F. Sirveaux

University of Lorraine | UdL · Centre chirurgical Emile Gallé

Objective Our study aims to quantitatively determine the concavity of the glenoid articular surface in patients with hypermobile shoulders compared to those without. Method We examined medical records of shoulder CTs from 2017 to 2022, selecting 50 patients with clinical signs of joint hypermobility for our case group and 54 for our control group....

To evaluate the prevalence of shoulder adhesive capsulitis (AC) signs on MR studies of patients with various common shoulder conditions. MR images of 316 patients were retrospectively evaluated. Patients were divided into three groups: controls (66 patients), clinical AC (63 patients), and study group (187 patients). The final diagnosis of AC was r...

Purpose To determine, from a sizable cohort of reverse shoulder arthroplasty (RSA), whether the deltopectoral (DP) or anterosuperior (AS) approach grant better outcomes at a minimum follow-up of 24 months. Methods The authors reviewed 743 RSAs in patients with primary osteoarthritis (OA) with or without rotator cuff lesions and secondary OA due to...

Several competing concepts of anteroposterior stabilization have been developed for total knee arthroplasty (TKA), with an overall great success despite some differences in terms of clinical or radiological outcomes. The CORIN KneeTec DeepDish TM is a novel mobile-bearing implant, stabilized with an ultra-congruent deep-dish poly- ethylene insert....

Introduction Gastrointestinal stromal tumors represent the most frequently encountered primary mesenchymal tumors. Whereas the liver and the peritoneum are known to be the preferential metastasis sites, no therapeutic standard has yet been established for the management of bone metastases because of their very low incidence. We report a unique exam...

PurposeThis study of residents’ initial performance was performed to determine which factors predisposed residents for success in demonstrating the best arthroscopic skills.Methods Each orthopaedic first-year resident was officially invited to take part in a one hour evaluation on a VirtaMed™ ArthroS™ simulator. On the FAST module, the Periscoping...

Hallux rigidus is a painful condition of the great toe characterized by restriction of the metatarsophalangeal range of motion and progressive osteophyte formation. Many etiologies have been postulated including excessive length of the first ray, trauma, abnormally elevated first metatarsal and a positive family history. However, most cases are lik...

Purpose: To compare the capabilities of intravoxel incoherent motion (IVIM) to those of monoexponential diffusion-weighted imaging for differentiating benign from malignant non-vascular, non-fatty soft tissue tumors (NVSFSTT). Material and methods: A total of 64 patients with 64 histologically confirmed soft-tissue tumors were retrospectively in...

Background: Short uncemented stems have recently been proposed as an alternative to classic long stems for shoulder arthroplasty. The early results are promising, but bony adaptations of the proximal humerus have been reported. The aim of this study was to quantify these phenomena using the Ascend Flex stem and to determine the risk factors. Mate...

Aims The aim of this study was to report the outcomes of different treatment options for glenoid loosening following reverse shoulder arthroplasty (RSA) at a minimum follow-up of two years. Patients and Methods We retrospectively studied the records of 79 patients (19 men, 60 women; 84 shoulders) aged 70.4 years (21 to 87) treated for aseptic loos...

Introduction The current reduction in working hours and the worldwide attempt to guarantee patient safety have led to significant changes in the training of surgical assistants. Numerous studies meanwhile present arthroscopic virtual reality (VR) simulators as very efficient tools for resident training. Material and methods Based on a meta-analysi...

Purpose: The purpose of this study was to determine the performance of CT arthrography for the diagnosis of intra-articular long head of biceps (LHB) tendon intrinsic lesions using arthroscopy findings as standard of reference. Material and methods: CT arthrography studies of 98 patients (55 men, 43 women; mean age 54.8±12.7 [SD] years [range: 1...

Introduction La simulation arthroscopique est devenue incontournable pour la formation des internes, jusqu’à faire partie du programme du nouvel internat de chirurgie orthopédique. En France, un programme national de formation à la simulation arthroscopique et d’évaluation de tous les internes de première année en Orthopédie est mené. Dans la premi...

