Frédéric Sailhan

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

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Publications (31)42.83 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: El condroblastoma es un tumor óseo benigno del niño, del adolescente o del adulto joven; representa el 1% de todos los tumores óseos. De localización epifisaria o epifisometafisaria, esta lesión se desarrolla habitualmente a partir de centros secundarios de osificación cercanos a la rodilla, al hombro y a la cadera. En la radiografía suele observarse una lesión osteolítica epifisaria en contacto con el cartílago de crecimiento y con calcificaciones en su interior. El análisis anatomopatológico de una muestra obtenida por biopsia o raspado-biopsia proporciona el diagnóstico de certeza. El tratamiento del condroblastoma es quirúrgico y consiste en el raspado del tumor y el llenado de la cavidad residual. La recidiva es frecuente (hasta el 35% en algunas series) y necesita un nuevo raspado o, en ocasiones, la resección completa de la lesión.
    EMC - Aparato Locomotor. 01/2014; 47(1):1–9.
  • Frédéric Sailhan
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    ABSTRACT: Several surgical techniques have been described for the treatment of degenerative lumbar disc disease. The allow reaching the disc space from the anterior, posterior or lateral aspect of the spine. Posterior Lumbar Interbody Fusion, Transforaminal Lumbar Interbody Fusion and Anterior Lumbar Interbody Fusion techniques are described and compared. The interest of minimally invasive retractors is also discussed in these surgical procedures.
    Revue du Rhumatisme Monographies 01/2013; 80(4):252–259.
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    ABSTRACT: Los tumores óseos malignos primarios son tumores infrecuentes. Su baja incidencia y la necesidad de un tratamiento multidisciplinario, a cargo de médicos con experiencia en esta afección, imponen el traslado de estos pacientes a los centros de referencia o, como mínimo, el análisis de los casos en reuniones de concertación multidisciplinaria especializada. La resección quirúrgica de los tumores malignos óseos debe ser amplia, es decir, habrá que dejar en contacto con el tumor una capa de tejido sano (margen). En más del 80% de los casos es posible reconstruir el segmento óseo o la articulación y, por tanto, conservar el miembro. Las diáfisis se reconstruyen con preferencia mediante una combinación de auto y aloinjerto con osteosíntesis. En la mayoría de los casos, las articulaciones se reconstruyen con una prótesis masiva o se efectúa una reconstrucción compuesta (prótesis rodeada por un aloinjerto). Cuando, además de la articulación, la resección incluye los músculos periarticulares, se prefiere la artrodesis. Las resecciones de la pelvis, si se limitan al ala ilíaca o al marco isquiopúbico, no necesitan reconstrucción. En cambio, las resecciones de la región acetabular y del ala ilíaca, que interrumpen la continuidad del anillo pélvico, imponen la reconstrucción a efectos de lograr un resultado funcional aceptable. La reconstrucción de la cadera tras la resección del acetábulo es mucho más difícil. En caso de resección de la región acetabular, sola o asociada a la del marco isquiopúbico, los autores de este artículo prefieren la reconstrucción con un autoinjerto de fémur proximal y una prótesis. También es posible usar las prótesis en silla de montar, las de tipo Mac Minn con auto o aloinjerto, las prótesis modulares y a medida, los aloinjertos masivos con o sin prótesis y las artrodesis femoroilíacas. En caso de resección del ala ilíaca y de la región acetabular, las reconstrucciones posibles son: la artrodesis isquiofemoral y femorosacra, la reconstrucción mediante autoinjerto de fémur proximal y prótesis, la medialización de la cabeza femoral, los aloinjertos y las prótesis masivas. Las amputaciones se tratan en otro artículo de la EMC.
    EMC - Aparato Locomotor. 09/2012; 45(3):1–20.
