2 in all cases. We were unable to identify any factor predictive of these osteolytic lesions. The short-term clinical results with this type of arthroplasty was comparable with earlier results described with classical Charnely-Kerboull implants using a metal-polyethylene bearing. The Merkel osteolysis observed in this series occurred early for one-third of the hips with no measurable polyethylene wear. We suggest surgeons should be cautious about using the zirconia head. We are continuing our surveillance of these patients.
    Revue de Chirurgie Orthopédique et Réparatrice de l Appareil Moteur 09/2005; 91(5):439-45. · 0.55 Impact Factor
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    ABSTRACT: Pigmented villonodular synovitis of the hip is a rare disease. Synovectomy is generally accepted as the only surgical treatment for the disorder, but there have been few studies with a sufficient sample size and duration of follow-up to allow the evaluation of long-term outcomes. The aim of this study was to determine the long-term outcome of the treatment in sixteen patients. Sixteen patients (nine men and seven women), with a mean age of 35.5 years at the time of surgery, were treated between 1970 and 1996. Complete synovectomy was performed in all patients; in addition, three had a cup arthroplasty, four had a total hip arthroplasty, and one had a monopolar arthroplasty. Clinical and radiographic outcomes were evaluated retrospectively at a mean of 16.7 years postoperatively. Only one patient was followed for less than eight years. Nine patients needed repeat surgery, but only one had recurrent synovitis, as detected with pathological examination fourteen years after treatment with synovectomy and cup arthroplasty. Secondary osteoarthritis developed in all eight patients who had been treated with synovectomy alone, and four of them required a total hip arthroplasty within the follow-up period. These results support earlier data indicating that osteoarthritis consistently develops in patients with pigmented villonodular synovitis of the hip. Complete synovectomy seems to be effective in preventing recurrence of the synovitis, but it does not appear to prevent the development of secondary osteoarthritis.
    The Journal of Bone and Joint Surgery 06/2005; 87(5):1019-24. DOI:10.2106/JBJS.C.01297 · 4.31 Impact Factor
  • Revue de Chirurgie Orthopédique et Réparatrice de l Appareil Moteur 06/2005; 91(4):355-357. DOI:10.1016/S0035-1040(05)84337-5 · 0.55 Impact Factor
  • Revue de Chirurgie Orthopédique et Réparatrice de l Appareil Moteur 10/2004; 90(6):144-144. DOI:10.1016/S0035-1040(04)70695-9 · 0.55 Impact Factor
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    ABSTRACT: The purpose of this retrospective study was to analyze the utility of a trochanteric claw plate in the treatment of an ununited greater trochanter following total hip arthroplasty. From 1986 through 1999, seventy-two consecutive procedures to reattach an ununited greater trochanter were performed in seventy-one patients. The average age at the time of the index arthroplasty was 66.2 years. The arthroplasty that resulted in the nonunion of the greater trochanter was primary in fifty-four hips, a first revision in sixteen hips, and a second and third revision in one hip each. The mean duration between the hip replacement and the treatment of the nonunion was 8.1 months. The greater trochanter was fixed with the trochanteric plate alone in forty-eight hips and with the plate in conjunction with vertical wires in the remaining twenty-four hips. The average duration of followup was 5.1 years. Osseous union occurred in fifty-one of the seventy-two hips. There was a persistent nonunion in twelve hips and fibrous consolidation in the remaining nine hips. The mean time to osseous consolidation was 3.7 +/- 2.1 months (range, two to twelve months). The mean Merle d'Aubigne hip score was 16.1 +/- 2.4 points at the time of the latest follow-up. A highly significant improvement in function was achieved only in the group with osseous consolidation (p < 0.0001). The highest rate of osseous union was achieved when vertical wires had been used in conjunction with the claw plate. Union occurred in twenty-one of the twenty-four hips in that group (p = 0.025). Nonunion of the greater trochanter following total hip arthroplasty can be successfully treated with a trochanteric claw plate. The use of adjunctive vertical wires results in better osseous contact and union.
    The Journal of Bone and Joint Surgery 09/2004; 86-A Suppl 1(Pt 2):112-8. · 4.31 Impact Factor
  • Revue de Chirurgie Orthopédique et Réparatrice de l Appareil Moteur 09/2004; 90(5):210-210. DOI:10.1016/S0035-1040(04)70386-4 · 0.55 Impact Factor

Publication Stats

656 Citations
89.68 Total Impact Points

Institutions

  • 2013
    • Université René Descartes - Paris 5
      Lutetia Parisorum, Île-de-France, France
  • 2002
    • Paris Diderot University
      Lutetia Parisorum, Île-de-France, France
  • 2000
    • Institut Universitaire de France
      Lutetia Parisorum, Île-de-France, France
  • 1977
    • Hôpital Cochin (Hôpitaux Universitaires Paris Centre)
      Lutetia Parisorum, Île-de-France, France