Hypothesis: Reverse Shoulder Arthroplasty (RSA) may be indicated in displaced proximal humerus fractures in elderly patients. We hypothesized that tuberosity fixation and healing around the prosthesis would result in better outcomes and patient satisfaction. Methods: Thirty-eight acute displaced or dislocated 3- and 4-part fractures in elderly pati...

The various surgical techniques to treat iliotibial band friction syndrome consist in releasing the iliotibial band by means of plasties that partially interrupt its continuity or by release of the deep aspect. We describe an original technique of digastric distal iliotibial band release from Gerdy's tubercle. Via a 2 cm approach above Gerdy's tube...

Objectives To evaluate the diagnostic performance of digital tomosynthesis (DTS) for the diagnosis of hip prosthesis loosening (PL) compared with conventional radiographs and CT with metal artifact reduction (CT-MAR). Methods Forty-nine patients with painful hip prosthesis were prospectively included and underwent anteroposterior and lateral radio...

PurposeOsteoarthritis may be observed after surgery for instability and in the natural history of pathology. The primary objective was to analyze the late clinical and radiographic results of reverse shoulder arthroplasties (RSA) for patients who had instability arthropathy. Methods This is a retrospective cohort of 25 patients with a mean follow-u...

Reverse shoulder arthroplasty is now the standard treatment for displaced, three- or four-part, proximal humeral fractures in patients older than 70 years. Inadequate tuberosity repair or inappropriate humeral stem position are associated with poorer outcomes, notably regarding rotation and stability. Strict operative technique during prosthesis im...

Introduction: The PFMR® proximal femoral modular reconstruction implant (Protek, Sulzer Orthopedics, Switzerland) is a straight modular stem in sanded titanium with press-fit anchorage, intended to achieve spontaneous bone reconstruction following Wagner's principle. The aim of the present study was to analyze long-term clinical and radiological o...

Introduction La simulation chirurgicale est apparue indispensable pour compléter la formation des jeunes internes, dont l’accès au bloc opératoire est réduit par l’évolution des pratiques. Elle est rendue possible par le développement de véritables écoles de chirurgie virtuelle, en parallèle des laboratoires d’anatomie. Des transferts de compétence...

Résumé Background La butée postérieure de l’épaule est une option thérapeutique reconnue dans le traitement des instabilités postérieures de l’épaule. Le but de cette étude rétrospective multicentrique était d’évaluer les résultats cliniques et radiologiques des butées postérieures. Matériel et méthodes Soixante-six patients, 55 hommes et onze fe...

Résumé Dans les cas d’instabilité postérieure de l’épaule (luxations récidivantes, subluxation postérieure involontaire ou subluxation volontaire devenue involontaire), en cas d’échec du traitement fonctionnel et en l’absence de contexte psychologique défavorable, un traitement chirurgical peut être proposé. La butée acromiale pédiculée à un lambea...

Introduction L’arthroplastie totale d’épaule anatomique est le traitement de référence de l’omarthrose centrée résistante au traitement médical. La gestion de l’analgésie postopératoire après ce geste est un axe de réflexion actuel pour permettre une meilleure récupération du patient. Les techniques de diffusion continue intra-articulaire d’anesthé...

Introduction Le descellement glénoïdien est la principale complication à long terme des prothèses anatomique d’épaule, les taux rapportés excédant 50 % à 10 ans de recul. La qualité de l’os sous-chondral est un facteur important de stabilité de l’implant glénoïdien. Une technique de greffe compactée de la glène avant scellement de l’implant a été p...

Introduction L’observation d’une encoche du pilier inférieur de la scapula est fréquente après la mise en place d’une prothèse inversée. Toutefois, l’évolutivité et le retentissement fonctionnel de ces encoches restent débattus dans la littérature. De plus, il semble que l’ostéolyse glénoïdienne ne se limite pas au pilier inférieur, mais puisse s’é...