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    ABSTRACT: We asked whether locally applied recombinant-Bone Morphogenic Protein-2 (rh-BMP-2) with an absorbable Type I collagen sponge (ACS) carrier could enhance the consolidation phase in a callotasis model. We performed unilateral transverse osteotomy of the tibia in 21 immature male rabbits. After a latency period of 7 days, a 3-weeks distraction was begun at a rate of 0.5mm/12h. At the end of the distraction period (Day 28) animals were randomly divided into three groups and underwent a second surgical procedure: 6 rabbits in Group I (Control group; the callus was exposed and nothing was added), 6 rabbits in Group II (ACS group; receiving the absorbable collagen sponge soaked with saline) and 9 rabbits in Group III (rh-BMP-2/ACS group; receiving the ACS soaked with 100μg/kg of rh-BMP-2, Inductos(®), Medtronic). Starting at Day 28 we assessed quantitative and qualitative radiographic parameters as well as densitometric parameters every two weeks (Days 28, 42, 56, 70 and 84). Animals were sacrificed after 8 weeks of consolidation (Day 84). Qualitative radiographic evaluation revealed hypertrophic calluses in the Group III animals. The rh-BMP-2/ACS also influenced the development of the cortex of the calluses as shown by the modified radiographic patterns in Group III when compared to Groups I and II. Densitometric analysis revealed the bone mineral content (BMC) was significantly higher in the rh-BMP-2/ACS treated animals (Group III).
    Injury 07/2011; 42(12):1460-6. · 1.93 Impact Factor
  • F Sailhan
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    ABSTRACT: Distraction osteogenesis (DO) is a surgical technique widely used in orthopedic surgery for the treatment of various pathological conditions such as leg length discrepancy, bone deformity or bone defects. The basic principle of the callotasis technique includes performing a transverse bone section before gradually distracting the two bone segments. New bone tissue is generated in the gap between the two segments. Bone regeneration during DO is believed to occur in response to the longitudinal mechanical strain applied to the callus during healing. One of the limitations of this technique is the long period of time required for the newly formed bone tissue to mineralize and consolidate. Various studies have reported that among growth factors, bone morphogenetic proteins (BMPs) may play a central role in the molecular signaling cascade leading to bone renegeration and remodeling in a DO procedure. Ongoing research is aimed at developing methods to accelerate bone consolidation in order to reduce the time required to obtain consolidation. One of these methods is to test the ability of exogenous BMPs to increase bone regeneration and accelerate bone consolidation.
    Osteoporosis International 06/2011; 22(6):2011-5. · 4.04 Impact Factor
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    ABSTRACT: The most commonly used method for unstable slipped capital femoral epiphysis (SCFE) remains in situ fixation. Depending on the surgeon's preference, screws or Kirschner wires are used for stabilizing the slipped upper femoral epiphysis. The purpose of this study was to evaluate the ability of a single cannulated screw with a proximal threading to ensure stabilization, growth, and remodeling of the slipped epiphysis. A retrospective study was performed identifying 23 children treated for unstable SCFE under 50° by means of a single cannulated screw with proximal threading. All patients attended a radiological evaluation immediately after surgery and at physeal closure. The width of the epiphysis cut by the Klein line, the width and length of the femoral neck, the centrocalcar distance (CCD) angle, and the articulotrochanteric distance (ATD) were evaluated. All patients had a stabilized epiphysis at the last follow-up, with no case of recurring slip. Radiological comparison of the affected side between the preoperative and the last follow-up evaluation showed a statistically significant improvement in the neck length and width. Fixation of the epiphysis using proximally threaded screws allows the preservation of femoral neck growth. The cannulated screw with proximal threading seems to be a safe and relevant implant to help to restore a close-to-normal hip at skeletal maturity.
    Journal of Children s Orthopaedics 04/2011; 5(2):83-8.
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    The Journal of Bone and Joint Surgery 01/2011; 93(2):195-8. · 3.23 Impact Factor
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    ABSTRACT: Extra-abdominal desmoid fibromatosis (EADF) is a benign tumoral condition, classically managed by more or less radical and sometimes mutilating excision. This treatment strategy is associated with a recurrence rate of nearly 50% according to various reports. EADF may show spontaneous stabilization over time. A retrospective series of 26 cases of EADF managed by simple observation was studied to assess spontaneous favorable evolution and identify possible factors impacting evolution. Eleven cases were of primary EADF with no treatment or surgery, and 15 of recurrence after surgery with no adjuvant treatment. MRI was the reference examination during follow-up. Twenty-four cases showed stabilization at a median 14 months; there were no cases of renewed evolution after stabilization. One primary tumor showed spontaneous regression, and one recurrence still showed evolution at end of follow-up (23 months). The sole factor impacting potential for evolution was prior surgery. No radiologic or pathologic criteria of evolution emerged from analysis. The present series, one of the largest dedicated to EADF managed by observation, confirmed recent literature findings: a conservative "wait-and-see" attitude is reasonable and should be considered when large-scale resection would entail significant functional or esthetic impairment. Level IV, retrospective study.
