M Gorin

Publications (6)5.36 Total impact

• Article: Pelvis and total hip arthroplasty acetabular component orientations in sitting and standing positions: measurements reproductibility with EOS imaging system versus conventional radiographies.

  J Y Lazennec, M A Rousseau, A Rangel, M Gorin, C Belicourt, A Brusson, Y Catonné
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  ABSTRACT: The literature has recently underlined the interest of pelvic and acetabular component orientation measurements in the standing and sitting position. Radiographic follow-up of total hip arthroplasty (THA) is based on standard AP and lateral X-rays. The use of EOS™ 2D imaging system reduces patient's radiation exposure compared to conventional X-rays. However, using this system, the validity and reproducibility of angular measurements, have not been studied yet for the measurement of pelvic and acetabular parameters in patients with THA. The EOS™ 2D imaging system offers similar advantages to conventional X-rays in the measurement of pelvic and acetabular orientation parameters which are commonly used. Five angular parameters characterizing pelvic tilt and acetabular cup orientation were determined using the same digital measurement Imagika™ software based on two series of standard X-rays and EOS™ 2D images acquired in both standing and sitting positions. Radiographs from 50 patients with unilateral THA were measured three times by two observers. Intra- and interobserver reproducibility using each method was independently studied then paired comparison was performed. The ICC and Spearman rank correlation coefficient demonstrated an excellent EOS/conventional X-ray correlation. According to the parameters, the mean difference between these two imaging modalities ranged from 0.30° to 3.43° (P<0.05). The intra- and interobserver variability ranged from ± 2.97° to ± 6.46° using the EOS™ imaging system and from ± 4.26° to ± 10.22° using conventional X-rays (P<0.05). The EOS™ 2D imaging system may replace conventional X-rays in the assessment and monitoring of pelvic and acetabular cup orientation in THA. Level III. Prospective diagnostic study.
  Orthopaedics & Traumatology Surgery & Research 06/2011; 97(4):373-80. · 0.94 Impact Factor
• Chapter: Why use an all Ceramic Tripolar THR ? — clinical and experimental data

  Jean-Yves Lazennec, H. Ali, M. Gorin, B. Roger, A. Baudoin, A. Rangel
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  ABSTRACT: A tripolar all ceramic joint is an emerging technology that reduces the risk of dislocation and subluxation in T.H.R. Muscular insufficiency, caricatural lower limbs discrepancies or neurological problems are classical causes for T.H.P. dislocations or subluxations [10,11]. Instability may also be linked to 2 specific mechanisms, lever-out (with impingement) and shear-out (without impingement).
  12/2006: pages 173-178;
• Article: Variations of caudal, central, and cranial acetabular anteversion according to the tilt of the pelvis.

  S Zilber, J Y Lazennec, M Gorin, G Saillant
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  ABSTRACT: Variations of acetabular anteversion measured at the level of the diameter of the acetabulum according to the tilt of the pelvis are known. But the values of this anteversion at other levels of the acetabulum, near the roof or near the obturator foramen, are unknown. Attracted by the very changeable morphology of the acetabular cover, we studied the caudal, central, and cranial acetabular anteversion of 12 pelvises in four positions of dorsal-ventral inclination. The caudal, central, and cranial acetabular anteversion diminished with the ventral tilt of the pelvis. The anteversions also diminished from the caudal part of the acetabulum to the cranial part, whatever the inclination of the pelvis. These notions represent a reference that, once completed with clinical studies of healthy volunteers and patients presenting an anomaly of the acetabulum cover, will enable researchers to define threshold values of normal and pathological conditions.
  Surgical and Radiologic Anatomy 01/2005; 26(6):462-5. · 1.06 Impact Factor
• Article: Hip-spine relationship: a radio-anatomical study for optimization in acetabular cup positioning.