Introduction Le syndrome de l’essuie-glace est une pathologie fréquente chez les coureurs de longue distance. Le traitement chirurgical est classiquement proposé après échec des traitements médicaux. Plusieurs techniques ont été proposées, en chirurgie ouverte ou arthroscopique, avec des résultats comparables et satisfaisants. Leur point commun est...

Background: The posterior bone block procedure is a well-known treatment option for posterior shoulder instability. The goal of this retrospective multicenter study was to evaluate the clinical and radiological outcomes of this procedure. Material and methods: The study cohort consisted of 66 patients (55 men, 11 women) with an average age of 27...

In posterior shoulder instability (recurrent dislocation, involuntary posterior subluxation or voluntary subluxation that has become involuntary), surgery may be considered in case of failure of functional treatment if there are no psychological contraindications. Acromial bone-block with pediculated deltoid flap, as described by Kouvalchouk, is an...

Introduction As the revision number of shoulder arthroplasties increases, we focused on the difficulties of extracting or converting the humeral stem. The purpose of this multicentric study was to assess the outcomes and the radiographic results of a new, short, and convertible humeral stem (Aequalis Ascend™ Flex, Tornier SAS–Wright Medical Inc®, B...

The treatment of the four-part fractures of the proximal humerus remains a therapeutic challenge. The decision-making is based on preoperative criteria concerning the displacement of the fracture, the stability of the fracture and the risk of avascular necrosis of the humeral head. The aim of this study was to analyse the inter- and intra-observer...

Background: The concept of free interposition arthroplasty proved successful for small joints of the hand, wrist, and foot, particularly after the use of implants coated with pyrocarbon, which enhanced their tribologic and elastic properties. The present study reports preliminary outcomes of a pyrocarbon-coated interposition shoulder arthroplasty...

Résumé Introduction Dans les ostéosynthèses des fractures céphalobitubérositaires de l’extrémité supérieure de l’humérus, il n’existe pas de critères objectifs permettant de choisir entre le clou et la plaque. L’objectif de cette étude est d’identifier des critères radiologiques en faveur de l’une ou de l’autre technique. Matériel et méthode Il s...

Introduction La prothèse fémorale modulaire de révision (PFM-R [Zimmer]) est une tige modulaire, droite, en titane sablé, à ancrage press-fit, visant à obtenir une reconstruction osseuse spontanée selon le principe de Wagner. L’objectif de ce travail était d’analyser les résultats cliniques et radiographiques à long terme de cet implant. Patients...

Introduction Des cas d’ostéolyse humérale proximale ont été décrits autour de tiges sans ciment de prothèses d’épaule. L’objet de ce travail était d’analyser les résultats radiographiques à 2 ans d’une nouvelle tige courte convertible (Aequalis Ascend™ Flex, Tornier Inc.y) pour tenter de quantifier cette ostéolyse et d’en analyser les facteurs de s...

Introduction Peu d’études rapportent le taux d’infections de site opératoire (ISO) après arthroscopie d’épaule. L’objectif de cette étude était d’évaluer rétrospectivement au sein d’une série monocentrique continue, ce taux d’infection après arthroscopie d’épaule de première intention toutes pathologies confondues. L’analyse secondaire évaluait les...

Introduction: No objective criteria exist to help surgeons choose between IM nailing and plate fixation for 4-part fractures of the proximal humerus. The goal of this study was to identify radiological criteria that would make one technique a better choice than the other. Material and methods: This was a comparative, multicentre, retrospective s...

Résumé Introduction L’arthrodèse de cheville constitue un traitement de choix des arthropathies tibio-taliennes évoluées, résistantes au traitement médical. L’arthroscopie permet de minimiser l’effraction des tissus mous, avec une efficacité similaire aux techniques à ciel ouvert. Les taux de consolidation rapportés dans la littérature varient de...

Résumé Introduction Les fractures complexes 4-fragments de l’humérus proximal font partie des fractures les plus complexes à prendre en charge. Depuis quelques années, l’arthroplastie inversée (PTEI) est proposée comme alternative à l’hémiarthroplastie (HA) lorsque l’ostéosynthèse est dépassée. L’objectif de cette étude était de comparer les résul...