    Orthopaedics & Traumatology Surgery & Research 11/2010; 96(8):884-9. · 1.06 Impact Factor
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    ABSTRACT: Introduction Les fibromatoses desmoïdes extra-abdominales (FDEA) sont des tumeurs bénignes dont la prise en charge était habituellement fondée sur une chirurgie d’exérèse plus ou moins large, parfois mutilante, avec un taux de récidive de près de 50 % dans plusieurs séries. Hypothèse Les FDEA ont la capacité de se stabiliser spontanément avec le temps. Méthodes Les auteurs rapportent une série rétrospective de 26 cas de FDEA surveillées afin d’étudier leur évolution favorable spontanée, et d’identifier des facteurs influençant l’évolution de cette tumeur. Dans 11 cas, il s’agissait d’une FDEA primaire jamais traitée ni opérée et dans 15 cas, il s’agissait de FDEA récidivants après traitement chirurgical, les patients n’ayant bénéficié d’aucun traitement adjuvant. L’IRM était l’examen de référence pour le suivi. Résultats Dans 24 cas, les tumeurs se sont stabilisées avec une médiane de 14 mois. Après arrêt de leur évolution, aucune tumeur n’a évolué à nouveau. Une tumeur primaire a régressé spontanément et une récidive continuait à évoluer au dernier contrôle à 23 mois. Le seul facteur influençant le potentiel évolutif était la présence d’une chirurgie antérieure. Aucun critère évolutif radiologique ni anatomopathologique n’a été mis en évidence. Discussion Cette série, qui est une des plus importantes concernant des cas de fibromatoses desmoïdes extra-abdominales surveillées, confirme les données récentes de la littérature. Une attitude conservatrice wait and see est une approche raisonnable et doit être discutée quand une résection large ne peut être réalisée sans atteinte fonctionnelle ou esthétique importante. Niveau de preuve Niveau IV étude rétrospective.
    Resuscitation 01/2010; 96(8):978-984. · 4.10 Impact Factor
  • The Journal of Rheumatology 11/2009; 36(11):2621-2. · 3.26 Impact Factor
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    ABSTRACT: We asked whether locally applied recombinant-bone morphogenic protein-2 (rh-BMP-2) with a type I collagen carrier could enhance the consolidation phase in distraction osteogenesis and whether a dose effect could be reported. We performed unilateral transverse osteotomy of the tibia in 15 immature male rabbits. In Group I (five rabbits), 750 microg of rh-BMP-2 on the type I collagen sponge (Inductos, Medtronic) was locally applied on the day of osteotomy; the Group II animals (five rabbits) received 375 microg of the drug and the Group III (control group, five rabbits) had no local application. After 7 days, 3 weeks of distraction was begun at a rate of 0.5 mm/12 h. Starting week 2 of distraction, we assessed radiographic, ultrasonographic, and densitometric parameters once per week. Animals were sacrificed after a 3-week consolidation period. Radiographic evaluation revealed increased regenerate ossification in the rh-BMP-2 groups compared with the control group. The bone mineral content was significantly higher in the rh-BMP-2 treated groups at each time point. A dose effect is shown as densitometric parameters were significantly higher between Groups I and II. 3/5 of the Group I treated animals developed a premature bony union in the regenerate resulting in premature fusion and incomplete distraction.