  J-Y Lazennec, N Charlot, M Gorin, B Roger, N Arafati, A Bissery, G Saillant
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  ABSTRACT: The criteria for acetabular cup positioning during total hip replacement are a matter of considerable discussion, particularly with regards to the optimal degree of anteversion. "Anatomical anteversion" is defined in the transverse plane, and "surgical anteversion" in the sagittal plane. Computed tomography measurements of anteversion are characteristic of a given transverse section plane and fail to take into account the position of the pelvis. We suggest a simple method for evaluating acetabular cup position in both the transverse and sagittal planes during standing and sitting. By shedding new light on the relationships between the pelvis and the spine, this method may help to understand some cases of impingement, instability or abnormal wear.
  Surgical and Radiologic Anatomy 05/2004; 26(2):136-44. · 1.06 Impact Factor
• Article: Sagittal alignment in lumbosacral fusion: relations between radiological parameters and pain.

  J Y Lazennec, S Ramaré, N Arafati, C G Laudet, M Gorin, B Roger, S Hansen, G Saillant, L Maurs, R Trabelsi
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  ABSTRACT: The objective of this study was to conduct a radiological analysis of posture before and after lumbosacral fusion to evaluate the influence of spinal alignment on the occurrence and pattern of post surgical pain. The study included 81 patients, of whom 51 had a history of previous low back surgery. We excluded patients with suspected or confirmed nonunion. In the fusion group, the 27 patients who were pain free after the procedure were compared to the 54 patients with residual pain. Thirty patients had pain only or primarily when they were standing immobile, 18 when they were sitting immobile, and six in both positions. Measurements were done on full-length lateral radiographs of the spine, with the patient standing according to Duval Beaupère criteria. The subgroup with postfusion pain was characterized at baseline by a more vertical sacrum with less sacral tilt (ST) (P < 0.0062) and more pelvic tilt (PT) (P < 0.0160). PT at last follow-up (PT fu) correlated with the presence of postfusion pain (NP: P = 0.0003). In the patients with postfusion pain, PT was almost twice the normal value. ST at last follow-up (ST fu) in the standing position was also correlated with the presence of postfusion pain (P < 0.0001) indicating that the sacrum remained abnormally vertical in the subjects with postfusion pain. Using logistic regression, the only prognostic factor for residual pain at last follow-up was ST fu. Both at pre-operative evaluation and at last follow-up, patients with pain in the standing position or in both the standing and sitting positions were characterized at pre-operative status by a more vertical sacrum with less sacral tilt. The results of this study indicate that, achieving a strong fusion should not be the only goal. Appropriate position of the fused vertebrae is also of paramount importance to minimize muscle work during posture maintenance. The main risk is failing to correct or to causing excessive pelvic retroversion with a vertical sacrum leading to a sagittal alignment that replicates the sitting position. This situation is often accompanied by loss of lumbar lordosis and adversely affects stiff or degenerative hips.
  European Spine Journal 02/2000; 9(1):47-55. · 1.97 Impact Factor
• Article: Hip spine relationships: application to total hip arthroplasty.

  J Y Lazennec, A Riwan, F Gravez, M A Rousseau, N Mora, M Gorin, A Lasne, Y Catonne, G Saillant
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  ABSTRACT: Lumbo-sacral orientation in the sagittal plane is of utmost importance, as it plays a critical role in the function of the spine and the hip joints. Equilibrium of the trunk influences the tridimensional orientation of the acetabulum and the functional range of motion of the hips. Each patient is characterized by a "morphological" parameter named incidence angle; its sagittal balance is the consequence of a postural adaptation for other functional parameters (pelvic tilt, sacral slope, lumbar lordosis, acetabular sagittal tilt, functional anteversion). Understanding variations of the sacral slope on lateral pelvic X-rays is essential for planning total hip arthroplasty and identifying patients at risk of impingement, as lumbosacral posture influences functional anteversion of the acetabulum. Posterior pelvic version as in sitting position (sacral slope decrease) is linked to the increase of the functional acetabular anteversion. Anterior pelvic version as in standing position (sacral slope increase) is linked to the decrease of the functional acetabular anteversion.
  Hip international: the journal of clinical and experimental research on hip pathology and therapy 17 Suppl 5:S91-104. · 0.34 Impact Factor