Résumé Introduction De nombreuses techniques d’imagerie sont utilisées pour le diagnostic des complications des prothèses. Ces techniques ont progressé mais il n’y a pas de guide de bon usage concernant leurs indications. Méthode Nous avons réuni un comité d’experts dans différentes disciplines concernées par l’imagerie des prothèses (radiologie,...

Background: Several imaging modalities can be used to diagnose complications of hip prosthesis placement. Despite progress in these imaging techniques, there are, as yet, no guidelines as to their respective indications. Methods: We formed a panel of experts in fields related to prosthesis imaging (radiology, nuclear medicine, orthopedic surgery...

Introduction The aim of this study was to investigate three methods of prediction of the bone quality of the distal humerus: dual-energy X-ray absorptiometry (DEXA), Ct-Scan and plain radiographs. Materials and methods The bone mineral density (BMD) of 21 cadaveric distal humerus was determined using DEXA at two levels. Then a CT-scan and anteropos...

Background: Ankle arthrodesis is a treatment of choice for advanced tibio-talar disease unresponsive to conservative treatment. Using arthroscopy to perform this procedure minimises soft-tissue trauma while providing similar outcomes to those of open surgery. Union rates have ranged across studies from 85% to 100%. The objective of this study was...

Introduction: Complex 4-part fractures of the proximal humerus are one of the most difficult fractures to manage. For several years, reverse total arthroplasty (RSA) has been proposed as an alternative to hemiarthroplasty (HA) when internal fixation is insufficient. The goal of this study was to compare the short and intermediate term results of t...

Hip prosthesis implantation requires a stable pelvic foundation, which may be lacking in patients with complex pelvic abnormalities (e.g., arthrodesis conversion, tumour excision, or revision with large bony defects). Many reconstructive options exist for these situations, but their outcomes vary with the initial amount of bone loss and with the te...

Introduction: The reversed shoulder prosthesis is becoming the gold standard for cases of complex fracture of the proximal humerus after 70 years of age. Material and methods: The French Society of Orthopaedic and Traumatology Surgery (SOFCOT) conducted a prospective and retrospective multicenter study to evaluate the results of the reversed sho...

Purpose: The aim of this study was to evaluate the short- and medium-term results of non-operative treatment of four-part fractures of the proximal end of the humerus. The initial hypothesis was that non-operative treatment of fractures with little or no displacement is equivalent or superior to surgical treatment, and that non-operative treatment...

The imaging characterization of musculoskeletal tumors can be challenging, and a significant number of lesions remain indeterminate when conventional imaging protocols are used. In recent years, clinical availability of functional imaging methods has increased. Functional imaging has the potential to improve tumor detection, characterization, and f...

Objective: To evaluate the performance of quantitative diffusion-weighted imaging (DWI) correlated with T2 signal in differentiating non-fatty benign from malignant tumors. Material and methods: A total of 76 patients with a histologically confirmed non-fatty soft tissue tumors (46 benign and 30 malignant) were prospectively included in this eth...

Few studies on oncogenesis of chondrosarcoma (CS) are available in the literature. Our previously published experimental evidence suggests that while the C-propeptide of procollagen Iα1 (PC1CP), a component of cartilage, favors tumor progression, the C-propeptide of procollagen IIα1 (PC2CP) exerts antitumor properties. In this study, we analyzed ex...

In a retrospective multicenter study, we evaluated the efficiency and outcomes of the different therapeutic options for infection after reversed shoulder arthroplasty. Thirty-two patients were reoperated on for infection after reversed shoulder arthroplasty between 1996 and 2011. The mean age was 71 (55-83) years. The involved implants were primary...

Merkel cell carcinoma is a rare lymphophilic skin tumor of neuroendocrine origin with the potential for rapid progression. Small, localized lesions are diagnosed and treated clinically, but advanced tumors often undergo imaging evaluation. Due to its rarity, radiologists are unaware of evocative imaging features and usually do not consider Merkel c...