    Injury 10/2009; 41(7):680-6. · 1.93 Impact Factor
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    ABSTRACT: Introduction L’aplasie tibiale est une anomalie congénitale rare souvent syndromique. L’amputation est la règle dans les aplasies totales mais un traitement conservateur peut être envisagé dans les formes partielles ou en cas de refus de l’amputation. Notre expérience de l’utilisation du fixateur d’Ilizarov nous a convaincus de la supériorité de cet appareil dans la correction progressive des inégalités de longueur des membres inférieurs et des déviations angulaires articulaires ou osseuses. L’objectif de cette étude était de montrer l’intérêt du matériel d’Ilizarov dans le traitement séquentiel conservateur des aplasies tibiales. Patients et méthode Une étude rétrospective a été menée identifiant neuf patients suivis pour une aplasie tibiale de type 1 ou 2 (Jones) traitée de manière séquentielle à l’aide du matériel d’Ilizarov. Le résultat fonctionnel en fin de correction a été apprécié sur des critères cliniques. Résultats Les différents temps du programme de correction ont été notés pour chaque patient. Le recul moyen à l’évaluation était de 18,3 ans (quatre à 32 ans). Les aplasies tibiales de type 1 avaient une amplitude maximale moyenne de flexion du genou de 35° (0 à 90°) et les aplasies de type 2 de 118° (90 à 140°). Un patient a été amputé et un patient a eu une arthrodèse bilatérale des genoux. Discussion Dans la littérature, il existe peu de séries avec un recul comparable sur le traitement conservateur des aplasies tibiales sévères. Le fixateur d’Ilizarov permet, dans notre expérience, l’optimisation du programme de correction progressive des aplasies tibiales sévères.
    Revue de Chirurgie Orthopédique et Traumatologique. 10/2009; 95(6).
  • Frédéric Sailhan, Franck Chotel, Roger Parot
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    ABSTRACT: Chondroblastoma is a rare benign bone lesion that occurs in young patients and has a high rate of recurrence. The purpose of the present study was to report on eighty-seven cases of chondroblastoma in children and to identify the possible factors that increase the risk of recurrence. We retrospectively reviewed eighty-seven cases of chondroblastoma in patients with open physes at the time of diagnosis and treatment. Historical data, complete imaging data, histological findings, and surgical charts were analyzed. Multiple logistic regression was used to identify predictors of recurrence. The series included fifty-three boys and thirty-four girls with a mean age of 12.5 years. Lesions were located in the epiphysis in 68% of the patients, especially in the proximal part of the tibia (twenty-four patients) and the proximal part of the femur (twenty-three patients). Pain was the presenting symptom in 84% of the patients. The treatment consisted of intralesional curettage with autogenous bone-grafting in 63% of the patients. The functional outcome at an average of 62.5 months of follow-up was good for 68.5% of the patients. At a minimum of twenty-four months of follow-up, 32% of the lesions had recurred. Sex, radiographic aggressiveness, an aneurysmal bone-cyst component on histological analysis, and the method of surgical treatment had no significant influence on recurrence. Epiphyseal chondroblastomas were associated with a higher risk of recurrence when compared with metaphyseal, apophyseal, and epiphyseal-metaphyseal lesions (p = 0.004). Chondroblastoma in growing children is most frequently located in the proximal part of the tibia and the proximal femoral epiphysis. The recurrence rate is high, particularly for strictly epiphyseal lesions. Proximal femoral lesions and tarsal lesions are associated with a poorer outcome.
    The Journal of Bone and Joint Surgery 10/2009; 91(9):2159-68. · 3.23 Impact Factor
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    ABSTRACT: Congenital longitudinal deficiency of the tibia is a rare and often syndromic anomaly. Amputation is usually the preferred treatment option in complete absence of the tibia; however, a conservative management might be implemented in partial forms or in case of amputation refusal. Our experience with the Ilizarov fixator, convinced us this device was the best suited for progressive correction of lower limbs length discrepancies and articular or bone angular limb deformities (ALD). The aim of this study is to highlight the interest of the Ilizarov fixator in the multistage conservative treatment of congenital tibial deficiencies. A retrospective study was conducted in nine patients suffering from Type I or II congenital tibial deficiencies (Jones) and sequentially managed using the Ilizarov technique. The functional outcome after treatment completion was then clinically assessed. The different stages of correction were recorded for each individual patient. Patients were assessed at a mean follow-up of 18,3 years (4-32 years). The mean maximum knee flexion was 35 degrees (0 degrees -90 degrees ) in type I deficiencies and 118 degrees (90 degrees -140 degrees ) in type II deficiencies. One patient underwent amputation and a bilateral knee arthrodesis was performed in another case. Few series in the literature report a comparable length of follow-up period in the conservative management of severe congenital tibial deficiencies. In our study, the Ilizarov fixator provided satisfactory progressive corrections of severe congenital tibial deficiencies. Level IV therapeutic retrospective study.
    Orthopaedics & Traumatology Surgery & Research 10/2009; 95(6):431-6. · 1.06 Impact Factor
  • Revue de Chirurgie Orthopédique et Traumatologique 10/2009; 95(6):531-537.