Introduction: The reversed shoulder prosthesis is becoming the gold standard for cases of complex fracture of the proximal humerus after 70 years of age. Material and methods: The French Society of Orthopaedic and Traumatology Surgery (SOFCOT) conducted a prospective and retrospective multicenter study to evaluate the results of the reversed should...

Background The objective of this randomised trial was to compare surgical rotator cuff repair to simple decompression by acromioplasty and biceps tenotomy in patients older than 60 years of age with a mean follow-up of 4 years. Hypothesis Tendon repair produces better functional outcomes than simple decompression and prevents progression towards c...

Objectives: To compare the image quality of CT with iterative reconstruction alone and in association with projection-based single-energy metal artifact reduction (SEMAR) for the visualization of specific periarticular soft tissue structures in patients with hip prostheses. Methods: CT studies from 48 consecutive patients with a hip prosthesis (...

Introduction Intramedullary fixation of displaced surgical neck fractures of the humerus can be performed either by retrograde pinning or anterograde nailing. The goal of the current study was to compare the postoperative reduction and stability obtained with these two techniques. Hypothesis Intramedullary nailing will provide the best reduction a...

Introduction La stabilisation endomédulaire des fractures déplacées du col chirurgical de l’humérus peut faire appel à l’embrochage fasciculé rétrograde ou à l’enclouage antérograde. Cette étude compare la qualité de la réduction postopératoire et la stabilité obtenues avec ces deux techniques. Hypothèse L’enclouage centromédulaire permet un meill...

Hypothèse Les fractures distales de l’humérus sont difficiles à caractériser et à classer selon l’AO. Le but de notre étude était de montrer l’intérêt de l’imagerie par tomodensitométrie (TDM) et d’évaluer sur une étude multicentrique, sa reproductibilité intra- et inter-observateur en fonction de leur expérience. Matériel et méthodes À partir d’u...

Distal humerus fractures are difficult to characterise and to classify according to the AO system. In this multicentre study, our objectives were to assess the usefulness of computed tomography (CT) and to measure intra-observer and inter-observer reliability according to observer experience. An online survey of professional practice was performed...

Purpose To compare the enhancement dynamics of osteoid osteomas with other benign and malignant lytic bone lesions using CT perfusion. Patients and methods CT perfusion parameters of 15 patients with a final diagnosis of osteoid osteoma, 15 patients with lesions that mimic osteoid osteomas and 26 patients with other bone lytic lesions were compare...

Objectif Comparer les paramètres dynamiques du rehaussement des ostéomes ostéoïdes à ceux d’autres lésions ostéolytiques bénignes et malignes au moyen de la TDM de perfusion. Patients et méthodes Les paramètres de TDM de perfusion ont été comparés entre 15 patients présentant un ostéome ostéoïde confirmé, 15 patients présentant des lésions simulan...

Introduction Les séquelles traumatiques au niveau du coude posent un problème de prise en charge, compte tenu des déformations osseuses, des modifications du rapport articulaire et de la perte du capital osseux. Patients et méthodes La prothèse totale est une option thérapeutique lorsque l’interligne articulaire est détruit. Dix-neuf patients ont...

L'utilisation de l'arthroscopie dans le traitement des fractures articulaires de l'épaule doit répondre aux exigences habituelles de qualité en termes de réduction et de stabilisation des fragments. L'abord arthroscopique nécessite une adaptation des techniques et du matériel.

Traumatic sequelae of the elbow are difficult to manage because of bone deformities, changes in joint congruency and bone defects. Total elbow arthroplasty is a therapeutic option when the joint space has disappeared. Nineteen patients underwent semi-constrained Coonrad-Morrey(®) total elbow arthroplasty in 12 cases for post-traumatic elbow arthrit...

Introduction: Fractures of the distal humerus in patients over the age of 65 remain a therapeutic challenge. Treatment options include conservative treatment, internal fixation or total elbow arthroplasty. The complications of these different treatment options were evaluated in a multicentre study. Materials and methods: Four hundred and ninety-...

Introduction Les fractures de la palette humérale du sujet de plus de 65 ans représentent un challenge thérapeutique. Les moyens thérapeutiques varient entre le traitement orthopédique, les ostéosynthèses ou la prothèse totale de coude. À travers une étude multicentrique, les complications de ces différents traitements ont été évaluées. Matériel e...

Introduction Les fractures de l’extrémité distale de l’humérus du sujet âgé sont souvent complexes et difficiles à prendre en charge. Le but de cette étude est de rapporter les résultats d’une série multicentrique d’ostéosynthèses de fracture de la palette humérale du sujet âgé de type A-B et C de la classification de l’AO, pour identifier les béné...

Introduction L’objectif de cette étude prospective randomisée était de comparer la réparation arthroscopique de la coiffe des rotateurs au traitement décompressif simple par acromioplastie et ténotomie du long biceps, chez le sujet de plus de 60 ans, à 4 ans de recul moyen. Hypothèse La réparation tendineuse donnerait des résultats fonctionnels su...

Distal humerus fractures in elderly patients are often complex fractures that are difficult to treat. The goal of this study was to report on the results of a multicentre series of internal fixation of AO type A, B and C distal humerus fractures in elderly patients and to identify the pros and cons of various fixation constructs. Two studies were p...

The indications for reverse shoulder arthroplasty (RSA) continue to be expanded. Associated impairment of the deltoid muscle has been considered a contraindication to its use, as function of the RSA depends on the deltoid and impairment of the deltoid may increase the risk of dislocation. The aim of this retrospective study was to determine the fun...

Introduction L’os acromial est un défaut de fusion des noyaux d’ossification de l’acromion. Le plus souvent, il est asymptomatique et de découverte fortuite. Quand il est douloureux, il représente un diagnostic différentiel à ne pas méconnaitre du syndrome sous-acromial. Hypothèse L’instabilité d’un os acromial est responsable de scapulalgies atyp...

Objective: To evaluate the relationship between multiple MR perfusion parameters and symptoms of patients with osteoid osteomas after percutaneous laser therapy. Methods: MR perfusion studies of 20 patients diagnosed with an osteoid osteoma, treated with CT-guided percutaneous laser therapy, were retrospectively evaluated. Multiple perfusion par...

Introduction: Os acromiale is a failure of fusion of the acromial process. It is usually asymptomatic and discovered by chance. When it is painful a differential diagnosis must be made in relation to the subacromial impingement syndrome. Hypothesis: Unstable os acromiale is the cause of atypical scapulalgias. Stabilization by tension band wiring...

Les tumeurs des tissus mous de l’appareil musculosquelettique sont d’observation relativement fréquente. La qualité des informations fournies par les différentes techniques d’imagerie (échographie-Doppler, scanner multibarettes, IRM avec spectroscopie et séquences de diffusion) permet dans un nombre croissant de situations d’envisager avec une gran...

Shoulder arthroplasty has emerged as a reliable treatment for displaced or comminuted fractures of the proximal humerus. The outcomes of humeral head replacement have improved as technology and techniques have evolved. Reverse shoulder arthroplasty has yielded promising results in early investigations. With either type of instrumentation, meticulou...

Soft tissue tumours of the musculoskeletal system are reported relatively frequently. The quality of the information gained from different imaging modalities (Doppler sonography, multislice CT, MRI spectroscopy, and diffusion MRI) means that in a growing number of situations, we can envisage determining with great accuracy not only the usual inform...

El fibroma condromixoide es un tumor benigno poco frecuente de la estirpe celular cartilaginosa. Su localización clásica es la metáfisis de los huesos largos de un paciente entre los 20 y los 30 años. Se presenta en forma de una osteólisis excéntrica, con una fina circunvalación a veces lobulada. Su carácter agresivo y su polimorfismo histológico h...