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    ABSTRACT: Wide bone resection is sometimes necessary for bone tumors, and reconstruction is a major challenge. Vascularized fibular graft is one alternative but may result in progressive limb-length discrepancy (LLD) in children with substantial growth left. Progressive distraction lengthening with an external fixator is now a standard procedure to generally correct LLD. However, lengthening of free vascularized fibular grafts for lower limb reconstruction has not been reported frequently and then only in small series or case reports. We report our experience with three patients with lengthening after tibial reconstruction with a free vascularized fibular graft and review the literature.
    Clinical Orthopaedics and Related Research 01/2009; 467(5):1377-84. · 2.79 Impact Factor
  • Franck Chotel, Frédéric Sailhan, Jérôme Berard
    Journal of Hand Surgery (European Volume) 11/2008; 33(5):681-2. · 1.22 Impact Factor
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    ABSTRACT: Although there are many publications concerning the mechanical behavior of adult bone, there are few data about mechanical properties of children's bone. In vivo bone stiffness measurement with Orthometer device has been validated and extensively used in adults to assess bone healing after fracture or lengthening. We hypothesized that in vivo stiffness measurement with Orthometer was applicable in children and was correlated with age, height, body weight, and corpulence index. The purpose was to establish baseline stiffness values for femur and tibia in growing children.Sixteen bone measurements (7 femurs and 9 tibias) were obtained during application of an external fixator for leg lengthening in 11 children aged between 5.5 and 16.7 years. A 3-point bending test with an Orthometer was carried out on the intact bone (before osteotomy) under general anesthesia. The anteroposterior stiffness measurement was successful in all children of the series, aged from 5.5 to 16.7 years. A wide variation of femoral and tibial bone stiffness values were observed. The use of a unique value as in adults as the end point of bending stiffness during bone healing process is not possible for children. The anteroposterior bone stiffness was found to have linear correlation with children's height and body weight, but not with age and corpulence indexes. The original data obtained by this study will give a stiffness reference for height and weight and could be useful as reference values for monitoring of healing process after fracture or limb lengthening.
    Journal of Pediatric Orthopaedics 06/2008; 28(5):534-7. · 1.16 Impact Factor
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    ABSTRACT: We asked whether locally applied rhBMP-7 with a Type I collagen carrier could enhance the consolidation phase in distraction osteogenesis. We performed unilateral transverse osteotomy of the tibia in 28 immature male rabbits. In half the animals (14 rabbits), 70 microg rhBMP-7 (28.5 mg rhBMP-7/CC, OP-1) was applied locally on the day of the osteotomy; the control group (14 rabbits) had no local application. After 7 days, 3 weeks of distraction was begun at a rate of 0.5 mm every 12 hours. Starting with Week 2 of distraction, we assessed radiographic, ultrasonographic, and densitometric parameters once per week. Animals were sacrificed after 3 weeks of distraction, and after 1, 2, and 3 weeks of additional consolidation. Radiographic evaluation revealed a tendency for increased bony union and bone differentiation in the control group compared with the rhBMP-7/CC group. The bone mineral content was higher in the control group at each time. Ultrasonographic evaluation revealed the development of a cyst in the regenerate in 92% of the animals in the rhBMP-7/CC group versus 0% in the control group. Ultrasonography and histomorphometry showed delayed regenerate development in the rhBMP-7/CC group. We suggest the poor results related to the relatively large bulk of the solid carrier of the OP-1 that might have acted as a mechanical obstacle to osteogenesis.
    Clinical Orthopaedics and Related Research 05/2007; 457:227-34. · 2.79 Impact Factor
  • F. Sailhan
    Revue de Chirurgie Orthopédique et Réparatrice de l'Appareil Moteur. 04/2007; 93(2):195–197.

Publication Stats

88 Citations
42.83 Total Impact Points

Institutions

  • 2011
    • Université René Descartes - Paris 5
      Lutetia Parisorum, Île-de-France, France
  • 2009
    • Centre Hospitalier Universitaire de Grenoble
      Grenoble, Rhône-Alpes, France
  • 2007
    • CHU de Lyon - Hôpital de la Croix-Rousse
      Lyons, Rhône-Alpes, France